Abstract:
BACKGROUND:Tricyclic antidepressants (TCAs) are still used in 30% of anxiety/depression cases and have been related to increased cardiovascular risk. Newer serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs) safety remains conflicting. Our aim was to assess the risk of a first acute coronary syndrome (ACS) in patients treated by various types of antidepressants. METHODS:Study was a retrospective nested case-control of 40-80 years old northern-Israeli members of Clalit Health Services (CHS) during 1.1.2003-31.12.2013. Patients with severe psychiatric, cardiac or systemic diseases, or pre-enrollment antidepressants were excluded. Cases that had a first ACS during the study period were matched in 1:30 ratio with controls. The association between antidepressants use and ACS was tested by adjusted multivariable conditional logistic regression. RESULTS:The cohort included 535,315 individuals 128,550 of whom met the exclusion/inclusion criteria. 3391 Cases with first ACS, (incidence rate of 24.6/10,000 person years) were matched with 88,016 controls. ACS was not associated with use of either SSRIS/SNRIS or TCAs compared with no antidepressants use. However, treatment by SSRIS/SNRIS was associated with a 36% decreased risk ACS compared to TCAs, OR = 0. 64, 95%CI (0.43-0.95), p = 0.029. Age 40-64 years, male gender and metabolic syndrome associated with reduced risk of ACS among SSRIS/SNRIS compared to TCAs users. CONCLUSION:In this study of patients without prior cardiovascular disease- neither antidepressant group imposed excess risk for ACS, compared to-no treatment. SSRIs treatment seemed safer compared to TCAs in regard of ACS. This study probably adds to our confidence of preferring SSRIs over TCAs in patients without prior cardiovascular disease.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Almog R,Carasso S,Lavi I,Amir Odoi
10.1016/j.ijcard.2018.04.137subject
Has Abstractpub_date
2018-09-15 00:00:00pages
28-34eissn
0167-5273issn
1874-1754pii
S0167-5273(17)36988-7journal_volume
267pub_type
杂志文章abstract:INTRODUCTION:Increased central sympathetic activity has a central role in the pathophysiology of cardiac arrhythmias. Despite the recently published negative results regarding the impact of renal sympathetic denervation (RDN) on resistant hypertension treatment, the beneficial effects of this intervention on cardiac ar...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Diabetes mellitus (DM) alters the energy substrate metabolism in the heart and the early sign of diabetic cardiomyopathy is the diastolic dysfunction. Although it is known that the extracellular matrix must be altered in the presence of diabetes, its local regulation has not been fully elucidated. Our aim wa...
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00