Key result
The use of SSRIs in depressed patients with previous cardiovascular events significantly decreased the risk of MACE (RR 0.74; 95% CI 0.55-0.99).
Why the study?
Do selective serotonin reuptake inhibitors (SSRIs) reduce major adverse cardiovascular events in depressed patients with previous cardiovascular events?
Meta-Analysis
Do selective serotonin reuptake inhibitors (SSRIs) reduce major adverse cardiovascular events in depressed patients with previous cardiovascular events?
Effect estimate: RR 0.74 (95% CI 0.55-0.99)
In depressed patients with prior cardiovascular events, SSRI use is associated with a significantly lower risk of MACE, driven primarily by a reduction in myocardial infarction.
Supports SSRI consideration to lower MACE in depressed patients with prior CV events; extends meta-analytic evidence for CV benefit.
It has been reported that selective serotonin reuptake inhibitors (SSRIs) might induce major adverse cardiovascular events (MACE), but the association between the use of SSRIs and MACE has not been elucidated as yet. Therefore, the aim of this study was to evaluate the association between the use of SSRIs and MACE in depressed patients with previous cardiovascular events. Two researchers independently selected randomized-controlled studies (RCTs) according to the predefined inclusion criteria and evaluated the quality of articles. A quantitative analysis was carried out to estimate pooled risk ratios (RRs) for the association between the use of SSRIs and MACE. Ten RCTs were selected in the final analysis. The use of SSRIs in depressed patients with previous cardiovascular events significantly decreased the risk of MACE [RR: 0.74; 95% confidence interval (CI): 0.55-0.99]. The risk of myocardial infarction was also reduced significantly (RR: 0.59, 95% CI: 0.37-0.93), associations with stroke and all-cause-death (cardiac or other causes): risk of stroke (RR: 0.88, 95% CI: 0.35-2.25) or all-cause death (RR: 0.83; 95% CI: 0.66-1.05). This meta-analysis suggests that the use of SSRIs decreased the risk of MACE by significantly reducing the risk of myocardial infraction in patients with depression and previous cardiovascular events.
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Kim et al. (2018) conducted a meta-analysis in Depression with previous cardiovascular events. Selective serotonin reuptake inhibitors (SSRIs) was evaluated on Major adverse cardiovascular events (MACE) (RR 0.74, 95% CI 0.55-0.99). The use of SSRIs in depressed patients with previous cardiovascular events significantly decreased the risk of MACE (RR 0.74; 95% CI 0.55-0.99).
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