This article is more than 5 years old. Information may no longer be current.
SADHART-CHF: no difference in HF events with sertraline
Nurse-facilitated supportive intervention, however, was a factor in improved measures of depression.
Click Here to Manage Email Alerts
Patients with depression who also had congestive heart failure did not derive additional benefit from sertraline.
According to researchers for the Safety and Efficacy of Sertraline for Depression in Patients with CHF (SADHART-CHF) trial, although sertraline was shown to be safe in terms of major adverse events, patients with depression and CHF demonstrated neither improvement nor harmful effects when treated with sertraline, a select serotonin reuptake inhibitor, vs. placebo.
“SADHART-CHF is the largest interventional trial to date for therapy of depression and of HF,” Christopher O’Connor, MD, director of the cardiovascular clinical services unit at Duke University Medical Center said in his presentation. “Data confirm that HF patients with depression have higher event rates and perhaps emphasizes that we need to screen and treat depression in this population.”
The researchers enrolled 469 patients into two arms, with one arm assigned sertraline 50 mg daily plus nurse-facilitated supportive intervention (n=234) and the other arm assigned placebo plus nurse-facilitated supportive intervention (n=235). Primary endpoints were changes in severity of depressive symptoms and reduction in CV events, mortality and morbidity. Patients were followed for 12 weeks.
“The results of the composite CV endpoint showed that sertraline plus nurse-facilitated supportive intervention was equivalent to nurse-facilitated supportive intervention alone,” O’Connor said. “For nonfatal CV events, there was also no major signal suggesting any benefit or harm.”
A significant finding of the study, according to the discussant, was the apparent beneficial effect that care given by psychiatrically trained nurses had on the depressed patients.
For more information:
- O’Connor C. Safety and efficacy of sertraline for depression in patients with congestive heart failure SADHART-CHF. LBCT 1.
Perhaps the most important part of SADHART-CHF is that it looked at two different interventions — a nursing-facilitated support intervention and a pharmacological on top of the nurse-facilitated intervention. I would submit that with a disease that is as poorly understood as depression, the benefits of the nursing-facilitated support may trump the benefits of pharmacologic intervention — particularly for people who have as many comorbidities and significant HF as the patients in SADHART-CHF.
– Douglas L. Mann, MD
Cardiology Today Editorial Board member