SSRI safe for depression in MI. (Clinical Capsules).

The selective serotonin reuptake inhibitor (SSRI) sertraline is safe to use for depression with concomitant acute coronary syndromes, and it appears to be very effective in patients at greatest risk for persistent or recurrent depression, said Dr. Alexander H. Glassman of the New York State Psychiattic Institute, New York, and his associates in the Sertraline Antidepressant Heart Attack Randomized Trial (SADHART).

The study involved 369 patients with acute MI or unstable angina and a concurrent episode of major depression; they were treated at 40 cardiology or psychiatric centers in seven countries. The patients, who were taking a mean of 11 cardiovascular medications, were randomly assigned to receive 24 weeks of treatment with placebo or sertraline.

At the end of the trial the two groups were similar in all measures of cardiovascular safety, including left ventricular ejection fraction, heart rate, blood pressure, QRS duration, QT interval, runs of ventricular tachycardia, electrolyte levels, creatinine levels, and blood cell counts. The rate of severe cardiac events was "numerically lower" (by 20%) in the sertraline group, but that did not reach statistical significance (JAMA ...