Use of venlafaxine compared with other antidepressants and the risk of sudden cardiac death or near death: a nested case-control study.
Use of venlafaxine compared with other antidepressants and the risk of sudden cardiac death or near death: a nested case-control study.
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DOI：
10.1136/bmj.c249
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发表时间：
2010-02-05
期刊：
影响因子：
--
通讯作者：
Suissa S
中科院分区：
文献类型：
--
作者：
Martinez C;Assimes TL;Mines D;Dell'aniello S;Suissa S
目的评价与其他常用抗抑郁药相比，使用抗抑郁药文拉法辛是否与心源性猝死或濒死风险增加相关。设计基于人群的观察性研究。我们对使用英国全科医学研究数据库形成的新用户队列进行了嵌套病例对照分析。参与者：1995年1月1日或之后新使用文拉法辛、氟西汀、西酞普兰或多舒平和18至89岁，诊断为抑郁或焦虑。对参与者进行随访，直到2005年2月，或从医疗记录中确定的非致命性急性室性心动过速、心脏原因导致的猝死或急性缺血性心脏事件导致的院外死亡的心脏性猝死或接近死亡的发生。对于每个病例，选择30名符合年龄、性别、日历时间和适应症的对照。我们使用条件logistic回归来计算与当前使用文拉法辛与当前使用氟西汀、西酞普兰或多舒舒平相关的心源性猝死或濒死的校正优势比。结果随访207384例，平均3.3年。568例心脏性猝死或濒临死亡，与14812例对照相匹配。与使用氟西汀相关的心源性猝死或濒死校正比值比为0.66(95%可信区间0.38 ~ 1.14)，而与西酞普兰相关的校正比值比为0.89(0.50 ~ 1.60)，与多舒舒平相关的校正比值比为0.83（0.46 ~ 1.52）。结论：在这项基于人群的大型研究中，与氟西汀、多舒平或西酞普兰相比，文拉法辛的使用与抑郁症或焦虑症患者心源性猝死或濒死风险的增加无关。
Objective To assess whether use of the antidepressant venlafaxine is associated with an increased risk of sudden cardiac death or near death compared with other commonly used antidepressants. Design Population based observational study. Setting We did a nested case-control analysis within a new user cohort formed using the United Kingdom General Practice Research Database. Participants New users of venlafaxine, fluoxetine, citalopram, or dosulepin on or after 1 January 1995, aged 18 to 89 years, with a diagnosis of depression or anxiety. Participants were followed-up until February 2005, or the occurrence of sudden cardiac death or near death, identified from medical records indicating non-fatal acute ventricular tachyarrhythmia, sudden death due to cardiac causes, or out of hospital deaths from acute ischaemic cardiac events. For each case, 30 controls were selected matched for age, sex, calendar time, and indication. We used conditional logistic regression to calculate the adjusted odds ratio of sudden cardiac death or near death associated with current use of venlafaxine compared with current use of fluoxetine, citalopram or dosulepin. Results 207 384 participants were followed-up for an average of 3.3 years. There were 568 cases of sudden cardiac death or near death, which were matched to 14 812 controls. The adjusted odds ratio of sudden cardiac death or near death associated with venlafaxine use was 0.66 (95% confidence interval 0.38 to 1.14) relative to fluoxetine use, whereas compared with citalopram it was 0.89 (0.50 to 1.60) and with dosulepin 0.83 (0.46 to 1.52). Conclusions In this large, population based study, the use of venlafaxine was not associated with an excess risk of sudden cardiac death or near death compared with fluoxetine, dosulepin, or citalopram, in patients with depression or anxiety.
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影响因子：
6.2
作者：
De Maio, VJ;Stiell, IG;Spaite, DW
通讯作者：
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