title: Exposure to tricyclic antidepressants is associated with an increased risk of incident CHD events in a population-based study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  In this prospective population-based study, exposure to tricyclic antidepressants was associated with higher risk of first CHD events.
authors.forename: Leah B
authors.initials: LB
authors.lastname: Rosenberg
authors.forename: William
authors.initials: W
authors.lastname: Whang
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Ashish
authors.initials: A
authors.lastname: Shah
authors.forename: Peter A
authors.initials: PA
authors.lastname: Shapiro
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
mesh_terms: D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D003327:Coronary Disease / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000379:methods / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000929:Antidepressive Agents, Tricyclic