Effect of antidepressants on death in patients with heart failure: a systematic review and meta-analysis

AbstractDepression is associated with an increased risk of death in patients with heart failure (HF); however, the association between the use of antidepressants and HF prognoses remains controversial. Therefore, this meta-analysis aimed to evaluate the effect of antidepressants on the risk of death in HF patients. We retrieved data from the PubMed and EMBASE databases until August 2019 for studies reporting the use of antidepressants in HF patients. Data were extracted from the eligible articles, and a random effects model was used to pool the effect estimates (risk ratios (RRs) and 95% confidence intervals (CIs)). A total of 8 studies were included in this meta-analysis. Overall, the use of antidepressants was associated with increased risks of all-cause death (RR  = 1.27; 95% CI, 1.21–1.34) and cardiovascular death (RR = 1.14; 95% CI, 1.08–1.20) in HF patients with or without depression. Specifically, HF patients with depression taking antidepressants had increased risks of all-cause death (RR = 1.21; 95% CI, 1.16–1.27) and cardiovascular d eath (RR = 1.21; 95% CI, 1.13–1.30). Compared with nonusers, the use of selective serotonin reuptake inhibitors (SSRIs), tricyclics (TCAs), and selective serotonin reuptake inhibitors (SNRIs) significantly increased the rate of all-cause death (SSRIs (RR = 1.26; 95% CI, 1.19–1.32), TCAs (RR = 1.30; 95% CI, 1.16–1.46), and SNRIs (RR = 1.17; 95% CI, 1.08–1.26)) but not cardiovascular death (SSRIs ...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research