A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.

Autor: Lim GEH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore., Tang A; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Chin YH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Yong JN; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tan D; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tay P; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Chan YY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Lim DMW; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Yeo JW; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Chan KE; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Devi K; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Ong CEC; Department of Emergency Medicine, Ng Teng Fong General Hospital, Singapore, Singapore., Foo RSY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore., Tan HC; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore., Chan MY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore., Ho R; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore., Loh PH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore., Chew NWS; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Nov 30; Vol. 17 (11), pp. e0278326. Date of Electronic Publication: 2022 Nov 30 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0278326
Abstrakt: Background: Post-acute coronary syndrome (ACS) depression is a common but not well understood complication experienced by ACS patients. Research on the effectiveness of various therapies remains limited. Hence, we sought to conduct a network meta-analysis to assess the efficacy of different interventions for post-ACS depression in improving patient outcomes.
Methods and Findings: Three electronic databases were searched for randomised controlled trials describing different depression treatment modalities in post-ACS patients. Each article was screened based on inclusion criteria and relevant data were extracted. A bivariate analysis and a network meta-analysis was performed using risk ratios (RR) and standardized mean differences (SMD) for binary and continuous outcomes, respectively. A total of 30 articles were included in our analysis. Compared to standard care, psychosocial therapy was associated with the greatest reduction in depression scores (SMD:-1.21, 95% CI: -1.81 to -0.61, p<0.001), followed by cognitive behavioural therapy (CBT) (SMD: -0.75, 95% CI: -0.99 to -0.52, p<0.001), antidepressants (SMD: -0.73, 95% CI: -1.14 to -0.31, p<0.001), and lastly, combination therapy (SMD: -0.15, 95% CI: -0.28 to -0.03, p = 0.016). No treatment modalities was found to be more effective in reducing depression scores when compared to one another. Additional analysis showed that these treatment modalities did not have significant impact on the overall mortality, cardiac mortality and recurrent myocardial infarction.
Conclusion: This network meta-analysis found that the treatment effect of the various psychological modalities on depression severity were similar. Future trials on psychological interventions assessing clinical outcomes and improvement in adherence to ACS-specific interventions are needed.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2022 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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