Safety of selective serotonin reuptake inhibitor in adults undergoing coronary artery bypass grafting.

Authors

• Dae Hyun Kim
• Constantine Daskalakis
• David J Whellan
• Isaac R Whitman
• Sam Hohmann
• Sofia Medvedev
• Walter K Kraft

Publication/Presentation Date

5-15-2009

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are commonly used in patients with coronary artery disease and depression, but they have been reported to increase the risk for bleeding. However, data on the short-term outcomes comparing SSRI and non-SSRI antidepressant use after coronary artery bypass grafting (CABG) are limited. A retrospective analysis was conducted of 1,380 adults who received any antidepressants before CABG from 2003 to 2006 at academic medical centers participating in the University HealthSystem Consortium. The primary end point was defined as a composite of in-hospital mortality or any bleeding events, including postprocedural hemorrhage or hematoma, gastrointestinal hemorrhage, and reopening of surgical site. A total of 1,076 adults (78%) received SSRIs. After controlling for propensity of receiving SSRIs compared with non-SSRIs, no significant differences were found in the primary end point (9.4% vs 8.2%, adjusted odds ratio [OR] 1.03, 95% confidence interval [CI] 0.60 to 1.78), any bleeding events (6.5% vs 7.2%, OR 0.93, 95% CI 0.50 to 1.76), or in-hospital mortality (3.1% vs 2.3%, OR 0.88, 95% CI 0.47 to 1.65). There was no increased risk associated with SSRI use when the analysis was restricted to patients who received antiplatelet and anticoagulant therapy for acute coronary syndromes (OR 1.03, 95% CI 0.40 to 2.61) and when examined by age, gender, nonsteroidal anti-inflammatory drug use, and type of CABG (on pump or off pump). In conclusion, compared with non-SSRIs, the preoperative use of SSRIs does not seem to increase the risk for bleeding or in-hospital mortality after CABG.

Volume

103

Issue

10

First Page

1391

Last Page

1395

ISSN

1879-1913

Published In/Presented At

Kim, D. H., Daskalakis, C., Whellan, D. J., Whitman, I. R., Hohmann, S., Medvedev, S., & Kraft, W. K. (2009). Safety of selective serotonin reuptake inhibitor in adults undergoing coronary artery bypass grafting. The American journal of cardiology, 103(10), 1391–1395. https://doi.org/10.1016/j.amjcard.2009.01.348

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

19427434

Department(s)

Administration and Leadership

Document Type

Article