Exposure to tricyclic antidepressants is associated with an increased risk of incident CHD events in a population-based study

Abstract

The purpose of this study was to assess the association between antidepressant use and incident coronary heart disease (CHD) events in a sample of individuals without known baseline heart disease. We studied a group of 970 randomly selected community-dwelling adults in the 1995 Nova Scotia Health Survey, who were followed for up to 10 years. Antidepressant usage was classified according to class. Primary outcomes were acute coronary syndrome hospitalizations or cardiac death, determined by centralized, standardized ratings. During a follow-up period of 10 years, there were 147 incident CHD events (139 acute coronary syndromes and 8 cardiac deaths) during the 8129 person-years of observation (incidence rate = 18.1 events/1000 person-years). In a model controlling for age, sex, Framingham risk score, time to last annual exam, aspirin exposure, and depressive symptoms, an increased risk of CHD events was associated with tricyclic antidepressant exposure (adjusted hazard ratio, 2.10; 95% confidence interval, 1.09-4.06; p = 0.027). In this prospective population-based study, exposure to tricyclic antidepressants was associated with higher risk of first CHD events.