The effect of selective serotonin re‐uptake inhibitors on the risk of myocardial infarction in a cohort of patients with depression

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Depression is associated with an increased risk of cardiovascular disease. Some studies, but not all, have identified an association between use of selective serotonin re‐uptake inhibitors (SSRIs) and reduced risk of myocardial infarction (MI). There may be a difference among SSRIs based on their affinity for the serotonin receptor. WHAT THIS STUDY ADDS • Current use of SSRIs by patients with depression may be associated with a reduced risk of MI. However, the risk seemed to be reduced only with longer term use of SSRIs. In addition, we did not observe a relationship between the affinity of SSRIs for the serotonin transporter and risk of MI. AIM To evaluate whether selective serotonin re‐uptake inhibitor (SSRI) exposure influences the risk of myocardial infarction (MI) in patients with depression. METHODS This study included 693 patients with MI (cases) and 2772 controls. Conditional logistic regression was used to calculate the odds ratio (OR). RESULTS SSRI exposure may be associated with a reduced MI risk (OR = 0.77, 95% CI 0.57, 1.03). However, reduced risk was only observed with longer term use (OR = 0.73, 95% CI 0.53, 1.00) and not with shorter term use (OR = 1.15, 95% CI: 0.65, 2.05). CONCLUSIONS Only longer term use of SSRIs was associated with reduced MI risk, suggesting that other mechanisms, besides an acute anti‐platelet effect, may reduce MI risk.