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To the Editor: Dr Glassman and colleagues¹ found that sertraline treatment was not associated with significant changes in left ventricular ejection fraction (LVEF) or in electrocardiographic or Holter recording parameters among patients with acute myocardial infarction (MI) or unstable angina. Although there was a lower rate of cardiac hospitalizations in patients treated with sertraline vs placebo, the trend was nonsignificant. Thus, sertraline may produce an increase, a decrease, or no difference in cardiac hospitalization rates. A larger trial, with more meaningful end points, is necessary to assess the safety of this intervention.

The authors found that sertraline was more efficacious than placebo in treating depression in this population. No information, however, is provided regarding procedures to ensure the blindness of ratings on the depression rating scales. Because those who rated depression also monitored adverse events, such as nausea and diarrhea, it cannot be assumed that they remained blinded to treatment . . . [Full Text of this Article]

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Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina
Alexander H. Glassman, Christopher M. O'Connor, Robert M. Califf, Karl Swedberg, Peter Schwartz, J. Thomas Bigger, Jr, K. Ranga Rama Krishnan, Louis T. van Zyl, J. Robert Swenson, Mitchell S. Finkel, Charles Landau, Peter A. Shapiro, Carl J. Pepine, Jack Mardekian, Wilma M. Harrison, and for the Sertraline Antidepressant Heart Attack Randomized Trial Group
JAMA. 2002;288(6):701-709.
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