Citalopram in the treatment of elderly chronic heart failure combined with depression: A systematic review and meta-analysis

BACKGROUND: Depression is an independent factor to predict the hospitalization and mortality in the chronic HF patients. Citalopram is known as an effective drug for depression treatment. Currently, there is no specific recommendation in the HF guidelines for the treatment of psychological comorbidity. In recent years, many studies have shown that the citalopram may be safe in treating of chronic HF with depression. OBJECTIVE: To evaluate the efficacy and safety of the citalopram in the treatment of elderly chronic HF combined with depression. METHODS: PubMed, EMBASE, Cochrane, Web of Science, CNKI, VIP, CBM, and Wanfang were searched from their inception to May 2022. In the treatment of elderly chronic HF combined with depression, randomized controlled studies of the citalopram were included. Independent screening and extraction of data information were conducted by two researchers, and the quality was assessed by the Cochrane bias risk assessment tool. Review manager 5.4.1 was employed for statistical analysis. RESULTS: The results of meta-analysis prove that the citalopram treatment for depressed patients with chronic HF has a benefit for HAMD-24 (MD: −8.51, 95% CI: −10.15 to −6.88) and LVEF (MD: 2.42, 95% CI: 0.51 to 4.33). Moreover, the score of GDS decreases, and NT-proBNP (MD: −537.78, 95% CI: −718.03 to −357.54) is improved. However, the comparison with the control group indicates that there is no good effect on HAMD-17 (MD: −5.14, 95% CI: −11.60 to 1.32), MADRS (MD: −1.57, 95% CI: −3.47 to 0.32) and LVEDD (MD: −1.45, 95% CI: −3.65 to −0.76). No obvious adverse drug reactions were observed. CONCLUSION: Citalopram treatment for depressed patients with chronic HF has a positive effect on LVEF and NT-proBNP. It can alleviate HAMD-24 and GDS, but the relative benefits for LVEDD, HAMD-17 and MADRS still need to be verified. Systematic Review Registration: PROSPERO [CRD42021289917].