TABLE 3.
Major bleeding risk among patients with atrial fibrillation (AF) taking DOACs with or without concurrent antidepressants.
| Concurrent medication | Person-Quarters with DOAC use | No. of Bleeding Events | Crude Major Bleeding Incidence Rate (95% CI) per 1000 Person-Years | *Adjusted Incidence Rate (95% CI) per 1000 Person-Years | *Adjusted Rate Ratio (95% CI) | |||
| SNRI | ||||||||
| With | 6642 | 97 | 58.84 | (47.80–72.43) | 59.25 | (48.22–72.79) | 1.15 | (0.93–1.42) |
| †without | 698 879 | 7940 | 45.93 | (44.83–47.06) | 51.47 | (49.06–54.01) | 1 | |
| SSRI | ||||||||
| With | 25 344 | 329 | 51.86 | (46.29–58.09) | 52.47 | (46.90–58.71) | 1.02 | (0.91–1.15) |
| †without | 680 177 | 7708 | 45.83 | (44.72–46.97) | 51.45 | (49.92–53.01) | 1 | |
| TCA | ||||||||
| With | 25 083 | 319 | 50.99 | (45.44–57.21) | 51.4 | (45.84–57.63) | 1.02 | (0.91–1.15) |
| †without | 680 438 | 7718 | 45.87 | (44.75–47.01) | 50.38 | (48.92–51.90) | 1 | |
| TeCA | ||||||||
| With | 19 179 | 267 | 55.68 | (49.05–63.21) | 56.42 | (49.76–63.98) | 1.07 | (0.95–1.22) |
| †without | 686 342 | 7770 | 45.78 | (44.67–46.91) | 52.51 | (51.03–54.04) | 1 | |
| Others | ||||||||
| With | 3511 | 41 | 47.02 | (34.35–64.36) | 47.44 | (34.79–64.68) | 0.97 | (0.71–1.33) |
| †without | 702 010 | 7996 | 46.04 | (44.94–47.17) | 48.86 | (47.40–50.36) | 1 | |
| Bupropion | ||||||||
| With | 1457 | 26 | 71.61 | (49.25–104.11) | 71.8 | (49.55–104.04) | #1.49 | (1.02–2.16) |
| †without | 704 064 | 8011 | 46 | (44.90–47.12) | 48.33 | (46.75–49.97) | 1 | |
*Adjusted by inverse probability of treatment weighting using the propensity score (gender, age, medical utilization, hypertension, myocardial infarction, congestive heart failure, percutaneous coronary intervention, coronary bypass surgery, peripheral vascular disease, cerebrovascular disease, ischemic stroke, transient ischemic attack, hemiplegia or paraplegia, dementia, epilepsy, diabetes mellitus, chronic kidney disease, chronic pulmonary disease, peptic ulcer disease, liver disease, malignancy, anemia, rheumatic disease, human immunodeficiency virus infection, antibiotics and antifungal drugs, antiepileptics, antihypertensives, antiplatelets, bisphosphate, cardiovascular drugs, cyclosporine, glucocorticoid, insulin, lipid lower drugs, non-steroid anti-inflammatory drugs, residence, income level, and occupation; see Tables 1, 2 and Supplementary Tables 2–4).
†“Without” indicates DOACs alone.
#P < 0.05, compared with DOACs alone.
DOAC, direct oral anticoagulant; SNRI, selective serotonin–norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitors; TCA, tricyclic antidepressant; TeCA, tetracyclic antidepressant.