In a nutshell
This study investigated the effect of selective serotonin reuptake inhibitors (SSRIs) after percutaneous coronary intervention (PCI). They found that SSRIs were associated with a lower risk compared to other anti-depressants.
Some background
Coronary artery disease (CAD) is a serious medical condition. It can lead to major adverse cardiac events (MACE). These include heart attacks, strokes or death. CAD is caused by a reduced blood flow to the heart. One surgical treatment to restore blood flow is percutaneous coronary intervention (PCI).
Many patients with CAD also have depression. Only certain anti-depressant drugs can be used in these patients. These are mirtazapine (Remeron) and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) or sertraline (Zoloft). These drugs are considered safe for use in CAD. It is unclear if SSRIs can affect CAD. Some evidence suggests that SSRIs may reduce clotting. The antidepressant effect of SSRIs works on neurons in the brain. However, SSRIs can also act on platelets. Platelets are cells in the blood that cause clotting. It is unclear if SSRIs have an effect on MACE after PCI.
Methods & findings
This study included 8284 patients that underwent PCI. Patients were separated into three groups depending on depression treatment. These were mirtazapine, SSRIs or no treatment (control). The authors analyzed the rates of MACE 1 year after PCI. Major bleeding episodes were also analyzed.
SSRI use was associated with a 39% reduced risk of MACE compared to mirtazapine. Overall, the use of SSRIs was associated with a 21% higher risk of MACE than control patients. The risk of major bleeding was similar across all groups 1-year after PCI.
The bottom line
The authors concluded that SSRIs were associated with a lower risk of MACEs compared to other anti-depressants.
The fine print
This was a retrospective study, meaning it looked back at medical records. Some information was not available for analysis. More investigation is needed to confirm this.
What’s next?
If you have any concerns regarding CAD, please consult with your physician.
Published By :
Clinical drug investigation
Date :
Mar 21, 2019
