Author + information
- Bai Hongyuan,
- Jin Wei,
- Anqi Song,
- Canzhan Zhu,
- Yajuan Ni and
- Xin Dong
Depression, often accompanied by anxiety, is a common co-morbid condition in patients with coronary heart disease (CHD) and has been identified as an independent risk factor for increased cardiovascular events. Previous western studies have showed that sertraline can reduce depression and anxiety symptoms and may improve CHD prognosis. This point of view is not widely recognized in China because of little native evidence. Therefore, we carried out a meta-analysis to evaluate effectiveness of sertraline on CHD patients with depression in China.
Studies on conventional treatment of CHD plus sertraline versus conventional treatment alone in treating CHD patients with depression were retrieved from MEDLINE, EMBASE, Cochrane Library, CNKI, and WANFANG DATA from 1970 to 2015. Primary outcomes were Hamilton Depression Scale (HAMD) scores, Hamilton Anxiety Scale (HAMA) scores and cardiovascular death; secondary outcomes were Self-Rating Depression scale (SDS) scores, Self-Rating Anxiety Scale (SAS) scores and major adverse cardiovascular events (MACE).
We identified 13 RCTs enrolling 1981 patients who fulfilled our inclusion criteria. When compared with conventional treatment alone, conventional treatment plus sertraline was associated with significant improvement in HAMD scores (mean difference, −7.98; 95% confidence intervals [CI], −13.24-−2.73), HAMA scores (mean difference, −13.03; 95% CI, −19.52-−6.54), cardiovascular death (risk ratio [RR], 0.19; 95% CI, 0.05-0.73), SDS scores (mean difference, −11.39; 95% CI, −14.94-−7.84), SAS scores (mean difference, −11.59; 95% CI, −15.62-−7.55) and MACE (RR, 0.20; 95% CI, 0.11-0.37). Adverse events observed in the studies were not severe and resolved without special treatment.
Sertraline reduce depression and anxiety symptoms and cardiovascular events of Chinese patients with CHD and depression. However, further studies with more subjects, long-term follow-up, systemic adverse events evaluation are still required to verify the efficacy and safety of sertraline in CHD patients with depression in China.