Effect Of Sertraline In Depressed Patients After Acute Myocardial Infarction

【Objective】To evaluate the effect of setraline on depressive state, cardiac autonomic function, platelet activation, endothelial function, inflammatory factor in depressed patients after acute myocardial infarction, and follow-up the incident rate of cardiac events, and approach its potential link.【Methods】According to the enrolling standard and removing standard,seventy post–MI depressed patients were divided into two group: sertraline-treated group and control group, thirty-five patients per group. All patients received conventional medicine and psychotherapy, the sertraline-treated group receive sertraline 50mg per day with a 12-week follow-up. The effects of sertraline treatment on depression and the incident rate of cardiac events were observed. Depression was defined on Hospital Anxiety and Depression Scale (HAD) and Hamilton Depression Rating Scale for Depression (HAMD). For evaluating cardiac autonomic function, platelet activation, endothelial function, inflammatory factor in depressed patients after acute myocardial infarction, we detected average heart rate and Heart rate variability(HRV) by dynamic electrocardiogram; detected the interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and soluble P-selectin(SP-selectin) by enzyme linked immunosorbent assay (ELISA), detected endothelin-1(ET-1) by nitrate reductase, detected nitrogen monoxidum(NO) by radio-immunity.【Results】1. The rate of HAMD score decrease and the effective rate in patients received sertraline were obviously excellent to control group(P<0.01).2.Compared to control group, the incident rate of cardiac events in post–MI depressed patients received sertraline were obviously decreased (P<0.05).3.SDNN,SDANN,TP,VLF,LF in patients received sertraline were obviously increased(P<0.05). No significant alteration of average heart rate, rMSSD, PNN50 and HF were shown defore and after treatment.4.Compared to control group,SP-selectin in patients received sertraline was obviously decreased (P<0.05).5.There were no significant changes of NO and ET-1 before and after sertraline treatment.6.No significant alteration of IL-6 and TNF-αwere shown defore and after sertraline treatment.【Conclusions】1.Sertraline could increase SDNN,SDANN,TP,VLF,LF,raise HRV,and improve cardiac autonomic function.2.Sertraline could decrease serum SP-selectin, and depress platelet activity.3.We did not find functions of sertraline on inflammatory reaction and endothelial function .4. At the same time of antidepressant, sertraline could reduce the incident rate of cardiac events and improve short-term prognosis, which may owe to its adjustment effect on autonomic nerve function and platelet activity.