Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Antidepressants lessen risk of heart attack

05.07.2005


The use of antidepressants in patients who have suffered a heart attack appears to reduce the risk of recurrent events and cardiac death, according to a large, multi-center study conducted by the National Heart, Lung and Blood Institute. The findings suggest that post-heart attack patients who suffer from depression should talk with their physicians about taking the medication.



"Our study provides much stronger evidence than we’ve ever had before that antidepressants are safe and may benefit these patients," said C. Barr Taylor, MD, professor of psychiatry and behavioral sciences at the Stanford University School of Medicine and lead author of the paper published in the July issue of Archives of General Psychiatry.

Cardiovascular disease, the leading cause of death, major morbidity and disability in the United States, is often linked with depression: according to past studies, 20 percent of patients with coronary heart disease suffer from major depression and 20 percent from minor depression. Studies have also shown that depression among post-heart attack patients is associated with death and recurrent heart attacks.


Researchers launched the ENRICHD (ENhancing Recovery In Coronary Heart Disease) study to determine whether cognitive behavioral therapy would impact mortality and morbidity in post-heart attack patients with depression. Following publication of their findings that cognitive therapy significantly reduced depression but had little effect on mortality rates, the researchers conducted a secondary analysis on the use of antidepressants among the study participants.

"Our initial results were published in JAMA, and there was some evidence that the participants on antidepressants had decreased morbidity and mortality," said Taylor. "Once we saw the effect we wanted to examine it more thoroughly."

The ENRICHD study, which is the largest psychotherapy trial in coronary patients to date, involved 1,834 depressed or "socially isolated" post-heart attack patients (985 men and 849 women). The participants were enrolled during a three-year period (October 1996-October 1999) and randomized to the therapy group or the control group.

Patients who received therapy participated in a series of individual and group sessions delivered over six to nine months. Those patients who had more severe depression or who didn’t respond after five weeks of treatment were also given sertraline hydrochloride (Zoloft). If antidepressants were still needed at the end of the study, patients were referred to physicians for subsequent treatment.

Taylor and his colleagues at eight study sites used patient interviews and records, hospital records and/or participants’ physicians to conduct follow-up evaluations six months after randomization and annually after that. By the end of the follow-up, 28 percent of the participants who had received therapy had used antidepressants, and 20 percent of participants in the control group had. The median duration of antidepressant use was 12 months for both groups, and participants were most likely to take selective serotonin reuptake inhibitors, or SSRIs, such as Zoloft instead of tricyclics or other types.

After analyzing the data, the researchers found that 26 percent of study participants who hadn’t received antidepressants died or had a recurrent heart attack, while 21 percent of those participants who had taken antidepressants at some point died or had a recurrent event. After adjusting for baseline depression and cardiac risk, SSRI use was associated with 43 percent lower risk of death or recurrent non-fatal heart attack, and 43 percent lower risk of death from all causes.

"The results basically suggest that these medications are very useful for patients who have had heart attacks and are depressed," said Taylor, adding that he would recommend that any post heart-attack patient with depression be evaluated for treatment.

While encouraged by the results, Taylor pointed out that the study does have limitations. Because the study was not designed to evaluate the use of antidepressants, its findings are observational. The researchers also lacked a direct measure of when exactly patients took the antidepressants.

The authors noted that the results of the study show a need for a prospective, randomized trial on the safety and benefit of antidepressants in this population.

Taylor is also now analyzing results of a related study, called IMPROVE (IMProve mood/Reduce risk Of Vascular Events), which examined the relationship between depression and cardiovascular physiology, risk factors and biological variables. The study focused on people who are more depressed than those in the ENRICHD study and who have not had a previous cardiovascular event.

Michelle Brandt | EurekAlert!
Further information:
http://www.stanford.edu

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>