Evidence map›Paper›PMID 30900189›Full record

ArticleClinical drug investigation2019

Effect of Selective Serotonin Reuptake Inhibitors on Cardiovascular Outcomes After Percutaneous Coronary Intervention: A Retrospective Cohort Study.

Carlo J Iasella, Madeline S Kreider, Lin Huang, James C Coons, James M Stevenson

Abstract read
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In one paragraph

Article in Clinical drug investigation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Carlo J IasellaDepartment of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 335 Sutherland Drive, Room 209 Salk Pavilion, Pittsburgh, PA, 15261, USA.
Madeline S KreiderDepartment of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 335 Sutherland Drive, Room 209 Salk Pavilion, Pittsburgh, PA, 15261, USA.
Lin HuangDepartment of Pharmacy, Peking University People's Hospital, Beijing, China.
James C CoonsDepartment of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 335 Sutherland Drive, Room 209 Salk Pavilion, Pittsburgh, PA, 15261, USA.
James M StevensonDepartment of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 335 Sutherland Drive, Room 209 Salk Pavilion, Pittsburgh, PA, 15261, USA. stevenson@pitt.edu.ORCID http://orcid.org/0000-0003-1640-1135
University of Pittsburgh · USPeking University · CN

Funding

American Heart Association 17MCPRP33400175American Heart Association-American Stroke Association 17MCPRP33400176
6 · The paper itself

Abstract

backgroundDepression and coronary artery disease (CAD) are leading causes of death and disability and commonly co-occur. Different antidepressant classes have similar efficacy for depressed patients with CAD, but cardiovascular implications are unclear. Selective serotonin reuptake inhibitors (SSRIs) and mirtazapine are first-line options for depressed patients with CAD. SSRIs, but not mirtazapine, have known antiplatelet effects. Whether this affects risk of bleeding and major adverse cardiac events (MACE) in patients requiring dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is unknown.

objectiveThe aim of this analysis is to examine the impact of SSRI treatment on the co-primary endpoints of composite MACE (death, myocardial infarction, or stroke) and composite bleeding events in patients treated with clopidogrel-based DAPT after PCI.

methodsWe conducted a retrospective study with co-primary endpoints of bleeding and MACE within 1 year of PCI. Three groups were compared: SSRI patients, mirtazapine patients, and patients on neither agent. Mirtazapine acted as a comparator to control for depression, for which diagnosis coding was inadequate. Time-to-event analyses were performed with Kaplan-Meier estimators and adjusted analyses utilized Cox proportional hazards. There were 6874 (820 SSRI, 55 mirtazapine, 5999 neither) patients included.

resultsSSRI patients had lower MACE risk than mirtazapine patients (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.38-0.97, p = 0.036) but higher MACE risk than patients on neither agent (HR 1.21, 95% CI 1.02-1.43, p = 0.030) in adjusted analyses. No significant differences were associated with bleeding risk (SSRI vs. neither adjusted HR 1.07, 95% CI 0.93-1.24, p = 0.36).

conclusionSSRI use was associated with a significant decrease in MACE rates compared with patients receiving mirtazapine. Bleeding risk was not affected by either antidepressant treatment. SSRIs may have cardioprotective benefits compared with mirtazapine.

Indexed as

AgedClopidogrelCohort StudiesCoronary Artery DiseaseFemaleHemorrhageHumansMaleMyocardial InfarctionPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsRetrospective StudiesSelective Serotonin Reuptake InhibitorsStrokeTreatment OutcomeClopidogrelPlatelet Aggregation InhibitorsSelective Serotonin Reuptake Inhibitors

Identifiers

PMID30900189
OpenAlexW2924576838

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.