Kim Hyewon, Lee You-Bin, Lee Jungkuk, Kang Dongwoo, Kim Gyuri, Jin Sang-Man, Kim Jae Hyeon, Hur Kyu Yeon, Jeon Hong Jin
Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Affect Disord. 2024 May 1;352:214-221. doi: 10.1016/j.jad.2024.02.034. Epub 2024 Feb 18.
To examine the association between depression, the use of antidepressants, and atherosclerotic cardiovascular disease (ASCVD).
The South Korean national claims data was used. Among a nationally representative population, 273,656 subjects who had been diagnosed with depression and prescribed antidepressants ("DEP with antidepressants") and 78,851 subjects who had been diagnosed with depression but not prescribed antidepressants ("DEP without antidepressants") were identified to be eligible. Healthy controls (HCs) were 1:1 matched with DEP with antidepressants group for age and sex. We followed up on the occurrence of ASCVD including ischemic heart diseases and ischemic stroke.
The risk of ASCVD was increased in the DEP with antidepressants group and decreased in the DEP without antidepressants group compared to HCs. Among those under antidepressants, tricyclic antidepressant users showed the highest risk of ASCVD compared to HCs. Among young adults, the risk of ASCVD was increased in both groups.
The risk of ASCVD increased in depression patients taking antidepressants, while it decreased in depression patients not taking antidepressants. However, the relationship showed differences according to drug class and age group.
研究抑郁症、抗抑郁药的使用与动脉粥样硬化性心血管疾病（ASCVD）之间的关联。
使用韩国全国性索赔数据。在具有全国代表性的人群中，确定了273656名被诊断为抑郁症并开具抗抑郁药的受试者（“使用抗抑郁药的抑郁症患者”）和78851名被诊断为抑郁症但未开具抗抑郁药的受试者（“未使用抗抑郁药的抑郁症患者”）符合条件。健康对照（HCs）与使用抗抑郁药的抑郁症患者组按年龄和性别进行1:1匹配。我们对包括缺血性心脏病和缺血性中风在内的ASCVD的发生情况进行了随访。
与HCs相比，使用抗抑郁药的抑郁症患者组中ASCVD的风险增加，未使用抗抑郁药的抑郁症患者组中ASCVD的风险降低。在服用抗抑郁药的人群中，与HCs相比，三环类抗抑郁药使用者的ASCVD风险最高。在年轻人中，两组的ASCVD风险均增加。
服用抗抑郁药的抑郁症患者中ASCVD的风险增加，而未服用抗抑郁药的抑郁症患者中ASCVD的风险降低。然而，这种关系因药物类别和年龄组而异。
