A prospective examination of antidepressant use and its correlates in patients with acute coronary syndrome.
BACKGROUND
Depression has been implicated in the occurrence of recurrent coronary events and cardiac or all-cause mortality in acute coronary syndrome (ACS) patients.


OBJECTIVE
The authors describe the frequency and type of antidepressant use and its correlates 18 months after ACS hospital discharge.


METHODS
A sample of 661 ACS inpatients, recruited from three hospitals, completed a sociodemographic survey and the Hospital Anxiety and Depression Scale (HADS), and clinical data were extracted from charts. A mailed survey 9 months and 18 months post-discharge assessed self-reported antidepressant use, and the HADS was re-administered.


RESULTS
Approximately 9% of participants reported antidepressant use both 9 and 18 months post-hospitalization, with 77% concordance in usage over time. Participants most frequently reported using selective serotonin reuptake inhibitors and least often tricyclics. Logistic regression revealed that antidepressant users were more likely to be anxious and have more comorbidity, and were less likely to work full-time, whereas number of medications, age, and marital status were not related.


CONCLUSIONS
Patients with comorbid physical and mental conditions who are unemployed may be more likely to receive an antidepressant because of greater depression symptoms or greater exposure to healthcare providers, which increases the potential for symptom recognition and treatment.
Grace
Sherry L
SL
York University and University Health Network Women's Health Program, York University. sgrace@yorku.ca
Leung
Yvonne W
YW
Stewart
Donna E
DE
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000928:Antidepressive Agents / Q000145:classification / Q000627:therapeutic use*; D003710:Demography; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D004562:Electrocardiography; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012153:Retention, Psychology; D012849:Sinoatrial Node / Q000503:physiopathology; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents