| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2001;104:1894.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Cardiovascular Division (W.H.S., S.E.K.), Department of Medicine, Hospital of the University of Pennsylvania and the Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology (J.A.B., S.E.K.), University of Pennsylvania School of Medicine, Philadelphia, Pa.
Correspondence to Stephen E. Kimmel, MD, MS, University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and Biostatistics, 717 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104-6021. E-mail skimmel{at}cceb.med.upenn.edu
Background Depression is an independent risk factor for myocardial infarction (MI). Selective serotonin reuptake inhibitors (SSRIs) may reduce this risk through attenuation of serotonin-mediated platelet activation in addition to treatment of depression itself.
Methods and Results A case-control study of first MI in smokers 30 to 65 years of age was conducted among all 68 hospitals in an 8-county area during a 28-month period. Cases were patients hospitalized with a first MI. Approximately 4 community control subjects per case were randomly selected from the same geographic area using random digit dialing. Detailed information regarding use of antidepressant medication as well as other clinical and demographic data were obtained by telephone interview. A total of 653 cases of first MI and 2990 control subjects participated. After adjustment, using multivariable logistic regression, for age, sex, race, education, exercise, quantity smoked per day, body mass index, aspirin use, family history of MI, number of physician encounters, and history of coronary disease, diabetes, hypertension, or hypercholesterolemia, the odds ratio for MI among current SSRI users compared with nonusers was 0.35 (95% CI 0.18, 0.68; P<0.01). Non-SSRI antidepressant users had a nonsignificant reduction in MI risk with wide confidence intervals (adjusted odds ratio 0.48, CI 0.17, 1.32; P=0.15). However, analysis of this group was limited by the small number of exposed subjects.
Conclusions The use of SSRIs may confer a protective effect against MI. This could be attributable to the inhibitory effect SSRIs have on serotonin-mediated platelet activation or possibly amelioration of other factors associated with increased risk for MI in depression.
Key Words: serotonin uptake inhibitors depression epidemiology myocardial infarction drugs platelets
This article has been cited by other articles:
![]() |
S. E. Linke, T. Rutledge, B. D. Johnson, V. Vaccarino, V. Bittner, C. E. Cornell, W. Eteiba, D. S. Sheps, D. S. Krantz, S. Parashar, et al. Depressive Symptom Dimensions and Cardiovascular Prognosis Among Women With Suspected Myocardial Ischemia: A Report From the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation Arch Gen Psychiatry, May 1, 2009; 66(5): 499 - 507. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Narayan and M. B. Stein Do depression or antidepressants increase cardiovascular mortality? The absence of proof might be more important than the proof of absence. J. Am. Coll. Cardiol., March 17, 2009; 53(11): 959 - 961. [Full Text] [PDF] |
||||
![]() |
C. M. Blanchette, L. Simoni-Wastila, F. Shaya, D. Orwig, J. Noel, and B. Stuart Health care use in depressed, elderly, cardiac patients and the effect of antidepressant use Am. J. Health Syst. Pharm., February 15, 2009; 66(4): 366 - 372. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. L. Rollman, B. H. Belnap, M. S. LeMenager, S. Mazumdar, H. C. Schulberg, and C. F. Reynolds III The Bypassing the Blues Treatment Protocol: Stepped Collaborative Care for Treating Post-CABG Depression Psychosom Med, February 1, 2009; 71(2): 217 - 230. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. POZUELO, G. TESAR, J. ZHANG, M. PENN, K. FRANCO, and W. JIANG Depression and heart disease: What do we know, and where are we headed? Cleveland Clinic Journal of Medicine, January 1, 2009; 76(1): 59 - 70. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. M. O'Connor, W. Jiang, M. Kuchibhatla, R. H. Mehta, G. L. Clary, M. S. Cuffe, E. J. Christopher, J. D. Alexander, R. M. Califf, and R. R. Krishnan Antidepressant Use, Depression, and Survival in Patients With Heart Failure Arch Intern Med, November 10, 2008; 168(20): 2232 - 2237. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. A. Wellenius, K. J. Mukamal, A. Kulshreshtha, S. Asonganyi, and M. A. Mittleman Depressive Symptoms and the Risk of Atherosclerotic Progression Among Patients With Coronary Artery Bypass Grafts Circulation, May 6, 2008; 117(18): 2313 - 2319. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. N. Morrell, H. Sun, M. Ikeda, J.-C. Beique, A. M. Swaim, E. Mason, T. V. Martin, L. E. Thompson, O. Gozen, D. Ampagoomian, et al. Glutamate mediates platelet activation through the AMPA receptor J. Exp. Med., March 17, 2008; 205(3): 575 - 584. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. E. Von Ruden, D. E. Adson, and M. Kotlyar Effect of Selective Serotonin Reuptake Inhibitors on Cardiovascular Morbidity and Mortality Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2008; 13(1): 32 - 40. [Abstract] [PDF] |
||||
![]() |
L. S. Kinder, K. A. Bradley, W. J. Katon, E. Ludman, M. B. McDonell, and C. L. Bryson Depression, Posttraumatic Stress Disorder, and Mortality Psychosom Med, January 1, 2008; 70(1): 20 - 26. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. B. Williams, D. A. Marchuk, I. C. Siegler, J. C. Barefoot, M. J. Helms, B. H. Brummett, R. S. Surwit, J. D. Lane, C. M. Kuhn, K. M. Gadde, et al. Childhood Socioeconomic Status and Serotonin Transporter Gene Polymorphism Enhance Cardiovascular Reactivity to Mental Stress Psychosom Med, January 1, 2008; 70(1): 32 - 39. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. Vaccarino, B. D. Johnson, D. S. Sheps, S. E. Reis, S. F. Kelsey, V. Bittner, T. Rutledge, L. J. Shaw, G. Sopko, and C. N. Bairey Merz Depression, Inflammation, and Incident Cardiovascular Disease in Women With Suspected Coronary Ischemia: The National Heart, Lung, and Blood Institute Sponsored WISE Study J. Am. Coll. Cardiol., November 20, 2007; 50(21): 2044 - 2050. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. C. Ziegelstein, K. Parakh, A. Sakhuja, and U. Bhat Depression and Coronary Artery Disease: Is There a Platelet Link? Mayo Clin. Proc., November 1, 2007; 82(11): 1366 - 1368. [Full Text] [PDF] |
||||
![]() |
P. de Jonge, A. Honig, J. P. van Melle, A. H. Schene, A. M.G. Kuyper, D. Tulner, A. Schins, J. Ormel, and The MIND-IT Investigators Nonresponse to Treatment for Depression Following Myocardial Infarction: Association With Subsequent Cardiac Events Am J Psychiatry, September 1, 2007; 164(9): 1371 - 1378. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. F. Muldoon, R. H. Mackey, K. Sutton-Tyrrell, J. D. Flory, B. G. Pollock, and S. B. Manuck Lower Central Serotonergic Responsivity Is Associated With Preclinical Carotid Artery Atherosclerosis Stroke, August 1, 2007; 38(8): 2228 - 2233. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Ramot and A. Nyska Drug-Induced Thrombosis--Experimental, Clinical, and Mechanistic Considerations Toxicol Pathol, February 1, 2007; 35(2): 208 - 225. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. J. Salaycik, M. Kelly-Hayes, A. Beiser, A.-H. Nguyen, S. M. Brady, C. S. Kase, and P. A. Wolf Depressive Symptoms and Risk of Stroke: The Framingham Study Stroke, January 1, 2007; 38(1): 16 - 21. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Kotzailias, T. Andonovski, A. Dukic, V. L. Serebruany, and B. Jilma Antiplatelet Activity During Coadministration of the Selective Serotonin Reuptake Inhibitor Paroxetine and Aspirin in Male Smokers: A Randomized, Placebo-Controlled, Double-blind Trial. J. Clin. Pharmacol., April 1, 2006; 46(4): 468 - 475. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. W. Ketterer, L. Wulsin, J. J. Cao, J. Schairer, A. Hakim, M. Hudson, S. J. Keteyian, S. Khanal, V. Clark, and W. D. Weaver "Major" Depressive Disorder, Coronary Heart Disease, and the DSM-IV Threshold Problem Psychosomatics, February 1, 2006; 47(1): 50 - 55. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Carpeggiani, M. Emdin, F. Bonaguidi, P. Landi, C. Michelassi, M. G. Trivella, A. Macerata, and A. L'Abbate Personality traits and heart rate variability predict long-term cardiac mortality after myocardial infarction Eur. Heart J., August 2, 2005; 26(16): 1612 - 1617. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. B. Taylor, M. E. Youngblood, D. Catellier, R. C. Veith, R. M. Carney, M. M. Burg, P. G. Kaufmann, J. Shuster, T. Mellman, J. A. Blumenthal, et al. Effects of Antidepressant Medication on Morbidity and Mortality in Depressed Patients After Myocardial Infarction Arch Gen Psychiatry, July 1, 2005; 62(7): 792 - 798. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. C. Bruce and D. L. Musselman Depression, Alterations in Platelet Function, and Ischemic Heart Disease Psychosom Med, May 1, 2005; 67(Supplement_1): S34 - S36. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. P. Roose and M. Miyazaki Pharmacologic Treatment of Depression in Patients With Heart Disease Psychosom Med, May 1, 2005; 67(Supplement_1): S54 - S57. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. K. Schulman, P. R. Muskin, and P. A. Shapiro Psychiatry and Cardiovascular Disease Focus, April 1, 2005; 3(2): 208 - 224. [Abstract] [Full Text] [PDF] |
||||
![]() |
L J Tata, J West, C Smith, P Farrington, T Card, L Smeeth, and R Hubbard General population based study of the impact of tricyclic and selective serotonin reuptake inhibitor antidepressants on the risk of acute myocardial infarction Heart, April 1, 2005; 91(4): 465 - 471. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Rozanski, J. A. Blumenthal, K. W. Davidson, P. G. Saab, and L. Kubzansky The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology J. Am. Coll. Cardiol., March 1, 2005; 45(5): 637 - 651. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. P. van Melle, P. de Jonge, T. A. Spijkerman, J. G. P. Tijssen, J. Ormel, D. J. van Veldhuisen, R. H. S. van den Brink, and M. P. van den Berg Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: A Meta-analysis Psychosom Med, November 1, 2004; 66(6): 814 - 822. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Mookadam and H. M. Arthur Social Support and Its Relationship to Morbidity and Mortality After Acute Myocardial Infarction: Systematic Overview Arch Intern Med, July 26, 2004; 164(14): 1514 - 1518. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Schrader, F. Cheok, A.-L. Hordacre, and N. Guiver Predictors of Depression Three Months After Cardiac Hospitalization Psychosom Med, July 1, 2004; 66(4): 514 - 520. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. W. Ketterer, G. Mahr, J. J. Cao, M. Hudson, S. Smith, and W. Knysz What's "Unstable" in Unstable Angina? Psychosomatics, June 1, 2004; 45(3): 185 - 196. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. A. Moffitt and A. K. Johnson Short-term fluoxetine treatment enhances baroreflex control of sympathetic nervous system activity after hindlimb unloading Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2004; 286(3): R584 - R590. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Wassertheil-Smoller, S. Shumaker, J. Ockene, G. A. Talavera, P. Greenland, B. Cochrane, J. Robbins, A. Aragaki, and J. Dunbar-Jacob Depression and Cardiovascular Sequelae in Postmenopausal Women: The Women's Health Initiative (WHI) Arch Intern Med, February 9, 2004; 164(3): 289 - 298. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. L. L. Movig, M. W. H. E. Janssen, J. de Waal Malefijt, P. J. Kabel, H. G. M. Leufkens, and A. C. G. Egberts Relationship of Serotonergic Antidepressants and Need for Blood Transfusion in Orthopedic Surgical Patients Arch Intern Med, October 27, 2003; 163(19): 2354 - 2358. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. B. Williams, J. C. Barefoot, and N. Schneiderman Psychosocial Risk Factors for Cardiovascular Disease: More Than One Culprit at Work JAMA, October 22, 2003; 290(16): 2190 - 2192. [Full Text] [PDF] |
||||
![]() |
R. B. Williams Invited Commentary: Socioeconomic Status, Hostility, and Health Behaviors--Does It Matter Which Comes First? Am. J. Epidemiol., October 15, 2003; 158(8): 743 - 746. [Full Text] [PDF] |
||||
![]() |
V. L. Serebruany, A. H. Glassman, A. I. Malinin, C. B. Nemeroff, D. L. Musselman, L. T. van Zyl, M. S. Finkel, K. R. R. Krishnan, M. Gaffney, W. Harrison, et al. Platelet/Endothelial Biomarkers in Depressed Patients Treated With the Selective Serotonin Reuptake Inhibitor Sertraline After Acute Coronary Events: The Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy Circulation, August 26, 2003; 108(8): 939 - 944. [Abstract] [Full Text] [PDF] |
||||
![]() |
V.L. Serebruany, A.H. Glassman, A.I. Malinin, D. Atar, D.C. Sane, B.R. Oshrine, J.J. Ferguson, and C.M. O'Connor Selective serotonin reuptake inhibitors yield additional antiplatelet protection in patients with congestive heart failure treated with antecedent aspirin Eur J Heart Fail, August 1, 2003; 5(4): 517 - 521. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Ruo, J. S. Rumsfeld, M. A. Hlatky, H. Liu, W. S. Browner, and M. A. Whooley Depressive Symptoms and Health-Related Quality of Life: The Heart and Soul Study JAMA, July 9, 2003; 290(2): 215 - 221. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. H. Sauer, J. A. Berlin, and S. E. Kimmel Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction Circulation, July 8, 2003; 108(1): 32 - 36. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Tsiara, M. Elisaf, I. A. Jagroop, and D. P. Mikhailidis Platelets as Predictors of Vascular Risk: Is There a Practical Index of Platelet Activity? Clinical and Applied Thrombosis/Hemostasis, July 1, 2003; 9(3): 177 - 190. [Abstract] [PDF] |
||||
![]() |
Writing Committee for the ENRICHD Investigators Effects of Treating Depression and Low Perceived Social Support on Clinical Events After Myocardial Infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial JAMA, June 18, 2003; 289(23): 3106 - 3116. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Danner, S. V. Kasl, J. L. Abramson, and V. Vaccarino Association Between Depression and Elevated C-Reactive Protein Psychosom Med, May 1, 2003; 65(3): 347 - 356. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Szasz and G. L. Dale Thrombospondin and fibrinogen bind serotonin-derivatized proteins on COAT-platelets Blood, September 26, 2002; 100(8): 2827 - 2831. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. H. Glassman, C. M. O'Connor, R. M. Califf, K. Swedberg, P. Schwartz, J. T. Bigger Jr, K. R. R. Krishnan, L. T. van Zyl, J. R. Swenson, M. S. Finkel, et al. Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina JAMA, August 14, 2002; 288(6): 701 - 709. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Fumeron, D. Betoulle, V. Nicaud, A. Evans, F. Kee, J.-B. Ruidavets, D. Arveiler, G. Luc, and F. Cambien Serotonin Transporter Gene Polymorphism and Myocardial Infarction: Etude Cas-Temoins de l'Infarctus du Myocarde (ECTIM) Circulation, June 25, 2002; 105(25): 2943 - 2945. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Jakovljevic and J. Tuomilehto Use of Selective Serotonin Reuptake Inhibitors and the Risk of Stroke: Is There Reason for Concern? Stroke, June 1, 2002; 33(6): 1448 - 1449. [Full Text] [PDF] |
||||
![]() |
P. Pacher and Z. Ungvari Use of Selective Serotonin Reuptake Inhibitors and Myocardial Infarction Circulation, April 9, 2002; 105 (14): e84 - e84. [Full Text] [PDF] |
||||
![]() |
SSRIs May Protect Against Myocardial Infarction Journal Watch Psychiatry, March 6, 2002; 2002(306): 3 - 3. [Full Text] |
||||
|
Circulation Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 2001 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. |