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Depression following thrombotic cardiovascular events in elderly medicare beneficiaries: risk of morbidity and mortality.

Blanchette CM, Simoni-Wastila L, Shaya FT, Orwig D, Noel J, Stuart B - Cardiol Res Pract (2009)

Bottom Line: Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI) users.Conclusions.Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical and Outcomes Research, Lovelace Respiratory Research Institute, Albuquerque, NM 87108, USA.

ABSTRACT
Purpose. Depression and antidepressant use may independently increase the risk of acute myocardial infarction and mortality in adults. However, no studies have looked at the effect of depression on a broader thrombotic event outcome, assessed antidepressant use, or evaluated elderly adults. Methods. A cohort of 7,051 community-dwelling elderly beneficiaries who experienced a thrombotic cardiovascular event (TCE) were pooled from the 1997 to 2002 Medicare Current Beneficiary Survey and followed for 12 months. Baseline characteristics, antidepressant utilization, and death were ascertained from the survey, while indexed TCE, recurrent TCE, and depression (within 6 months of indexed TCE) were taken from ICD-9 codes on Medicare claims. Time to death and first recurrent TCE were assessed using descriptive and multivariate statistics. Results. Of the elders with a depression claim, 71.6% had a recurrent TCE and 4.7% died within 12 months of their indexed TCE, compared to 67.6% and 3.9% of those elders without a depression claim. Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI) users. Depression was associated with a shorter time to death (P = .008) in the unadjusted analysis. However, all adjusted comparisons revealed no effect by depression, antidepressant use, or SSRI use. Conclusions. Depression was not associated with time to death or recurrent TCEs in this study. Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

No MeSH data available.


Related in: MedlinePlus

Time to recurrent TCE by group.
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fig2: Time to recurrent TCE by group.

Mentions: Kaplan Meier survival plots showed that elders with a depression claim had a recurrent TCE sooner than other elders (Logrank P = .008). However, there was no difference in time to death between elders with a depression claim and those without. There also was no difference in time to recurrent TCE or death between any of the other subgroups of elders with a depression claim, antidepressant user compared to nonantidepressant user or SSRI users compared with other antidepressant users. Antidepressant users and SSRI users were compared to elders without depression claims and no difference was found in time to either recurrent TCE or death. Chi-square statistics were also calculated between each group for unadjusted comparisons of counts with similar nonsignificant findings (Figures 1 and 2).


Depression following thrombotic cardiovascular events in elderly medicare beneficiaries: risk of morbidity and mortality.

Blanchette CM, Simoni-Wastila L, Shaya FT, Orwig D, Noel J, Stuart B - Cardiol Res Pract (2009)

Time to recurrent TCE by group.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2800999&req=5

fig2: Time to recurrent TCE by group.
Mentions: Kaplan Meier survival plots showed that elders with a depression claim had a recurrent TCE sooner than other elders (Logrank P = .008). However, there was no difference in time to death between elders with a depression claim and those without. There also was no difference in time to recurrent TCE or death between any of the other subgroups of elders with a depression claim, antidepressant user compared to nonantidepressant user or SSRI users compared with other antidepressant users. Antidepressant users and SSRI users were compared to elders without depression claims and no difference was found in time to either recurrent TCE or death. Chi-square statistics were also calculated between each group for unadjusted comparisons of counts with similar nonsignificant findings (Figures 1 and 2).

Bottom Line: Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI) users.Conclusions.Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical and Outcomes Research, Lovelace Respiratory Research Institute, Albuquerque, NM 87108, USA.

ABSTRACT
Purpose. Depression and antidepressant use may independently increase the risk of acute myocardial infarction and mortality in adults. However, no studies have looked at the effect of depression on a broader thrombotic event outcome, assessed antidepressant use, or evaluated elderly adults. Methods. A cohort of 7,051 community-dwelling elderly beneficiaries who experienced a thrombotic cardiovascular event (TCE) were pooled from the 1997 to 2002 Medicare Current Beneficiary Survey and followed for 12 months. Baseline characteristics, antidepressant utilization, and death were ascertained from the survey, while indexed TCE, recurrent TCE, and depression (within 6 months of indexed TCE) were taken from ICD-9 codes on Medicare claims. Time to death and first recurrent TCE were assessed using descriptive and multivariate statistics. Results. Of the elders with a depression claim, 71.6% had a recurrent TCE and 4.7% died within 12 months of their indexed TCE, compared to 67.6% and 3.9% of those elders without a depression claim. Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI) users. Depression was associated with a shorter time to death (P = .008) in the unadjusted analysis. However, all adjusted comparisons revealed no effect by depression, antidepressant use, or SSRI use. Conclusions. Depression was not associated with time to death or recurrent TCEs in this study. Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

No MeSH data available.


Related in: MedlinePlus