title: Determinants and escitalopram treatment effects on suicidal ideation in patients with acute coronary syndrome: Findings from the K-DEPACS and EsDEPACS studies.
abstract: BACKGROUND
  This study is aimed to investigate the determinants of suicidal ideation as well as to assess escitalopram treatment effects on suicidal ideation in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  A total of 1152 patients were consecutively recruited at baseline, 2 to 14weeks after a confirmed ACS episode. Of 446 baseline participants with comorbid depressive disorders, 300 were randomized to a 24-week double-blind trial of escitalopram or placebo treatment. Suicidal ideation was determined using the "suicidal thoughts" item of the Montgomery and Asberg Depression Rating Scale. Socio-demographic and clinical characteristics, including depressive and anxiety symptoms, cardiovascular risk factors, and current cardiac status, were assessed.
  
  
  RESULTS
  Suicidal ideation was independently associated with past history of depression, depressive and anxiety disorders, and higher troponin I levels. Escitalopram treatment was significantly more efficacious in reducing and treating suicidal ideation than placebo treatment over a 24-week period. These effects were largely explained by remission status of depressive and anxiety disorders.
  
  
  CONCLUSIONS
  Suicidal ideation is associated with unfavorable psychiatric and ACS status during the acute phase of ACS. Successful treatment of depression and anxiety with escitalopram had significant beneficial effects on suicidal ideation in these patients.
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: 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: Kyung-Yeol
authors.initials: KY
authors.lastname: Bae
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: Departments of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Departments of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Departments of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Gwangju Center, Korea Basic Science Institute, Republic of Korea.
authors.forename: Hyuno
authors.initials: H
authors.lastname: Kang
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea. Electronic address: jsyoon@chonnam.ac.kr.
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015283:Citalopram / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D059020:Suicidal Ideation; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
keywords: Acute coronary syndrome; Anxiety; Depression; Escitalopram; Suicidal ideation