Antidepressant treatment in patients following acute coronary syndromes : a systematic review and Bayesian meta-analysis

© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology..

AIMS: The aim of this study is to investigate the effect of antidepressant therapy on mortality and cardiovascular outcomes in patients with acute coronary syndrome (ACS).

METHODS AND RESULTS: We systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and performed a Bayesian random-effects meta-analysis of randomized controlled trials that investigated antidepressant pharmacotherapy in patients following ACS. The primary outcome was all-cause mortality. Secondary outcomes were repeat hospitalizations and recurrent myocardial infarctions (MIs). Ten randomized controlled trials with a total of 1935 patients qualified for inclusion. Selective serotonin reuptake inhibitors were investigated in six, bupropion in three, and mirtazapine in one trial. Placebo was used as control in eight trials. There was no difference in all-cause mortality [odds ratio (OR) 0.97, 95% credible interval (CrI) 0.66-1.42] and recurrent MI (OR 0.64, 95% CrI 0.40-1.02) between patients receiving antidepressants compared with controls, whereas antidepressant therapy was associated with less repeat hospitalizations (OR 0.62, 95% CrI 0.40-0.94). In patients with ACS and concomitant depression, antidepressants reduced the odds of recurrent MI compared with usual care/placebo (OR 0.45, 95% CrI 0.25-0.81). Extended funnel plots suggest robustness of the observations.

CONCLUSIONS: Antidepressants in patients following ACS have no effect on mortality but reduce repeat hospitalizations; in patients with depression, there is a reduced risk of recurrent MI with antidepressant therapy.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:7

Enthalten in:

ESC heart failure - 7(2020), 6 vom: 15. Dez., Seite 3610-3620

Sprache:

Englisch

Beteiligte Personen:

Sweda, Romy [VerfasserIn]
Siontis, George C M [VerfasserIn]
Nikolakopoulou, Adriani [VerfasserIn]
Windecker, Stephan [VerfasserIn]
Pilgrim, Thomas [VerfasserIn]

Links:

Volltext

Themen:

Acute coronary syndrome
Antidepressants
Depression
Journal Article
Mental health
Meta-analysis
Myocardial infarction

Anmerkungen:

Date Revised 10.11.2022

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1002/ehf2.12861

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31507793X