The SADHART-CHF Study

However, there was an additional study that followed up on the SADHART trial 8 years later called the SADHART-CHF trial. The SADHART-CHF trial was a “randomized, double blind placebo controlled trial of sertraline 50 to 200 mg/ day versus placebo for 12 weeks” (O’Connor et al., 2010). Patients who were eligible for the study had to be 45 years or older with heart failure and diagnosed with depression according to the DSM IV edition. The sample size of the study was 469 patients and 234 of the patients were randomized to the sertraline trial. In the analysis of the SADHART-CHF, it was demonstrated that during a 12-week intervention with selective serotonin reuptake inhibitors, more specifically sertraline, “had comparable effects on depression
One reason similar effects could have been detected was due to the fact that rather than the sertraline drug itself other factors such as close cardiovascular follow up along with nursing staff interactions could have led to improved mood disorders (O’Connor et al., 2010). In addition, the SADHART-CHF trial further confirmed that patients with depression and heart failure are at a high risk of mortality. According to the study, at the 12-week mark, a “mortality rate of 7% was confirmed” (O’Connor et al., 2010). Some of the limitations of the study was that nursing support in the placebo group may have lead to the improvement of scores in the placebo group, therefore narrowing the difference between the sertraline intervention and placebo group. According to the authors of the SADHART-CHF trial, it is possible that greater support networks through nursing facilitating support may have had an effect on reducing the adverse outcomes associated with negative life stressors, which often leads to a decrease in cognitive function (Jiang et al.,
SSRIs have shown “to increase heart rate variability and decrease cortisol concentrations” (Ruden et al., 2008). Even in non depressed individuals with coronary heart disease, “SSRIs have reported to decrease sympathetic nervous system activity at rest” (Ruden et al., 2008). Similar studies suggest a small improvement in cardiovascular symptoms for patients with comorbid condition of heart disease and depression. For example, a study conducted by Pizzi, found that when considering all observational studies, “SSRI use was associated with a significant decrease in CHD readmission and all cause mortality rates” (Pizzi et al., 2010). Interestingly enough, there are some studies that suggest the opposite that SSRIs could lead to serious cardiac events such as hospitalizations. In a study done by Glen Xiong et al., it was found that the use of SSRIs could, in fact, lead to higher rates of mortality and rehospitilization for patients who were receiving coronary artery bypass grafting, which is a surgical procedure that moves tissue from one site of the body to another (Xiong et al., 1999). In this study, patients were obtained using the Duke Database for Cardiovascular Disease to find patients who received coronary artery bypass grafting surgery from January 1, 1999 to December 31, 2003. As noted by the study, patients who received valvular surgery were excluded from the study, obtaining a sample of