on June 23, 2003
Published online before print June 23, 2003, doi: 10.1161/01.CIR.0000079172.43229.CD
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on February 10, 2003
From the Cardiovascular Division (W.H.S., S.E.K.), Department of Medicine, Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology (J.A.B., S.E.K.), and Center for Education and Research on Therapeutics (J.A.B.), University of Pennsylvania School of Medicine, Philadelphia, Pa. * To whom correspondence should be addressed. E-mail: skimmel{at}cceb.med.upenn.edu.
Background--Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), attenuate platelet activation by depleting serotonin storage and may decrease risk of myocardial infarction (MI). These drugs differ in their affinity for the platelet serotonin transporter and therefore may vary in their effects on MI protection. Methods and Results--A case-control study of first MI in patients aged 40 through 75 years was conducted among 36 hospitals in a 5-county area during a 3-year period. Case subjects were patients hospitalized with a first MI, and control subjects were randomly selected from the same geographic area. Detailed information regarding medication use and other clinical and demographic data were obtained by telephone interview. Among the 1080 cases and 4256 controls who participated, there were 223 users of antidepressants with high serotonin transporter affinity, all of which were SSRIs (paroxetine, fluoxetine, and sertraline). After adjustment with multivariable logistic regression for age, gender, race, education, physical activity, quantity of cigarettes smoked per day, body mass index, aspirin use, family history of MI, and history of diabetes, hypertension, or hypercholesterolemia, the odds ratio for MI among current users of antidepressants with high serotonin transporter affinity compared with nonusers was 0.59 (95% CI 0.39 to 0.91; P=0.02). Increasing serotonin transporter affinity was associated with reduced odds of MI among users of all SSRIs (P for trend <0.01) but not tricyclic (P=0.77) or atypical (P=0.70) antidepressants. There was no association detected between non-SSRI antidepressant use and MI. Conclusions--Increasing serotonin transporter affinity correlates with greater MI protection with SSRI but not other antidepressant exposure.
Revised on April 1, 2003
Accepted on April 4, 2003
Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction
William H. Sauer MD,
Key words: serotonin uptake inhibitors • antidepressant agents • epidemiology • myocardial infarction • drugs
This article has been cited by other articles:
 |
|
 |
|
  I. Lopez-Vilchez, M. Diaz-Ricart, J. G. White, G. Escolar, and A. M. Galan Serotonin enhances platelet procoagulant properties and their activation induced during platelet tissue factor uptake Cardiovasc Res, November 1, 2009; 84(2): 309 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Shah, M. Gomberg-Maitland, T. Thenappan, and S. Rich Selective Serotonin Reuptake Inhibitors and the Incidence and Outcome of Pulmonary Hypertension Chest, September 1, 2009; 136(3): 694 - 700. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Seymour and T. B. Benning Depression, cardiac mortality and all-cause mortality Adv. Psychiatr. Treat., March 1, 2009; 15(2): 107 - 113. [Abstract] [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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 I. Anderson, I. Ferrier, R. Baldwin, P. Cowen, L Howard, G Lewis, K Matthews, R. McAllister-Williams, R. Peveler, J Scott, et al. Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2000 British Association for Psychopharmacology guidelines J Psychopharmacol, June 1, 2008; 22(4): 343 - 396. [Abstract] [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]
|
|
|
|
 |
|
 Y. Chen, J. J Guo, H. Li, L. Wulsin, and N. C Patel Risk of Cerebrovascular Events Associated with Antidepressant Use in Patients with Depression: A Population-Based, Nested Case-Control Study Ann. Pharmacother., February 1, 2008; 42(2): 177 - 184. [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]
|
|
|
|
|
|
E. M. Haney, B. K. S. Chan, S. J. Diem, K. E. Ensrud, J. A. Cauley, E. Barrett-Connor, E. Orwoll, M. M. Bliziotes, and for the Osteoporotic Fractures in Men Study Group Association of Low Bone Mineral Density With Selective Serotonin Reuptake Inhibitor Use by Older Men Arch Intern Med, June 25, 2007; 167(12): 1246 - 1251. [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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 J. S. Rumsfeld and P. M. Ho Depression and Cardiovascular Disease: A Call For Recognition Circulation, January 25, 2005; 111(3): 250 - 253. [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]
|
|
|
|
|
|
R. Ramasubbu SSRI Treatment-Associated Stroke: Causality Assessment in Two Cases Ann. Pharmacother., July 1, 2004; 38(7): 1197 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J C Davies, P. R Jackson, J. Potokar, and D. J Nutt Treatment of anxiety and depressive disorders in patients with cardiovascular disease BMJ, April 17, 2004; 328(7445): 939 - 943. [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Murphy, A. Lerner, G. Rudnick, and K.-P. Lesch Serotonin Transporter: Gene, Genetic Disorders, and Pharmacogenetics Mol. Interv., April 1, 2004; 4(2): 109 - 123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Le Melledo, D. Bailey, and G.B. Baker Selective Serotonin Reuptake Inhibitors and Myocardial Infarction Circulation, January 27, 2004; 109 (3): e19 - e19. [Full Text] [PDF]
|
|
|
|
 |
|
 Further Evidence that SSRIs Reduce Risk for MI Journal Watch Psychiatry, August 21, 2003; 2003(821): 2 - 2. [Full Text]
|
|