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Effects of antidepressant treatment following myocardial infarction

Department of Cardiology, Thoraxcenter, University Medical Center Groningen

PETER de JONGE, PhD

Department of Internal Medicine and Department of Psychiatry, University Medical Center Groningen

ADRIAAN HONIG, MD, PhD

Department of Psychiatry, St Lucas Andreas Hospital, Amsterdam

AART H. SCHENE, MD, PhD, ASTRID M. G. KUYPER, MD and HARRY J. G. M. CRIJNS, MD, PhD

Department of Cardiology, University Hospital Maastricht

ANNIQUE SCHINS, MD, PhD

Department of Psychiatry, University Hospital Maastricht

DORIEN TULNER, MD

Department of Psychiatry, Medical Center Leeuwarden

MAARTEN P. van den BERG, MD, PhD

Department of Cardiology, University Medical Center Groningen

JOHAN ORMEL, PhD

Department of Social Psychiatry and Psychiatric Epidemiology, University Medical Center Groningen, The Netherlands

Correspondence: Dr Peter de Jonge, Department of Internal Medicine and Department of Psychiatry, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, The Netherlands. Email: p.de.jonge{at}med.umcg.nl

Declaration of interest None. Funding detailed in Acknowledgements.

See invited commentary, pp. 467–468, this issue.

Background Depression following myocardial infarction is associated with poor cardiac prognosis. It is unclear whether antidepressant treatment improves long-term depression status and cardiac prognosis.

Aims To evaluate the effects of antidepressant treatment compared with usual care in an effectiveness study.

Method In a multicentre randomised controlled trial, 2177 myocardial infarction patients were evaluated for ICD–10 depression and randomised to intervention (n=209) or care as usual (n=122). Both arms were evaluated at 18 months post-myocardial infarction for long-term depression status and new cardiac events.

Results No differences were observed between intervention and control groups in mean scores on the Beck Depression Inventory (11.0, s.d.=7.5 v.10.2, s.d.=5.1, P=0.45) or presence of ICD–10 depression (30.5 v. 32.1%, P=0.68). The cardiac event rate was 14% among the intervention group and 13% among controls (OR=1.07, 95% CI 0.57–2.00).

Conclusions Antidepressant treatment did not alter long-term depression post-myocardial infarction status or improve cardiac prognosis.

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