Effect of St. John’s wort extract on depressive disorder in elderly patients with unstable angina.doc

Effect of St. John’s wort extract on depressive disorder in elderly patients with unstable angina BACKGROUND： The elderly patients with coronary heart disease （CHD） are often accompanied with depression. This study aimed to assess the effect of St. John’s wort extract （SWE） on depressive disorder in elderly patients with unstable angina pectoris. METHODS： Altogether 170 patients who met the set criteria were enrolled in this prospective study. They were randomly divided into SWE group （44 patients）， Deanxit group （44）， psychotherapy group （42）， and control group （40）. The effectiveness of SWE was evaluated by reduced percentage of Hamilton depression （HAMD） scale and reduced frequency of angina pectoris attack， which were measured before and at 12 weeks after the treatment with SWE. RESULTS： The reduced percentages of HAMD scale were 79.5%， 56.8% and 57.1% in the SWE， Deanxit and psychotherapy groups， respectively. Compared with the control， the three groups had significant differences in the percentages （P75%， and disappearance of all depressive symptoms； （2） marked improvement： HAMD 8-10， reduced percentage 50%-75%， and disappearance of some depressive symptoms； （3） improvement： HAMD 15， reduced percentage15， reduced percentage25%， and no improvement of depressive symptoms. Recovery and marked improvement were defined as marked effectiveness.[6] The HAMD score before and after treatment was assessed by specialist physicians. Before and after treatment， the patients were subjected to 24-hour Holter， electrocardiography， laboratory tests of blood， urine， liver and kidney function. The criteria for efficacy of CHD treatment were consistent with the severity criteria of angina set up by the Canadian Cardiovascular Society （Canada Cardiac Society， CCS）： 2 or more for marked improvement， 1 for improvement， no improvement for ineffectiveness. The marked improvement of myocardial ischemia was determined by electrocardiogram showing restoration of ST-T to normal or