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Depression, antidepressants, and the risk of coronary heart disease: a population-based cohort study

Chun-Jen Huang1, Ming-Hsiung Hsieh, Wen-Hsuan Hou

  • 1Department of Anesthesiology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan, ROC; School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC; School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.

International Journal of Cardiology
|August 17, 2013
PubMed

Insights

Depression significantly increases the risk of coronary heart disease (CHD). Antidepressant use did not alter this increased risk in individuals with depression.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Growing evidence links depression to coronary heart disease (CHD) pathogenesis, primarily from Western studies.
  • Conflicting data exist on the association between antidepressant use and CHD incidence.
  • This study investigated depression's predictive role in CHD and the impact of antidepressant use.

Purpose of the Study:

  • To assess the risk of composite coronary events in individuals with newly diagnosed depression compared to a control group.
  • To examine the association between antidepressant use and coronary event risk in patients with depression.

Main Methods:

  • A population-based cohort study involving 39,685 individuals (7,937 with depression, 31,748 without) from Taiwan's National Health Insurance Program.
  • Follow-up for up to 9 years, identifying coronary events using ICD-9-CM codes and antidepressant use via ATC codes.
  • Multivariable analysis adjusting for relevant factors to determine hazard ratios.

Main Results:

  • Individuals with depression exhibited a significantly increased risk of newly detected coronary events (HR=1.49, 95% CI=1.29-1.74, p<0.001).
  • Use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) did not significantly modify the risk of composite coronary events among depressed individuals.

Conclusions:

  • Depression is independently associated with an elevated risk of coronary heart disease.
  • Current evidence does not support an association between the use of common antidepressants and coronary events in depressed patients.
Abstract

Keywords:
AntidepressantsCoronary artery bypass graftingCoronary heart diseaseDepressionMyocardial infarctionPercutaneous coronary intervention

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