Author + information
- Siqin Ye,
- Jonathan Shaffer,
- Nina Rieckmann,
- Joseph Schwartz,
- Ian M. Kronish,
- Joseph A. Ladapo,
- William Whang,
- Matthew Burg and
- Karina Davidson
Enhanced depression treatment is a promising approach for patients with acute coronary syndrome (ACS) and depression, but there are limited data on its long-term effectiveness.
157 participants with persistent depression post-ACS were randomized to receive enhanced depression treatment (n=80) or usual care (n=77) for 6 months. We assessed the composite outcome of death or myocardial infarction/unstable angina (MI/UA) during the treatment period and during the subsequent 15 months. Proportional hazards analysis was performed with adjustment for age, sex, GRACE score, and LV ejection fraction.
Because of a significant time-by-treatment group interaction (p=0.008), we report separate results for during the treatment period and afterwards. During the 6-month treatment period, death or MI/UA occurred in 3 (4%) participants in the treatment group, compared with 11 (14%) in the usual care group (HR=0.23, 95% CI 0.06–0.82, p=0.02). In contrast, during the subsequent 15 months, 11 (14%) participants in the treatment group experienced the composite outcome, as compared to 3 (4%) in the usual care group (HR=3.38, 95% CI 0.92–12.35, p=0.07).
Enhanced depression treatment was associated with a reduced risk of death or MI/UA during treatment, but this effect did not persist. Ongoing depression treatment may be required to sustain improved outcomes in post-ACS patients with depression.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Acute Coronary Syndromes: Clinical Outcomes
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1299-173
- 2013 American College of Cardiology Foundation