Evidence map›Paper›PMID 35609671›Full record

Trial reportAmerican heart journal2022

Longer term benefits of exercise and escitalopram in the treatment of anxiety in patients with coronary heart disease: Six month follow-up of the UNWIND randomized clinical trial.

James A Blumenthal, Patrick J Smith, Wei Jiang, Alan Hinderliter, Lana L Watkins, Benson M Hoffman, William E Kraus, Stephanie Mabe, Lawrence Liao, Jonathan Davidson and 1 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Exercise and Anxiety.Current topics in behavioral neurosciences · 2024
    Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

James A BlumenthalDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Electronic address: James.Blumenthal@duke.edu.
Patrick J SmithDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Wei JiangDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Alan HinderliterDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Lana L WatkinsDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Benson M HoffmanDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
William E KrausDepartment of Medicine, Duke University Medical Center, Durham, NC.
Stephanie MabeDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Lawrence LiaoDepartment of Medicine, Duke University Medical Center, Durham, NC.
Jonathan DavidsonDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Andrew SherwoodDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Duke Medical Center · USDuke University Hospital · USUniversity of North Carolina at Chapel Hill · US

Funding

Exercise and Pharmacotherapy for Anxiety in Cardiac PatientsR01HL125522 · NHLBI · DUKE UNIVERSITY · PI BLUMENTHAL, JAMES A · 2015 to 2019
$3.9M
NHLBI NIH HHS R01 HL125522
6 · The paper itself

Abstract

backgroundAnxiety is a common comorbidity in patients with coronary heart disease (CHD) and is associated with worse prognosis. However, effective treatment for anxiety in CHD patients is uncertain. The UNWIND randomized clinical trial showed that 12-week treatment of escitalopram was better than exercise training or placebo in reducing anxiety in anxious CHD patients. The longer-term benefits of treatment for anxiety are not known.

methodsPatients were randomized to 12 weeks of Escitalopram (up to 20 mg), Exercise (3 times/wk), or placebo pill. At the conclusion of treatment, participants were followed for 6-months to determine the persistence of benefit on the primary anxiety endpoint assessed by the Hospital Anxiety and Depression Scale-Anxiety scale (HADS-A) and to assess the effects of treatment on major adverse cardiac events over a follow-up period of up to 6 years.

resultsOf the 128 participants initially randomized, 120 (94%) were available for follow-up. Participants randomized to the Escitalopram condition exhibited lower HADS-A scores (3.9 [3.1, 4.7]) compared to those randomized to Exercise (5.5 [4.6, 6.3]) (P = .007) and Placebo (5.3 [4.1, 6.5]) (P = .053). Over a median follow-up of 3.2 years (IQR: 2.3, 4.5), there were 29 adverse events but no significant between-group differences.

conclusionIn the UNWIND trial, 12 weeks of escitalopram treatment was effective in reducing anxiety. These beneficial effects were sustained for 6 months posttreatment. Although moderate or vigorous physical activity has a number of health benefits, exercise was not an effective treatment for anxiety in patients with CHD.

Indexed as

CitalopramCoronary DiseaseAnxietyEscitalopramExerciseFollow-Up StudiesHumansSelective Serotonin Reuptake InhibitorsCitalopramEscitalopramSelective Serotonin Reuptake InhibitorsAnxietyDepressionEscitalopramExercise

Identifiers

PMID35609671
PMCPMC9473683
OpenAlexW4281253202

What OpenQuestion holds

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Registered trials

None linked

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.