SSRIs may lessen risk of recurrent cardiac events and death
Selective serotonin reuptake inhibitors (SSRIs) may reduce the risk of recurrent myocardial infarction (MI) or death in patients who have had an acute MI, a secondary analysis of the enhancing recovery in coronary heart disease (ENRICHD) study has shown (Archives of General
Psychiatry 2005;62:792).
The researchers say that their observations warrant a prospective, randomised
controlled trial to determine whether SSRIs can alter cardiovascular
outcomes post MI.
The study involved 1,834 patients with acute MI and depression, of whom
446 took antidepressants, including 301 who were prescribed SSRIs. The
analysis showed that during an average follow up of 29 months, SSRI use
was associated with a 43 per cent lower risk of death or non-fatal MI
and a 43 per cent lower risk of all cause mortality compared with patients
not receiving SSRIs.
In an accompanying editorial (ibid, p711), Alexander Glassman, New York
State Psychiatric Institute, Columbia University, points out that only
the most depressed patients, who are known to be at higher risk of cardiac
events, were offered antidepressants. He adds: “This is a post-hoc
observation of an association, not an a priori test of a hypothesis.
It is, however, the strongest signal yet that antidepressant drugs can
reduce life-threatening events.” |
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