A secondary analysis of a duration response association between selective serotonin reuptake inhibitor use and the risk of acute myocardial infarction in the aging population
A secondary analysis of a duration response association between selective serotonin reuptake inhibitor use and the risk of acute myocardial infarction in the aging population
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DOI：
10.1016/j.annepidem.2007.11.004
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发表时间：
2008-04-01
影响因子：
5.6
通讯作者：
Stuart, Bruce
中科院分区：
文献类型：
--
作者：
Blanchette, Christopher M.;Simoni-Wastila, Linda;Stuart, Bruce
目得：我们评估的风险，选择性5-羟色胺再摄取抑制剂（SSRI）的使用对急性心肌梗死（AMI）的发生的基础上，曝光的持续时间。方法：一个历史汇集队列的所有老年人，社区居住的医疗保险受益人没有参加健康维护组织从1997年至2001年医疗保险目前的受益人调查。将SSRI使用者与非抗抑郁药使用者以及其他非SSRI抗抑郁药使用者的AMI风险进行比较（ICD-9：410或411）。描述性统计和二元逻辑回归模型被用来评估groups.Results之间的差异：有1,052 SSRI用户与762其他抗抑郁药用户和10,856非抗抑郁药用户相比。Logistic回归模型显示，SSRI使用者与非抗抑郁药使用者相比，在控制年龄、性别、种族、吸烟史和当前状态、体重指数、抑郁、焦虑和糖尿病时，AMI的几率显著更大（比值比1.85; 95%置信区间1.13-3-04）。按处方计数分层显示，与非使用者相比，使用三种以上处方的患者发生AMI的几率更大（比值比2.02，95%置信区间1.11-3.66）。结论：在老年人群中，与非抗抑郁药使用相比，使用SSRI导致AMI风险增加。在前一年有三次以上处方的患者中，AMI的几率增加，表明可能存在持续时间反应关系。
PURPOSE: We assessed the risk of selective serotonin reuptake inhibitor (SSRI) use on the occurrence of acute myocardial infarction (AMI) based on duration of exposure.METHODS: A historical pooled cohort of all elderly, community-dwelling Medicare beneficiaries not enrolled in health maintenance organizations from the 1997 to 2001 Medicare Current Beneficiary Survey was constructed. SSRI users were compared with non-antidepressant users as well as other non-SSRI antidepressant users on their risk of AMI (ICD-9: 410 or 411). Descriptive statistics and binary logistic regression models were used to assess differences between groups.RESULTS: There were 1,052 SSRI users compared with 762 other antidepressant users and 10,856 non-antidepressant users. Logistic regression models revealed that SSRI users were found to have significantly greater odds of AMI compared with nonantidepressant users when controlling for age, gender, race, smoking history and current status, body mass index, depression, anxiety and diabetes (odds ratio 1.85; 95% confidence intervals 1.13-3-04). Stratification by prescription counts revealed those with more than three prescriptions had greater odds of AMI compared with nonusers (odds ratio 2.02, 95% confidence intervals 1.11-3.66).CONCLUSIONS: SSRI use leads to an increased risk of AMI in comparison with nonantidepressant use in an elderly population. The odds of AMI increased in those with more than three prescriptions in the preceding year, indicating a possible duration response relationship.