Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease : A Real-Life Investigation From Italy
PURPOSE: The purpose of this study was to assess the possible relation between use of antidepressant (AD) drugs, that is, tricyclic ADs, selective serotonin reuptake inhibitors (SSRIs), and atypical ADs (AAs), and the risk of hospitalization for cardiovascular (CV) events among older patients with previous CV diseases.
METHODS: A nested case-control study was carried out among patients aged 65 years and older from 5 Italian health care territorial units who were discharged for CV disease during 2008 to 2010. The cohort was composed by 344,747 individuals, and of these, 97,739 (28%) experienced hospital admission for CV events (myocardial infarction, arrhythmia, stroke, heart failure) during follow-up (until 2014) and were included as cases. Up to 5 controls were randomly selected and matched to each. A conditional logistic regression was fitted to estimate the risk of CV events associated with ADs past or current use. A within-patient comparison was performed by the case-crossover design to account the effect of depression.
FINDINGS: Current users of SSRIs and AAs were at increased risk of CV events with odds ratios of 1.25 (95% confidence interval, 1.21-1.29) and 1.31 (1.25-1.37), respectively. An increased risk of arrhythmia and stroke was associated with current use of SSRIs and AAs, whereas an increased risk of heart failure was detected with current use of any ADs. The results were confirmed by the case-crossover approach.
IMPLICATIONS: Evidence that AD use is associated with an increased risk of CV events in accordance with specific mechanisms of action among older people with CV disease was added by this study.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Journal of clinical psychopharmacology - 40(2020), 2 vom: 01. März, Seite 112-121 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Biffi, Annalisa [VerfasserIn] |
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| Links: |
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| Themen: |
Antidepressive Agents |
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| Anmerkungen: |
Date Completed 04.12.2020 Date Revised 07.12.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/JCP.0000000000001189 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM30725836X |
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| 100 | 1 | |a Biffi, Annalisa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease |b A Real-Life Investigation From Italy |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 04.12.2020 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: The purpose of this study was to assess the possible relation between use of antidepressant (AD) drugs, that is, tricyclic ADs, selective serotonin reuptake inhibitors (SSRIs), and atypical ADs (AAs), and the risk of hospitalization for cardiovascular (CV) events among older patients with previous CV diseases | ||
| 520 | |a METHODS: A nested case-control study was carried out among patients aged 65 years and older from 5 Italian health care territorial units who were discharged for CV disease during 2008 to 2010. The cohort was composed by 344,747 individuals, and of these, 97,739 (28%) experienced hospital admission for CV events (myocardial infarction, arrhythmia, stroke, heart failure) during follow-up (until 2014) and were included as cases. Up to 5 controls were randomly selected and matched to each. A conditional logistic regression was fitted to estimate the risk of CV events associated with ADs past or current use. A within-patient comparison was performed by the case-crossover design to account the effect of depression | ||
| 520 | |a FINDINGS: Current users of SSRIs and AAs were at increased risk of CV events with odds ratios of 1.25 (95% confidence interval, 1.21-1.29) and 1.31 (1.25-1.37), respectively. An increased risk of arrhythmia and stroke was associated with current use of SSRIs and AAs, whereas an increased risk of heart failure was detected with current use of any ADs. The results were confirmed by the case-crossover approach | ||
| 520 | |a IMPLICATIONS: Evidence that AD use is associated with an increased risk of CV events in accordance with specific mechanisms of action among older people with CV disease was added by this study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Antidepressive Agents |2 NLM | |
| 650 | 7 | |a Antidepressive Agents, Second-Generation |2 NLM | |
| 650 | 7 | |a Antidepressive Agents, Tricyclic |2 NLM | |
| 650 | 7 | |a Serotonin Uptake Inhibitors |2 NLM | |
| 700 | 1 | |a Rea, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Scotti, Lorenza |e verfasserin |4 aut | |
| 700 | 1 | |a Lucenteforte, Ersilia |e verfasserin |4 aut | |
| 700 | 1 | |a Vannacci, Alfredo |e verfasserin |4 aut | |
| 700 | 1 | |a Lombardi, Niccolò |e verfasserin |4 aut | |
| 700 | 1 | |a Chinellato, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Onder, Graziano |e verfasserin |4 aut | |
| 700 | 1 | |a Vitale, Cristiana |e verfasserin |4 aut | |
| 700 | 1 | |a Cascini, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Ingrasciotta, Ylenia |e verfasserin |4 aut | |
| 700 | 1 | |a Roberto, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Mugelli, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Corrao, Giovanni |e verfasserin |4 aut | |
| 700 | 0 | |a Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE) |e verfasserin |4 aut | |
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