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抗抑郁药使用与静脉血栓栓塞风险之间的关联:一项系统评价和荟萃分析。

Association Between Antidepressant Use and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis.

作者信息

Uh Minyoung, Rhee Hey Young, Rhew Kiyon

机构信息

College of Pharmacy, Dongduk Women's University, Seoul 02748, Republic of Korea.

Division of Library & Information Science, College of Social Sciences, Dongduk Women's University, Seoul 02748, Republic of Korea.

出版信息

J Clin Med. 2025 Aug 5;14(15):5512. doi: 10.3390/jcm14155512.

DOI:10.3390/jcm14155512
PMID:40807134
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12347909/
Abstract

: To evaluate the association between antidepressant use and the risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism (PE), through a systematic review and meta-analysis of observational studies. : A comprehensive literature search was conducted in Medline, Embase, and Web of Science up to December 2024. Eighteen studies (cohort, case-control, and nested case-control designs) meeting inclusion criteria were analyzed. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed based on recency of antidepressant use, VTE onset type (first vs. recurrent), and VTE subtype (PE). : Antidepressant use was associated with a significantly increased risk of VTE (RR = 1.22; 95% CI: 1.12-1.32; < 0.001). Subgroup analyses revealed a stronger association for recent use (within 90 days), first-onset VTE, recurrent VTE, and PE. Heterogeneity was high (I = 87.92%), but sensitivity analysis confirmed result robustness. No publication bias was detected. : This meta-analysis indicates a modest but statistically significant increase in the risk of VTE associated with antidepressant use, particularly among recent users, individuals experiencing either first-time or recurrent VTE, and those with PE-type events. These findings highlight the importance of individualized VTE risk assessment when initiating antidepressant therapy.

摘要

通过对观察性研究的系统评价和荟萃分析,评估使用抗抑郁药与静脉血栓栓塞(VTE,包括深静脉血栓形成和肺栓塞(PE))风险之间的关联。

在截至2024年12月的Medline、Embase和科学网中进行了全面的文献检索。对18项符合纳入标准的研究(队列研究、病例对照研究和巢式病例对照研究设计)进行了分析。使用纽卡斯尔-渥太华量表评估研究质量。采用随机效应模型计算合并相对风险(RR)及95%置信区间(CI)。根据抗抑郁药使用的近期情况、VTE发病类型(首发与复发)和VTE亚型(PE)进行亚组分析。

使用抗抑郁药与VTE风险显著增加相关(RR = 1.22;95% CI:1.12 - 1.32;< 0.001)。亚组分析显示,近期使用(90天内)、首发VTE、复发VTE和PE的关联更强。异质性较高(I² = 87.92%),但敏感性分析证实了结果的稳健性。未检测到发表偏倚。

这项荟萃分析表明,使用抗抑郁药与VTE风险有适度但在统计学上显著的增加,特别是在近期使用者、首次或复发VTE患者以及发生PE型事件的患者中。这些发现凸显了在开始抗抑郁治疗时进行个体化VTE风险评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/769b662d8f2c/jcm-14-05512-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/1a56a98b22c0/jcm-14-05512-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/cedd62e93802/jcm-14-05512-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/769b662d8f2c/jcm-14-05512-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/1a56a98b22c0/jcm-14-05512-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/cedd62e93802/jcm-14-05512-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee2/12347909/769b662d8f2c/jcm-14-05512-g003.jpg

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本文引用的文献

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Sci Rep. 2024 Aug 29;14(1):20054. doi: 10.1038/s41598-024-69637-4.
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Recurrent venous thromboembolism and vaginal estradiol in women with prior venous thromboembolism: A nested case-control study.有静脉血栓栓塞史的女性中复发性静脉血栓栓塞和阴道雌二醇:一项巢式病例对照研究。
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在 FinnGen 和 UK Biobank 中,单一和双重杂合子携带因子 V Leiden 和凝血酶原 G20210A 的血栓形成风险。
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Use of combined oral contraceptives and risk of venous thromboembolism in young women: a nested case-control analysis using German claims data.联合使用口服避孕药与年轻女性静脉血栓栓塞风险:利用德国索赔数据进行的巢式病例对照分析。
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Clozapine-Related Thromboembolic Events.氯氮平相关的血栓栓塞事件
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Does administration of vaginal estrogens increase the risk of venous thromboembolism: A case-control study.阴道雌激素给药会增加静脉血栓栓塞的风险吗:一项病例对照研究。
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Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review.诊断为抑郁症的患者中抗抑郁药的使用:范围综述。
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