Antidepressants and risk of first-time hospitalization for myocardial infarction: A population-based case-control study
Antidepressants and risk of first-time hospitalization for myocardial infarction: A population-based case-control study
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DOI：
10.1016/j.amjmed.2004.06.027
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发表时间：
2004-11-15
影响因子：
5.9
通讯作者：
Sorensen, HT
中科院分区：
文献类型：
--
作者：
Monster, TBM;Johnsen, SP;Sorensen, HT
目的：几项研究发现抑郁症患者心肌梗死的风险增加。选择性5-羟色胺再摄取抑制剂（SSRIs）似乎没有三环类抗抑郁药的副作用，并被认为是抑制血小板聚集。我们研究是否使用不同的抗抑郁药类与较低的风险，首次住院治疗心肌梗死，相比nonuse.METHODS：我们确定了8887例首次住院治疗心肌梗死和88,862年龄和性别匹配的人口为基础的控制在1994-2002年，使用数据从北日德兰郡，丹麦。根据心血管疾病史对病例和对照进行分层。使用处方数据库识别所有因心肌梗死住院前的抗抑郁药处方。条件Logistic回归用于估计与抗抑郁药使用相关的心肌梗死的比值比，调整可能的混杂因素。结果：在有心血管疾病史的患者中，我们发现使用SSRIs的患者心肌梗死风险较低（校正比值比[OR] = 0.85; 95%置信区间[CI]：0.62 - 1.16），非选择性5-羟色胺再摄取抑制剂（调整OR = 0.83; 95%CI：0.50 - 1.38）和其他抗抑郁药（调整OR = 0.55; 95%CI：0.31 - 0.97）。有没有这样的协会之间的人没有心血管疾病的病史。结论：抗抑郁药的使用可能与心肌梗死住院治疗的风险降低的人有心血管疾病的病史，虽然它仍然不确定是否有不同的抗抑郁药类。(C)2004年，Elsevier Inc.
PURPOSE: Several studies have found an increased risk of myocardial infarction among depressed patients. Selective serotonin reuptake inhibitors (SSRIs) appear to lack the arrhythmic adverse effects of tricyclic antidepressants, and are thought to inhibit platelet aggregation. We examined whether use of different antidepressant classes is associated with a lower risk of first-time hospitalization for myocardial infarction, as compared with nonuse.METHODS: We identified 8887 cases of first-time hospitalization for myocardial infarction and 88,862 age- and sex-matched population-based controls during 1994-2002, using data from North Jutland County, Denmark. Cases and controls were stratified according to history of cardiovascular disease. All prescriptions for antidepressants before hospitalization for myocardial infarction were identified using a prescription database. Conditional logistic regression was used to estimate odds ratios of myocardial infarction associated with antidepressant use, adjusted for possible confounding factors.RESULTS: In patients with a history of cardiovascular disease, we found indications of a lower risk of myocardial infarction among those who used SSRIs (adjusted odds ratio [OR] = 0.85; 95% confidence interval [CI]: 0.62 to 1.16), nonselective serotonin reuptake inhibitors (adjusted OR = 0.83; 95% CI: 0.50 to 1.38), and other antidepressants (adjusted OR = 0.55; 95% CI: 0.31 to 0.97). There were no such associations among persons without a history of cardiovascular disease.CONCLUSION: Antidepressant use may be associated with a decreased risk of hospitalization for myocardial infarction among persons with a history of cardiovascular disease, although it remains uncertain whether there are differences by class of antidepressant. (C) 2004 by Elsevier Inc.