Concomitant Anticoagulant and Antidepressant Therapy in Atrial Fibrillation Patients and Risk of Stroke and Bleeding
We aimed to quantify the effects of antidepressant (AD) use in oral anticoagulant (OAC)‐treated patients with atrial fibrillation (AF). Using the Stockholm Healthcare database, we analyzed AF patients initiated with an OAC. Outcomes were severe bleeds and strokes and were analyzed using Cox models....
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| Published in: | Clinical pharmacology and therapeutics Vol. 107; no. 1; pp. 287 - 294 |
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01-01-2020
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| Abstract | We aimed to quantify the effects of antidepressant (AD) use in oral anticoagulant (OAC)‐treated patients with atrial fibrillation (AF). Using the Stockholm Healthcare database, we analyzed AF patients initiated with an OAC. Outcomes were severe bleeds and strokes and were analyzed using Cox models. We included 17,210 patients claiming warfarin and 13,385 claiming a non–vitamin K OAC. The number of patients that claimed an AD during follow‐up was 4,303. Concomitant OAC and AD use was associated with increased rates of severe bleeds (4.7 vs. 2.7 per 100 person‐years) compared with OAC treatment alone (adjusted hazard ratio (aHR) 1.42, confidence interval (CI): 1.12–1.80), but not significantly associated with increased stroke rates (3.5 vs. 2.1 per 100 person‐years, aHR 1.23, CI: 0.93–1.62). No significant differences in risks were observed between different OAC classes or different AD classes. In conclusion, concomitant use of an OAC and an AD is associated with an increased bleeding risk. |
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| AbstractList | We aimed to quantify the effects of antidepressant (AD) use in oral anticoagulant (OAC)‐treated patients with atrial fibrillation (AF). Using the Stockholm Healthcare database, we analyzed AF patients initiated with an OAC. Outcomes were severe bleeds and strokes and were analyzed using Cox models. We included 17,210 patients claiming warfarin and 13,385 claiming a non–vitamin K OAC. The number of patients that claimed an AD during follow‐up was 4,303. Concomitant OAC and AD use was associated with increased rates of severe bleeds (4.7 vs. 2.7 per 100 person‐years) compared with OAC treatment alone (adjusted hazard ratio (aHR) 1.42, confidence interval (CI): 1.12–1.80), but not significantly associated with increased stroke rates (3.5 vs. 2.1 per 100 person‐years, aHR 1.23, CI: 0.93–1.62). No significant differences in risks were observed between different OAC classes or different AD classes. In conclusion, concomitant use of an OAC and an AD is associated with an increased bleeding risk. |
| Author | Klungel, Olaf H. Wettermark, Björn Hjemdahl, Paul Mantel‐Teeuwisse, Aukje K. Forslund, Tomas Komen, Joris J. |
| Author_xml | – sequence: 1 givenname: Joris J. surname: Komen fullname: Komen, Joris J. organization: Public Healthcare Services Committee – sequence: 2 givenname: Paul surname: Hjemdahl fullname: Hjemdahl, Paul organization: Karolinska University Hospital Solna – sequence: 3 givenname: Aukje K. orcidid: 0000-0002-8782-0698 surname: Mantel‐Teeuwisse fullname: Mantel‐Teeuwisse, Aukje K. organization: Utrecht University – sequence: 4 givenname: Olaf H. orcidid: 0000-0002-5604-813X surname: Klungel fullname: Klungel, Olaf H. organization: Utrecht University – sequence: 5 givenname: Björn surname: Wettermark fullname: Wettermark, Björn organization: Karolinska University Hospital Solna – sequence: 6 givenname: Tomas surname: Forslund fullname: Forslund, Tomas email: tomas.forslund@sll.se organization: Karolinska University Hospital Solna |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31506933$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:141839191$$DView record from Swedish Publication Index |
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| Title | Concomitant Anticoagulant and Antidepressant Therapy in Atrial Fibrillation Patients and Risk of Stroke and Bleeding |
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