title: Use of antidepressant serotoninergic medications and cardiac valvulopathy: a nested case-control study in the health improvement network (THIN) database.
abstract: OBJECTIVE
  To quantify the risk of cardiac valvulopathy (CV) associated with the use of antidepressant serotoninergic medications (SMs).
  
  
  METHODS
  We conducted a case-control study nested in a cohort of users of antidepressant SMs selected from The Health Improvement Network database. Patients who experienced a CV event during follow-up were cases. Cases were ascertained in a random sample of them. Up to 10 controls were matched to each case by sex, age, month and year of the study entry. Use of antidepressant SMs during follow-up was defined as current (the last prescription for antidepressant SMs occurred in the 2 months before the CV event), recent (in the 2-12 months before the CV event) and past (>12 months before the CV event). We fitted a conditional regression model to estimate the association between use of antidepressant SMs and the risk of CV by means of odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Sensitivity analyses were conducted to test the robustness of our results.
  
  
  RESULTS
  The study cohort included 752,945 subjects aged 18-89 years. Throughout follow-up, 1663 cases (incidence rate: 3.4 per 10,000 person-years) of CV were detected and were matched to 16,566 controls. The adjusted OR (95% CI) for current and recent users compared with past users of antidepressant SMs were 1.16 (0.96-1.40) and 1.06 (0.93-1.22), respectively. Consistent effect estimates were obtained when considering cumulative exposure to antidepressant SMs during follow-up.
  
  
  CONCLUSIONS
  These results would suggest that exposure to antidepressant SMs is not associated with an increased risk of CV.
authors.affiliation: Department of Preclinical and Clinical Pharmacology 'Mario Aiazzi Mancini', University of Florence, Italy. francesco.lapi@uniﬁ.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Lapi
authors.forename: Federica
authors.initials: F
authors.lastname: Nicotra
authors.forename: Lorenza
authors.initials: L
authors.lastname: Scotti
authors.forename: Alfredo
authors.initials: A
authors.lastname: Vannacci
authors.forename: Mary
authors.initials: M
authors.lastname: Thompson
authors.forename: Francesco
authors.initials: F
authors.lastname: Pieri
authors.forename: Niccolò
authors.initials: N
authors.lastname: Mugelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Zambon
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mugelli
authors.forename: Annalisa
authors.initials: A
authors.lastname: Rubino
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000494:pharmacology; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044403:Receptor, Serotonin, 5-HT2B / Q000187:drug effects* / Q000378:metabolism; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk
chemical_list: D000928:Antidepressive Agents; D044403:Receptor, Serotonin, 5-HT2B