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Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction.

Publication ,  Journal Article
Taylor, CB; Youngblood, ME; Catellier, D; Veith, RC; Carney, RM; Burg, MM; Kaufmann, PG; Shuster, J; Mellman, T; Blumenthal, JA; Krishnan, R ...
Published in: Arch Gen Psychiatry
July 2005

BACKGROUND: Depression after myocardial infarction (MI) is associated with higher morbidity and mortality. Although antidepressants are effective in reducing depression, their use in patients with cardiovascular disease remains controversial. OBJECTIVE: To undertake a secondary analysis to determine the effects of using antidepressants on morbidity and mortality in post-MI patients who participated in the Enhancing Recovery in Coronary Heart Disease study. DESIGN: Observational secondary analysis. SETTING: Eight academic sites. PATIENTS: The Enhancing Recovery in Coronary Heart Disease clinical trial randomized 2481 depressed and/or socially isolated patients from October 1, 1996, to October 31, 1999. Depression was diagnosed using a structured clinical interview. This analysis was conducted on the 1834 patients enrolled with depression (849 women and 985 men). INTERVENTION: Use of antidepressant medication. MAIN OUTCOME MEASURES: Event-free survival was defined as the absence of death or recurrent MI. All-cause mortality was also examined. To relate exposure to antidepressants to subsequent morbidity and mortality, the data were analyzed using a time-dependent covariate model. RESULTS: During a mean follow-up of 29 months, 457 fatal and nonfatal cardiovascular events occurred. The risk of death or recurrent MI was significantly lower in patients taking selective serotonin reuptake inhibitors (adjusted hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.38-0.84), as were the risk of all-cause mortality (adjusted HR, 0.59; 95% CI, 0.37-0.96) and recurrent MI (adjusted HR, 0.53; 95% CI, 0.32-0.90), compared with patients who did not use selective serotonin reuptake inhibitors. For patients taking non-selective serotonin reuptake inhibitor antidepressants, the comparable HRs (95% CIs) were 0.72 (0.44-1.18), 0.64 (0.34-1.22), and 0.73 (0.38-1.38) for risk of death or recurrent MI, all-cause mortality, or recurrent MI, respectively, compared with nonusers. CONCLUSIONS: Use of selective serotonin reuptake inhibitors in depressed patients who experience an acute MI might reduce subsequent cardiovascular morbidity and mortality. A controlled trial is needed to examine this important issue.

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Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

July 2005

Volume

62

Issue

7

Start / End Page

792 / 798

Location

United States

Related Subject Headings

  • Selective Serotonin Reuptake Inhibitors
  • Secondary Prevention
  • Risk Factors
  • Psychiatry
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Taylor, C. B., Youngblood, M. E., Catellier, D., Veith, R. C., Carney, R. M., Burg, M. M., … ENRICHD Investigators, . (2005). Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry, 62(7), 792–798. https://doi.org/10.1001/archpsyc.62.7.792
Taylor, C Barr, Marston E. Youngblood, Diane Catellier, Richard C. Veith, Robert M. Carney, Matthew M. Burg, Peter G. Kaufmann, et al. “Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction.Arch Gen Psychiatry 62, no. 7 (July 2005): 792–98. https://doi.org/10.1001/archpsyc.62.7.792.
Taylor CB, Youngblood ME, Catellier D, Veith RC, Carney RM, Burg MM, et al. Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry. 2005 Jul;62(7):792–8.
Taylor, C. Barr, et al. “Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction.Arch Gen Psychiatry, vol. 62, no. 7, July 2005, pp. 792–98. Pubmed, doi:10.1001/archpsyc.62.7.792.
Taylor CB, Youngblood ME, Catellier D, Veith RC, Carney RM, Burg MM, Kaufmann PG, Shuster J, Mellman T, Blumenthal JA, Krishnan R, Jaffe AS, ENRICHD Investigators. Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry. 2005 Jul;62(7):792–798.

Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

July 2005

Volume

62

Issue

7

Start / End Page

792 / 798

Location

United States

Related Subject Headings

  • Selective Serotonin Reuptake Inhibitors
  • Secondary Prevention
  • Risk Factors
  • Psychiatry
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies