Effect of antidepressants on death in patients with heart failure: a systematic review and meta-analysis
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Effect of antidepressants on death in patients with heart failure: a systematic review and meta-analysis Wenfeng He 1 & Yue Zhou 2 & Jianyong Ma 3 & Bo Wei 4 & Yonghui Fu 4
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Depression 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 death (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 (RR = 1.03; 95% CI, 0.84–1.26), TCAs (RR = 1.02; 95% CI, 0.86–1.21), and SNRIs (RR = 0.92; 95% CI, 0.48–1.78)). Based on current publications, the use of antidepressants could increase the risk of all-cause death in HF patients, regardless of whether they have depression or the type of antidepressants they use. Further study is needed to determine the relationship between antidepressant use and cardiovascular death. Keywords Heart failure . Depression . Antidepressant . Death
Introduction Heart failure (HF) is associated with poor quality of life and frequent hospitalizations. Because of the increased risk of HFrelated death, HF represents a heavy burden on both family Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10741-019-09850-w) contains supplementary material, which is available to authorized users. * Yonghui Fu [email protected] 1
Jiangxi Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
2
Department of Children’s Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
3
Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
4
Department of Psychiatry, Jiangxi Mental Hospital, Nanchang 330029, Jian
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