Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
J Psychiatr Res. 2017 Nov;94:7-14. doi: 10.1016/j.jpsychires.2017.06.001. Epub 2017 Jun 3.
We aimed to investigate the association between antidepressant use and the risk of hospitalization for acute myocardial infarction (AMI).
A case-crossover study was conducted using a nationwide population-based sample from Taiwan's National Health Insurance Research Database. A total of 18,631 patients with incident AMI were included in this study. The effects of antidepressant use as well as that of various classes (including tricyclic or tetracyclic antidepressants; selective serotonin reuptake inhibitors; or serotonin norepinephrine reuptake inhibitors), doses, and receptor-binding profiles of the antidepressants on AMI were assessed. Conditional logistic regression models with adjustment for potential confounding factors were applied to determine the effects of antidepressant use on the risk of AMI during case and control time periods of 15, 30, and 60 days, respectively. The modifiable effects of age, gender, and comorbidity were evaluated by stratified analysis.
Antidepressant use was not associated with the risk of AMI (adjusted odds ratio [AOR] = 1.04; 95% confidence interval (CI): 0.88-1.24). Likewise, neither the class, dose, nor the binding affinity of serotonin transporter or norepinephrine transporter was associated with AMI risks, and there was no modifying effect of age, gender, or comorbid medical condition on the association between antidepressant use and AMI.
Use of antidepressant drugs was not associated with the risk of AMI.
本研究旨在探讨抗抑郁药的使用与急性心肌梗死(AMI)住院风险之间的关联。
本研究采用了来自台湾全民健康保险研究数据库的全国性人群样本进行病例交叉研究。共纳入 18631 例新发 AMI 患者。评估了抗抑郁药的使用以及各种类别(包括三环或四环抗抑郁药;选择性 5-羟色胺再摄取抑制剂;或 5-羟色胺去甲肾上腺素再摄取抑制剂)、剂量和抗抑郁药的受体结合特性对 AMI 的影响。应用条件逻辑回归模型,在病例和对照时期(分别为 15、30 和 60 天),对潜在混杂因素进行调整,以确定抗抑郁药的使用对 AMI 风险的影响。通过分层分析评估年龄、性别和合并症的可调节作用。
抗抑郁药的使用与 AMI 的风险无关(调整后的比值比 [AOR] = 1.04;95%置信区间 [CI]:0.88-1.24)。同样,抗抑郁药的类别、剂量或 5-羟色胺转运体或去甲肾上腺素转运体的结合亲和力与 AMI 风险均无相关性,年龄、性别或合并症对抗抑郁药的使用与 AMI 之间的关联没有调节作用。
抗抑郁药的使用与 AMI 的风险无关。