Table 1.
Characteristics of studies of antidepressants and coronary heart disease risk included in the final analysis (n = 16)
| Study (reference) | Country | Years enrolled | Population (age, years) | Exposure assessment | Category of antidepressant | Definition of use (highest category) | Main outcome | OR or RR (95% CI) | Adjustment for depression | |
|---|---|---|---|---|---|---|---|---|---|---|
| Case–control studies | ||||||||||
| 1 | Penttinen & Valonen (1996) [5] | Finland; nested CC | 1979–1980 | 83 cases and 249 controls; men (NA) | Community healthcare unit records | TCA | NA | MI | 5.40 (1.80–16.10) | No |
| 2 | Hippisley-Cox et al. (1998) [14] | UK | 1996 | 327 cases and 897 controls (68.7) | Computerized data | TCA | Use during 5 years preceding the diagnosis | IHD | Men: 3.55 (0.89–14.21) Women: 0.94 (0.37–2.35) |
Yes |
| 3 | Hippisley-Cox et al. (2001) [7] | UK | 1995–1999 | 933 cases and 5516 controls (NA) | Computerized data | TCA SSRI |
Use during 7.5 years preceding the diagnosis | IHD | 1.29 (0.89–1.87) 1.56 (1.18–2.05) |
No |
| 4 | Sauer et al. (2001) [11] | USA | 1995–1997 | 653 cases and 2990 controls (30–65) | Telephone interview | SSRI | Use during the week before the index date | MI | 0.35 (0.18–0.68) | No |
| 5 | Sauer et al. (2003) [55] | USA | 1998–2001 | 1080 cases and 4256 controls (40–75) | Telephone interview | SSRI TCA |
Use during the week before the index date | MI | 0.72 (0.49–1.05) 1.63 (0.89–2.88) |
No |
| 6 | Monster et al. (2004) [16] | Denmark | 1994–2002 | 5238 cases and 77,093 controls (21–102) | Prescription database | SSRI | Prescriptions redeemed in the 30 days before hospitalization | MI | 0.90 (0.67-1.19) | No |
| 7 | Tata et al. (2005) [8] | UK | 1988–2001 | 63,512 cases and 378,886 controls (over 18) | Prescription data | TCA SSRI |
Use during 28 days before index date | MI | 1.41 (1.37–1.45) 1.49 (1.43–1.56) |
No |
| Cohort studies | ||||||||||
| 1 | Lapane et al. (1995) [4] | USA | 1981 | 77 cases among 5998 (35–65) | Interview | TCA | Current use | IHD | 5.70 (2.60–12.80) | No |
| 2 | Pratt et al. (1996) [13] | USA | 1981 | 64 cases among 1551 (over 18) | Interview | TCA | Ever use | MI | 1.30 (0.52–3.29) | Yes |
| 3 | Cohen et al. (2000) [3] | USA | 1991–1992 | 207 cases among 54,997 (25–65) | Prescription data | TCA SSRI |
At least one prescription during the accrual period (1991, 1992) | MI | 2.20 (1.20–3.80) 0.80 (0.20–3.50) |
No |
| 4 | Blanchette et al. (2008) [9] | USA | 1997–2001 | 1052 SSRI users and 10,856 non-antidepressant users (over 65) | Interview | SSRI | Use during the baseline year | MI | 1.85 (1.13-3.04) | Yes |
| 5 | Smoller et al. (2009) [17] | USA | 1993–1998 | 2983 cases among 136,293 women (50–79) | Questionnaire | SSRI TCA |
Current use (first follow-up visit) | MI or CHD death | 0.95 (0.70–1.29) 1.13 (0.77–1.65) |
Yes |
| 6 | Rosenberg et al. (2010) [6] | Canada | 1995 | 147 cases among 970 (61) | Interview | SSRI TCA |
Current use (baseline visit) | IHD | 1.33 (0.49–3.64) 2.10 (1.09–4.06) |
Yes |
| 7 | Hamer et al. (2011) [19] | UK | 1995–2003 | 969 cases among 14,784 (52.4) | Interview | TCA SSRI |
Current use (baseline interview) | MI or CHD death | 1.24 (0.87–1.75) 0.81 (0.49–1.33) |
Yes |
| 8 | Scherrer et al. (2011) [12] | USA; retrospective | 1999–2000 | 93,653 depressed patients (51.5) | Patient records | SSRI TCA |
≥12 weeks of continuous use | MI | 0.48 (0.44–0.52) 0.39 (0.34–0.44) |
Yes |
| 9 | Coupland et al. (2011) [10] | UK | 1996–2007 | 60,746 depressed patients (over 65) | Medical record system | TCA SSRI |
At least one prescription | MI | 1.09 (0.96–1.23) 1.15 (1.04–1.27) |
Yes |
Abbreviations are as follows: CHD, coronary heart disease; CI, confidence interval; IHD, ischaemic heart disease; MI, myocardial infarction; NA, not available; OR, odds ratio; RR, relative risk; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant.