Association of Antidepressant Type with the Risk Cardiovascular Disease in the Atherosclerosis Risk in Communities (ARIC) Study 公开

Almuwaqqat, Zakaria (Summer 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/z603qx46m?locale=zh
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Abstract

BACKGROUND: Antidepressant medications (AD’s) are associated with autonomic dysfunction which is linked with future risk of (CVD) cardiovascular disease. However, it is not clear if certain AD’s types are associated with more CVD than others. We hypothesized that selective serotonin reuptake inhibitors (SSRI) are associated with reduced hazards of Atrial Fibrillation (AF), Heart Failure (HF), Myocardial Infarction (MI) and Ischemic Stroke (IS) as compared to other AD medications (non-SSRI). 

METHODS AND RESULTS:  We studied 2027 participants from the Atherosclerosis Risk in Communities (ARIC) Study (mean age 63 ± 10 years; 29% men; 78% white) who self-reported AD use during one of the ARIC five visits (1987 through 2013). Exposure to SSRI vs non-SSRI was determined. Participants were followed up to 2016 for a median of 13.5 years.  A total of 329, 366, 198 and 1345 events for AF, HF, MI and IS, respectively, were identified in this ARIC subset. Using multivariable Cox regression models to adjust for sociodemographic and clinical risk factors, SSRI was not significantly associated with hazards of AF, HF, MI and IS, when compared to non-SSRI medications [hazard ratio (HR)= 1.11, 95% confidence interval (95%CI) (0.8-8 1.40), HR= 0.93, 95%CI 0.72- 1.20, HR= 0.91, 95%CI, 0.65-1.27 HR= 1.02, 95%CI, (0.67-1.56), respectively.]

CONCLUSION: In a community-based sample of individuals initiating AD’s, type of AD was not associated with statistically different hazards of CVD outcomes including AF, HF, MI and IS. These results do not provide evidence supporting the use of a particular AD over another in relation to CVD risk.

Table of Contents

I.       CHAPTER I: LITERATURE REVIEW AND BACKGROUND 

II.       CHAPTER II: METHODOLOGY 

III.       CHAPTER III: RESULTS

IV.      DISCUSSION AND CONCLUSION

V.       REFERENCES: 

VI.       TABLES

VII.       FIGURES

VIII.       SUPPLEMENT 1: SAS CODE

IX.       SUPPLEMENT 2: SAS OUTPUT

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