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Hearth rhythm variability in elderly patients with unstable angina and depressive syndrome. Effects of sertraline

Lebedeva N. B., Ardashova N. Yu., Vasiljeva V. V., Barbarash O. L.

Keywords: heart rate variability, depression, instable angina, sertraline

DOI: 10.18087/rhj.2013.4.1770

Background. Clinical and prognostic significance of depression in acute forms of IHD is well known. Treating depression associated with ACS may be complicated because some antidepressant can induce adverse cardiovascular changes, particularly in elderly patients. Aim. Studying the effect of sertraline therapy on depression severity and parameters of heart rhythm variability (HRV) in elderly patients with unstable angina. Materials and methods. Study included 41 patients aged >65 years with Braunwald class III unstable angina and Zung scale depression score higher than 45. 20 of these patients received sertraline 25–50 mg / day; 21 patients did not receive sertraline. Psychological testing, clinical evaluation, and measurement of HRV parameters were performed on admission and at two months. Results. The sertraline therapy at doses of 25–50 mg / day for 2 months was effective and safe in elderly patients with unstable angina and depression symptoms. Clinical efficacy of this agent was evident as decreases in mean Zung scale depression scores from 50.2 to 32.3 (р<0.001), overall number of anginal attacks, requirement for nitroglycerin, mean duration of ischemia, and mean number of ventricular extrasystole per day according to 24h ECG monitoring. One mechanism for the beneficial effect of sertraline in unstable angina is restriction of the sympathetic influence on the myocardium and normalization of HRV parameters along with elimination of depression symptoms.
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Lebedeva N. B., Ardashova N. Yu., Vasiljeva V. V. et al. Hearth rhythm variability in elderly patients with unstable angina and depressive syndrome. Effects of sertraline. Russian Heart Journal. 2013;12(4):214-218

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