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P16

Poster
The perilousness of antidepressant drugs in a real-world cohort of patients with acute coronary syndrome.

A. Denegri1, L. Raeber2, S. Windecker2, B. Gencer3, F. Mach3, N. Rodondi2, D. Heg2, D. Nanchen4, C. Matter5, T. F. Luescher5 (1Mantova IT; 2Bern ; 3Geneva ; 4Lausanne ; 5Zurich)


Background: Although antidepressant therapy has been related to increased cardiovascular risk, depression and its adverse effects on prognosis is a well-recognized entity among acute coronary syndrome (ACS) patients. The aim of the study was to evaluate prevalence and outcome of antidepressant treatment in a real-world cohort of ACS patients.  

 

Methods: We sought to assess the prevalence of established antidepressant therapy (ADT) and its impact among 2,168 all-comers patients admitted to four Swiss University Hospital for acute coronary syndrome (ACS) and enrolled in the prospective multicenter SPUM registry (NCT 01000701). The primary endpoint was all-cause mortality. The association between ADT and mortality was tested by adjusted multivariable conditional logistic regression.

 

Results: Out of 2,168 ACS patients, 141 patients (6.5%) had ADT. Compared with the general ACS population, ADT patients were more likely to be unemployed (p=0.001) male (p=0.002), diabetic (p=0.010) already treated with cardiovascular preventive therapy with statins or beta-blockers (p<0.001). Patients with ADT presented a 2-fold risk of all-cause mortality (OR 2.2, 95%CI 1.20-4.00, p=0.009) with a 3-fold risk of non-cardiovascular (CV) death  (OR 3.24, 95%CI 1.10-9.70, p=0.026) and a 77% not significant higher risk of CV death (OR 1.77, 95%CI 0.83-3.80, p=0.130). This enhanced risk persisted after adjustment for confounding significant baseline characteristics, with a 47% (Adjusted HR 1.47, 95%CI 1.05-1.70, p=0.032, Figure 1).

 

Conclusions: Among a real-world cohort of ACS-patients, ADT is associated with a significant increased rate of all-cause mortality and non-CV death. These observations should lead clinicians to furtherly individualize ADT, employing newer and safer ADT, generally associated with a lower CV risk.

ISCP Figure.jpg
ISCP Figure.jpg
    
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Background: Although antidepressant therapy has been related to increased cardiovascular risk, depression and its adverse effects on prognosis is a well-recognized entity among acute coronary syndrome (ACS) patients. The aim of the study was to evaluate prevalence and outcome of antidepressant treatment in a real-world cohort of ACS patients.  

 

Methods: We sought to assess the prevalence of established antidepressant therapy (ADT) and its impact among 2,168 all-comers patients admitted to four Swiss University Hospital for acute coronary syndrome (ACS) and enrolled in the prospective multicenter SPUM registry (NCT 01000701). The primary endpoint was all-cause mortality. The association between ADT and mortality was tested by adjusted multivariable conditional logistic regression.

 

Results: Out of 2,168 ACS patients, 141 patients (6.5%) had ADT. Compared with the general ACS population, ADT patients were more likely to be unemployed (p=0.001) male (p=0.002), diabetic (p=0.010) already treated with cardiovascular preventive therapy with statins or beta-blockers (p<0.001). Patients with ADT presented a 2-fold risk of all-cause mortality (OR 2.2, 95%CI 1.20-4.00, p=0.009) with a 3-fold risk of non-cardiovascular (CV) death  (OR 3.24, 95%CI 1.10-9.70, p=0.026) and a 77% not significant higher risk of CV death (OR 1.77, 95%CI 0.83-3.80, p=0.130). This enhanced risk persisted after adjustment for confounding significant baseline characteristics, with a 47% (Adjusted HR 1.47, 95%CI 1.05-1.70, p=0.032, Figure 1).

 

Conclusions: Among a real-world cohort of ACS-patients, ADT is associated with a significant increased rate of all-cause mortality and non-CV death. These observations should lead clinicians to furtherly individualize ADT, employing newer and safer ADT, generally associated with a lower CV risk.

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denegriandrea@msn.com ) [session] => stdClass Object ( [id] => 1 [name] => Poster [date] => 2019-05-09 [start] => 00:00:00 [end] => 00:00:00 [abbr] => P [updated] => [created] => 0000-00-00 00:00:00 ) [formatted_authors] => A. Denegri1, L. Raeber2, S. Windecker2, B. Gencer3, F. Mach3, N. Rodondi2, D. Heg2, D. Nanchen4, C. Matter5, T. F. Luescher5 (1Mantova IT; 2Bern ; 3Geneva ; 4Lausanne ; 5Zurich) [detail_url] => https://www.iscp2019.com/abstracts/presentation/8 )