SynthesisClinical research in cardiology : official journal of the German Cardiac Society2021
The impact of SSRIs on mortality and cardiovascular events in patients with coronary artery disease and depression: systematic review and meta-analysis.
Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 9 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Inhibition of the serotonin transporter and risk of heart valve disease: A systematic review and meta-analysis.European journal of pharmacology · 2026Pooled it
- Guideline
- Cardiovascular mortality and depression: A systematic review and meta-analysis of the association with antidepressant treatment and co-morbidity.Journal of psychopharmacology (Oxford, England) · 2026Pooled it
- Management of brain-heart multimorbidity: a clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- The influence of selective serotonin reuptake inhibitors on stroke outcome: a systematic review and meta-analysis.Frontiers in neurology · 2026Pooled it
- Psychiatric Association of Türkiye Mood Disorders Section Depression Treatment Guideline - III: Treatment Approach for Depression Subtypes and Special Groups, Psychotherapies, and Psychosocial Interventions.Turk psikiyatri dergisi = Turkish journal of psychiatry · 2026Guideline
- Depression and cardiovascular disease: mind the gap in the guidelines.European heart journal · 2025Pooled it
- Efficacy and safety of antidepressant in post-myocardial infarction associated depression: a meta-analysis and systematic review.BMC psychiatry · 2025Pooled it
- Effects of Exercise Therapy on Anxiety and Depression in Patients With Coronary Heart Disease: A Meta-Analysis of a Randomized Controlled Study.Frontiers in cardiovascular medicine · 2021Pooled it
- Psycho-cardiovascular interaction network in cardiovascular health and disease: signaling pathways and molecular mechanisms.Precision clinical medicine · 2026Review
- Genetic perspectives on the comorbidity of anxiety and mood disorders with cardiovascular disease.Nature cardiovascular research · 2026Review
- Depression, Anxiety, and Bipolar Disorder and Atherosclerosis.Current atherosclerosis reports · 2026Review
- The Mental Health-Acute Coronary Syndrome Continuum: Bidirectional Pathophysiological Links and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
- Mental health sequelae and management in survivors of cardiogenic shock: a nationwide population-based study.Critical care (London, England) · 2026Article
- The Bidirectional Relationship Between Myocardial Infarction and Depression: Risk Factors, Mechanisms, and Interventions.Biomedicines · 2025Review
- Depression and Heart Failure in US Veterans.JAMA network open · 2025Article
- Article
- Mortality in patients with major depressive disorder: A nationwide population-based cohort study with 11-year follow-up.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- The Brain-Heart Axis: An Umbrella Review on Impact of Psychiatric Disease on Incidence, Management, and Outlook of Cardiovascular Disease.Life (Basel, Switzerland) · 2024Review
- Predictors of Psychological Distress among Post-Operative Cardiac Patients: A Narrative Review.Healthcare (Basel, Switzerland) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepression is common in patients after acute coronary syndromes (ACS) and with stable coronary artery disease (CAD) and has been associated with increased mortality and morbidity. However, it is unclear whether selective serotonin receptor inhibitors (SSRIs) reduce mortality or cardiac events in patients with CAD and depression.
objectiveWe conducted a systematic review and meta-analysis to assess the effects of SSRIs on cardiovascular events in depressed CAD patients.
methodsThe CENTRAL, MEDLINE, and PsycINFO databases were searched (April 2020) for randomized controlled trials (RCTs) and extended follow-up analyses of RCTs that compared SSRIs with placebo or no intervention in patients with CAD and depression. The primary outcomes were all-cause mortality, cardiovascular mortality, and myocardial infarction incidence. The results were calculated through random-effect meta-analyses and reported in terms of risk ratio (RR) with 95% confidence intervals (CI).
resultsWe retrieved 8 RCTs (2 of which with extended follow-up analyses), comprising a total of 1148 patients. 7 studies only included post-ACS patients. SSRIs were associated with a significantly lower risk of myocardial infarction in patients with CAD and depression (RR 0.54, 95% CI 0.34-0.86), and in post-ACS patients with depression (RR 0.56, 95% CI 0.35-0.90). We found no statistically significant difference in all-cause mortality, cardiovascular mortality, hospitalizations, angina, congestive heart failure, or stroke incidence.
conclusionThe use of SSRIs in post-ACS patients with depression was associated with a 44% relative risk reduction of myocardial infarction. No difference in mortality was found. Given that the quality of the evidence was low, further research is warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.