The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity |
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Authors: | Heidi T May Tami L Bair Brenda Reiss-Brennan Stacey Knight Jeffrey L Anderson Benjamin D Horne |
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Institution: | 1. Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA;2. Department of Medicine, University of Utah, Salt Lake City, UT, USA |
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Abstract: | Depression has been reported to be associated with a greater risk of death and cardiovascular disease (CVD); however, the impact of antidepressants (ADM) on CVD risk remains controversial. Statin use is known to decrease CVD risk. Whether the use of these medications together affects CVD risk has not been studied. Patients (N = 26,828) completing the patient health questionnaire (PHQ-9), ≥40 years of age, without prior CVD, and no prior ADM use were studied. Depressive severity was categorized as none-mild (PHQ-9 score ≤14, n = 21,517) and moderate-severe (PHQ-9 score ≥15, n = 5311). Cox hazard regression was used to evaluate the association of no ADM/no statin use (n = 23,104 86.1%]), ADM/no statin use (n = 877 3.3%]), no ADM/statin use (n = 2627 9.8%]), and ADM/statin use (n = 220 .8%]) with major adverse cardiovascular events (MACE: death, CAD, stroke). Patients averaged 56 ± 12 years; 61% female. There were 1182 (4.4%) 3 year MACE events. The association of ADM and statin use with MACE varied by depressive symptom severity, with statin therapy associated with a decreased risk in the none-mild group (HR = .78, p = .007) and ADM in the moderate-high group (HR = 0.58, p = 0.02). Concomitant use of ADMs and statins did not appear to provide additive benefit. |
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Keywords: | Depression antidepressant medication statins cardiovascular risk |
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