title: Correlates and Escitalopram Treatment Effects on Sleep Disturbance in Patients with Acute Coronary Syndrome: K-DEPACS and EsDEPACS.
abstract: OBJECTIVE
  To investigate the correlates of sleep disturbance and to assess escitalopram treatment effects of depression on sleep disturbance in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  A cross-sectional study in patients with ACS within 2 w post-ACS, and a 24-w double-blind controlled trial of escitalopram against placebo for patients with ACS who have comorbid depressive disorders.
  
  
  METHODS
  A university hospital in South Korea.
  
  
  METHODS
  There were 1,152 patients with ACS who were consecutively recruited. Of 446 patients with comorbid depressive disorders, 300 were randomized to the trial.
  
  
  RESULTS
  Sleep disturbance was evaluated by the Leeds Sleep Evaluation Questionnaire. Demographic and clinical characteristics were assessed, including cardiovascular risk factors, current cardiac status, and depressive symptoms. Depressive symptoms were most strongly and consistently associated with sleep disturbance. In addition, older age, female sex, hypertension, and more severe ACS status were associated with certain aspects of sleep disturbance. Escitalopram was significantly superior to placebo for improving sleep disturbance over the 24-w treatment period. These effects were substantially explained by improvement in depressive symptoms.
  
  
  CONCLUSIONS
  Depression screening is indicated in patients with acute coronary syndrome with sleep disturbance. Successful treatment of depression has beneficial effects on sleep outcomes in these patients.
  
  
  BACKGROUND
  ClinicalTrial.gov identifier for the 24-w drug trial, NCT00419471.
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: King's College London, Institute of Psychiatry, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Kyung-Yeol
authors.initials: KY
authors.lastname: Bae
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012307:Risk Factors; D012727:Sex Characteristics; D012890:Sleep / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015283:Citalopram
keywords: acute coronary syndrome; depression; double-blind study; escitalopram; sleep disorders