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SSRIs 引起的心血管毒性:向 FAERS 提交的自发报告分析。

Cardiovascular toxicity induced by SSRIs: Analysis of spontaneous reports submitted to FAERS.

机构信息

Department of Pharmacy, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China; School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China.

Department of Pharmacy, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

出版信息

Psychiatry Res. 2023 Aug;326:115300. doi: 10.1016/j.psychres.2023.115300. Epub 2023 Jun 22.

Abstract

Depression diagnoses have surged recently, and selective serotonin reuptake inhibitors (SSRIs) are the go-to treatment. However, studies indicate that long-term use of SSRIs can increase cardiovascular risk without systematic evaluation of the drug class. To offer clinical guidance, we performed an evaluation of the association between the six most commonly prescribed SSRIs and cardiovascular adverse events. Using the FDA Adverse Event Reporting System (FAERS) from Q1 2004 to Q2 2022, we conducted a disproportionality analysis and determined the magnitude of significant signals using statistical shrinkage transformations. Our study revealed that arrhythmias, torsades de pointes/QT prolongation, cardiomyopathy, and hypertension were among the most prevalent adverse events linked to SSRIs. Our analysis also showed a significant association between SSRIs and the aforementioned adverse events, with higher incidence in middle-aged and elderly patients and women. We further observed a rising trend in the incidence of arrhythmias, torsades de pointes/QT prolongation, and hypertension, highlighting the need for heightened cardiac monitoring in patients on SSRIs.

摘要

抑郁症的诊断近来有所增加,而选择性 5-羟色胺再摄取抑制剂(SSRIs)是首选的治疗方法。然而,研究表明,SSRIs 的长期使用会增加心血管风险,而没有对药物类别进行系统评估。为了提供临床指导,我们对六种最常开的 SSRIs 与心血管不良事件之间的关联进行了评估。使用 2004 年第一季度至 2022 年第二季度的 FDA 不良事件报告系统(FAERS),我们进行了不相称性分析,并使用统计收缩变换确定了显著信号的幅度。我们的研究表明,心律失常、尖端扭转型室性心动过速/QT 间期延长、心肌病和高血压是与 SSRIs 相关的最常见不良事件之一。我们的分析还表明,SSRIs 与上述不良事件之间存在显著关联,中年和老年患者以及女性的发生率更高。我们还观察到心律失常、尖端扭转型室性心动过速/QT 间期延长和高血压的发生率呈上升趋势,这强调了需要对服用 SSRIs 的患者进行更密切的心脏监测。

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