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Antidepressant use before coronary artery bypass surgery is associated with long-term mortality

Malin Stenman1, Martin J Holzmann, Ulrik Sartipy

  • 1Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden.

International Journal of Cardiology
|September 11, 2012
PubMed

Insights

Preoperative antidepressant use in patients undergoing coronary artery bypass grafting (CABG) was linked to higher long-term mortality. This study highlights potential risks associated with antidepressant use before major cardiac surgery.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Research

Background:

  • Depression is prevalent in coronary artery disease (CAD) patients, increasing cardiovascular risks.
  • Existing research on antidepressant use before coronary artery bypass grafting (CABG) and patient survival yields conflicting results.
  • This study investigates the association between preoperative antidepressant use and post-CABG survival.

Purpose of the Study:

  • To examine the relationship between antidepressant use before CABG and long-term survival.
  • To assess the impact of preoperative antidepressant medication on mortality and rehospitalization rates after CABG.

Main Methods:

  • A cohort of 10,884 patients undergoing primary isolated non-emergent CABG in Sweden (2006-2008) was identified.
  • Data on baseline characteristics and antidepressant exposure (dispensed prescription before surgery) were obtained from national registries.
  • Survival and rehospitalization outcomes were analyzed using multivariable adjustment.

Main Results:

  • 11% of patients (1171) used antidepressants pre-surgery.
  • Antidepressant use was associated with unadjusted lower 4-year survival (89% vs. 92%).
  • Multivariable analysis revealed antidepressant use correlated with increased mortality (HR 1.45), rehospitalization (HR 1.40), and a composite of death or rehospitalization (HR 1.44).

Conclusions:

  • Preoperative antidepressant use in patients undergoing CABG is significantly associated with increased long-term mortality.
  • The findings indicate a strong link between antidepressant use before surgery and poorer survival outcomes.
  • Further research may be warranted to explore the mechanisms behind this association and optimize care for depressed cardiac patients.
Abstract

Keywords:
CABGCoronary artery diseaseDepressionSurvival

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