Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Antidepressants lessen risk of heart attack


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:

More articles from Health and Medicine:

nachricht Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg

nachricht New potential cancer treatment using microwaves to target deep tumors
12.10.2016 | University of Texas at Arlington

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: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Resolving the mystery of preeclampsia

21.10.2016 | Health and Medicine

Stanford researchers create new special-purpose computer that may someday save us billions

21.10.2016 | Information Technology

From ancient fossils to future cars

21.10.2016 | Materials Sciences

More VideoLinks >>>