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AP Effects of a Selective Serotonin Reuptake Inhibitor on Morbidity, Mortality and Mood in Patients with Heart Failure and Depression

Background

Depression und chronic heart failure play very significant roles both clinically and economically. Between 20 and 40 percent of the 4 million people with heart failure in the Federal Republic of Germany also suffer from depression. Heart failure and depression influence each other, with adverse effects on the quality of life, costs, morbidity and mortality. MOOD-HF is the first randomized, controlled trial to study the long-term effect of treatment with a selective serotonin reuptake inhibitor for clinically relevant comorbid depression in patients with heart failure for „hard“ clinical end points. MOOD-HF will thus contribute to the development of evidence-based guidelines.

Objective

The multicentric MOOD-HF study was designed as a two-arm, double-blind and placebo-controlled study to clarify whether treatment with the selective serotonin reuptake inhibitor improves mortality, morbidity, quality of life, psychological well-being and other end points (e.g. health economics, biomarkers, vasoreactivity) in patients with heart failure and clinically relevant comorbid depression, and if so, by what mechanisms. At the same time, the extent to which optimization of the heart failure therapy also leads to improvement in depression will be investigated.

Main result

The innovative multi-centre trial MOOD-HF is currently still steadily recruiting (expected to finish mid 2014). Interim analyses of the data safety board were run confirming sufficient power to arrive at definitive results regarding hard clinical endpoints. Further, important and urgently awaited information will become available through the MOOD-HF trial regarding the differential effects of SSRI vs. specific heart failure related treatment on depressive symptoms, quality of life, progression of the underlying disease, presumed and newly hypothesized pathophysiologic factors, and cost effectiveness.

Publications

  • Angermann CE et al. Rationale and design of a randomised, controlled, multicenter trial investigating the effects of selective serotonin re-uptake inhibition on morbidity, mortality and mood in depressed heart failure patients (MOOD-HF). Eur J Heart Fail. 2007;9:1212-22.
  • Angermann CE et al. Somatic correlates of comorbid major depression in patients with systolic heart failure. Int J Cardiol. 2011;147:66-73.
  • Lossnitzer N et al. Incidence rates and predictors of major and minor depression in patients with heart failure. Int J Cardiol. 2012 Feb 16. [Epub ahead of print].

Perspective

The MOOD-HF trial will be first to generate reliable information on the clinical value of a specific anti-depressant pharmacological treatment strategy in patients with systolic heart failure suffering from coincident depression.

Contact

Prof. Dr. Christiane Angermann
Universitätsklinikum Würzburg und Deutsches Zentrum für Herzinsuffizienz Würzburg
Phone: +49 (0)931 20146360
E-Mail: ed.grubzreuw-inu.kinilknull@c_nnamregna