Safety of selective serotonin reuptake inhibitor use prior to coronary artery bypass grafting.
BACKGROUND
Selective serotonin reuptake inhibitors (SSRIs) have been shown to increase bleeding risks. This study examined the association of perioperative coronary artery bypass grafting (CABG) bleeding risks and SSRI use prior to CABG.


OBJECTIVE
SSRI may be associated with increased bleeding risks after CABG resulting in elevated reoperation rates due to bleeding complications.


METHODS
Patients who underwent CABG between 1999 and 2003 (n = 4794) were identified in a tertiary medical center. SSRI use (n = 246) was determined using inpatient pharmacy records. Outcomes included primary end point of reoperation due to bleeding complications and other secondary measures. Multivariate regression models were constructed to adjust for baseline differences between SSRI and control groups.


RESULTS
Reoperation due to bleeding complications among SSRI users was not significantly different (odds ratio [OR]: 1.14 (0.52-2.47); P = 0.75) compared to the control group. Other secondary outcomes and 30-day mortality (2.0% in SSRI vs 2.1% in control group; P = 0.92) between the 2 groups were similar. However, the adjusted total volume of postoperative red blood cell (RBC) units transfused was higher in the SSRI group.


CONCLUSIONS
We conclude that there is no compelling evidence to limit the use of SSRIs among patients with coronary artery disease who undergo CABG given the current evidence. Further research may be needed on individual SSRI medications.
Xiong
Glen L
GL
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA. gxiong@ucdavis.edu
Jiang
Wei
W
Clare
Robert M
RM
Shaw
Linda K
LK
Smith
Peter K
PK
O'Connor
Christopher M
CM
Ranga
K
K
Krishnan
R
R
Kristin Newby
L
L
D000046:Academic Medical Centers; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D017707:Erythrocyte Transfusion; D005260:Female; D006400:Hematocrit; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000601:surgery; D057216:Propensity Score; D012042:Registries; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors