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August 10, 2021Psychological MedicineOpen Access

Depression, anxiety, psychotropic drugs, and acute myocardial infarction: large prospective study of United Kingdom women

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Key result

Treatment for depression or anxiety with psychotropic drugs was not independently associated with an increased risk of acute myocardial infarction compared to no treatment (HR 0.96).

Why the study?

Reported associations between depression and myocardial infarction might be explained by psychotropic drug use, residual confounding, or reverse causation, warranting investigation in UK women without previous vascular disease.

Does treatment for depression or anxiety increase the risk of myocardial infarction in women without prior vascular disease?

Population

690 335 UK women with no prior heart disease, stroke, transient ischaemic attack, or cancer

Comparison

Treatment for depression or anxiety (with or without psychotropic drugs) vs not

Design

Prospective cohort study

Follow-up

Mean 13.9 years

Authors

LPLianne ParkinABAngela BalkwillJGJane Green

Discussion

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Member takes

Overview

Null findings after adjustment support no independent MI risk from depression; leaves open residual confounding or reverse causation in other groups.

Study Design

Type

Cohort (n=690,335)

Multicenter

Yes

Structured PICO

Does treatment for depression or anxiety increase the risk of myocardial infarction in women without prior vascular disease?

P
Population
690,335 UK women with no prior vascular disease or cancer, followed for a mean of 13.9 years to assess the risk of acute myocardial infarction associated with depression or anxiety.
E
Exposure
Treatment for depression or anxiety (subdivided by whether or not the treatment was with psychotropic drugs)
C
Comparator
No treatment for depression or anxiety
O
Outcome
First hospital admission or death from myocardial infarctionhard clinical

Main Result

Hazard Ratio: 0.96 (95% CI 0.89–1.03)

In a large prospective cohort of UK women, depression and anxiety were not found to be independent risk factors for myocardial infarction.

Limitations

  • Self-reported treatment for depression or anxiety rather than diagnostic psychiatric interviews
  • Did not adjust for ethnicity as most women in the study were White
  • Potential residual confounding despite extensive adjustment

Cite This Study

Parkin et al. (2021) conducted a cohort in Acute myocardial infarction (n=690,335). Treatment for depression or anxiety (with psychotropic drugs) vs. No treatment for depression or anxiety and no use of psychotropic drugs was evaluated on First hospital admission or death from acute myocardial infarction (HR 0.96, 95% CI 0.89-1.03). Treatment for depression or anxiety with psychotropic drugs was not independently associated with an increased risk of acute myocardial infarction compared to no treatment (HR 0.96).

synapsesocial.com/papers/6a7dd2b802c864aefccb4ddahttps://doi.org/10.1017/s0033291721003159
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Depressive disorder, coronary heart disease, and stroke: dose–response and reverse causation effects in the Whitehall II cohort study2014 · 82 citations
  2. 2The association of depression and all-cause and cause-specific mortality: an umbrella review of systematic reviews and meta-analyses2018 · 273 citations
  3. 3Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies2014 · 512 citations
  4. 4The role of health-related behavioural factors in accounting for inequalities in coronary heart disease risk by education and area deprivation: prospective study of 1.2 million UK women2016 · 46 citations
  5. 5Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England2012 · 62 citations