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

<h4>Background</h4>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...

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Main Authors: Grace En Hui Lim, Ansel Tang, Yip Han Chin, Jie Ning Yong, Darren Tan, Phoebe Tay, Yu Yi Chan, Denzel Ming Wei Lim, Jun Wei Yeo, Kai En Chan, Kamala Devi, Colin Eng Choon Ong, Roger S Y Foo, Huay-Cheem Tan, Mark Y Chan, Roger Ho, Poay Huan Loh, Nicholas W S Chew
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0278326&type=printable
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author Grace En Hui Lim
Ansel Tang
Yip Han Chin
Jie Ning Yong
Darren Tan
Phoebe Tay
Yu Yi Chan
Denzel Ming Wei Lim
Jun Wei Yeo
Kai En Chan
Kamala Devi
Colin Eng Choon Ong
Roger S Y Foo
Huay-Cheem Tan
Mark Y Chan
Roger Ho
Poay Huan Loh
Nicholas W S Chew
author_facet Grace En Hui Lim
Ansel Tang
Yip Han Chin
Jie Ning Yong
Darren Tan
Phoebe Tay
Yu Yi Chan
Denzel Ming Wei Lim
Jun Wei Yeo
Kai En Chan
Kamala Devi
Colin Eng Choon Ong
Roger S Y Foo
Huay-Cheem Tan
Mark Y Chan
Roger Ho
Poay Huan Loh
Nicholas W S Chew
author_sort Grace En Hui Lim
collection DOAJ
description <h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusion</h4>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.
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spelling doaj-art-a648e40e07ae4bb3b7b1466e53cf09122025-08-20T02:28:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027832610.1371/journal.pone.0278326A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.Grace En Hui LimAnsel TangYip Han ChinJie Ning YongDarren TanPhoebe TayYu Yi ChanDenzel Ming Wei LimJun Wei YeoKai En ChanKamala DeviColin Eng Choon OngRoger S Y FooHuay-Cheem TanMark Y ChanRoger HoPoay Huan LohNicholas W S Chew<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0278326&type=printable
spellingShingle Grace En Hui Lim
Ansel Tang
Yip Han Chin
Jie Ning Yong
Darren Tan
Phoebe Tay
Yu Yi Chan
Denzel Ming Wei Lim
Jun Wei Yeo
Kai En Chan
Kamala Devi
Colin Eng Choon Ong
Roger S Y Foo
Huay-Cheem Tan
Mark Y Chan
Roger Ho
Poay Huan Loh
Nicholas W S Chew
A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
PLoS ONE
title A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
title_full A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
title_fullStr A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
title_full_unstemmed A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
title_short A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome.
title_sort network meta analysis of 12 116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0278326&type=printable
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