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Depression Hinders Heart Rate Recovery in Coronary Patients

Those treated with the antidepressant sertraline may avoid greater deterioration

FRIDAY, Sept. 7 (HealthDay News) -- The heart rate variability of depressed acute coronary syndrome patients decreases when their depression fails to improve, according to the results of a study published in the September issue of the Archives of General Psychiatry.

Alexander H. Glassman, M.D., of Columbia University College of Physicians and Surgeons in New York City, and colleagues followed 258 patients with major depressive disorder who had been hospitalized for acute coronary syndrome. Participants were randomized to receive the antidepression medication sertraline or placebo, and their heart rate variability and depression levels were measured at 16 weeks.

No significant improvement in heart rate variability was observed from baseline to 16 weeks in either group, and in most measures it actually declined. A 9 percent increase in ultra low-frequency power was noted in the sertraline group, but that change was statistically significant only when compared to a 10 percent decrease in the ultra low-frequency power of the placebo group. Patients whose depression lessened experienced an improvement in low-frequency power, regardless of which group they were in, but this gain was attributed to a 20 percent decrease in low-frequency power among those patients whose depression did not lessen.

"From a clinician's point of view, patients with depression after myocardial infarction, especially those with prior episodes, should be both carefully watched and aggressively treated, because they are at elevated cardiac risk and less likely to get better spontaneously," the authors conclude.

The authors report receiving financial support from the pharmaceutical industry. Gaffney is a Pfizer employee.

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