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Antidepressant use and risk of coronary heart disease: meta‐analysis of observational studies
Author(s) -
Oh SeungWon,
Kim Joonseok,
Myung SeungKwon,
Hwang SeungSik,
Yoon DaeHyun
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12383
Subject(s) - medicine , meta analysis , odds ratio , observational study , cohort study , relative risk , subgroup analysis , antidepressant , confidence interval , hippocampus
Aims Our goal was to evaluate the association between antidepressant use and the risk of coronary heart disease ( CHD ) among subjects with no history of coronary heart disease. Methods A search of M edline, EMBASE , PsycINFO and the C ochrane L ibrary was performed in J anuary 2013. Two authors independently reviewed and selected eligible observational studies, based on predetermined selection criteria. Pooled relative risks ( RR s) with confidence intervals ( CIs ) were calculated using random‐effects or fixed‐effects models. Results Sixteen observational studies (seven case–control studies and nine cohort studies) were included in the final analysis. There was no association between selective serotonin reuptake inhibitor use and the risk of CHD overall [odds ratio ( OR ), 0.93; 95% CI , 0.65–1.33] or in subgroup meta‐analysis of case–control studies ( OR , 0.91; 95% CI , 0.60–1.37) and cohort studies ( RR , 0.96; 95% CI , 0.59–1.55). The use of tricyclic antidepressant was associated with an increased risk of CHD overall ( OR , 1.51; 95% CI , 1.07–2.12), but it was observed only in case–control studies ( OR , 1.56; 95% CI , 1.24–1.96) and low‐quality studies ( OR , 1.49; 95% CI , 1.20–1.85) in the subgroup meta‐analyses. Conclusions This meta‐analysis of observational studies in subjects with no history of CHD suggests that neither selective serotonin reuptake inhibitor nor tricyclic antidepressant use is associated with an increased risk of CHD .