Poster Session II: Prevention and health policy: tobacco, economics, clinical trials and quality of care

P169 Escitalopram prevents depression in patients with acute coronary syndrome (DECARD): a randomized controlled trial BH Hansen, JA Hanash, A Rasmussen, JF Hansen, NLT Andersen, M Birket-Smith Bispebjerg Hospital of the Copenhagen University Hospital, Copenhagen, Denmark Topic: Controlled clinical trials Background and aims: Prevalence of depression in patients recovering from acute coronary syndrome (ACS) i.e., myocardial infarction and unstable angina is higher than in general population and depression is associated with poor cardiac outcomes and higher mortality. Despite these findings no trials of prevention of depression in post-ACS patients has been undertaken. The aim of the DEpression in Coronary ARtery Disease (DECARD) study was to evaluate the efficacy of one year preventive treatment with selective serotonin reuptake inhibitor escitalopram. Methods: In a double blind randomized study 240 non-depressed patients were enrolled within 8 weeks after ACS to treatment with escitalopram or matching placebo (5-20 mg). Primary outcome measure was development of clinical depression and score >13 on Hamilton Depression Scale (HDS). Results: During the one year study period, 12 patients developed depression, two in the escitalopram and ten in the placebo group (p1⁄4.017). Twenty-four patients had significant depressive symptoms (HDS>13), 7 in the escitalopram and 17 in the placebo group (p1⁄4.030). Conclusion: Escitalopram prevented depression and depressive symptoms during the first year after ACS.