Depression After ACS Worsens Outcomes

Persistent depression after acute coronary syndrome continues to be a risk factor for early death for up to seven years, researchers said.

With a median of 6.7 years of follow-up, patients who encountered major depression after acute coronary syndrome -- and whose depression did not improve with treatment -- had a hazard ratio for death of 2.39 (95% CI 1.50 to 3.81) compared with those showing substantial improvement, according to Alexander Glassman, MD, of Columbia University, and colleagues.

The study involved patients in the randomized SADHART trial, which involved treatment with , sertraline (Zoloft) or placebo. Those who took their medications on schedule were more likely to show improvement in depression scores, the researchers wrote in the September issue of Archives of General Psychiatry.

Hence, they said, "physicians need to aggressively treat depression and be diligent in promoting adherence to guideline cardiovascular drug therapy."

The SADHART study (Sertraline Antidepressant Heart Attack Randomized Trial) began in 2000 with 369 patients hospitalized for acute coronary syndrome who were found to have major depression on screening.

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