title: Antidepressant use and risk of coronary heart disease: meta-analysis of observational studies.
abstract: OBJECTIVE
  Our goal was to evaluate the association between antidepressant use and the risk of coronary heart disease (CHD) among subjects with no history of coronary heart disease.
  
  
  METHODS
  A search of Medline, EMBASE, PsycINFO and the Cochrane Library was performed in January 2013. Two authors independently reviewed and selected eligible observational studies, based on predetermined selection criteria. Pooled relative risks (RRs) with confidence intervals (CIs) were calculated using random-effects or fixed-effects models.
  
  
  RESULTS
  Sixteen observational studies (seven case-control studies and nine cohort studies) were included in the final analysis. There was no association between selective serotonin reuptake inhibitor use and the risk of CHD overall [odds ratio (OR), 0.93; 95% CI, 0.65-1.33] or in subgroup meta-analysis of case-control studies (OR, 0.91; 95% CI, 0.60-1.37) and cohort studies (RR, 0.96; 95% CI, 0.59-1.55). The use of tricyclic antidepressant was associated with an increased risk of CHD overall (OR, 1.51; 95% CI, 1.07-2.12), but it was observed only in case-control studies (OR, 1.56; 95% CI, 1.24-1.96) and low-quality studies (OR, 1.49; 95% CI, 1.20-1.85) in the subgroup meta-analyses.
  
  
  CONCLUSIONS
  This meta-analysis of observational studies in subjects with no history of CHD suggests that neither selective serotonin reuptake inhibitor nor tricyclic antidepressant use is associated with an increased risk of CHD.
authors.affiliation: Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Repulbic of Korea.
authors.forename: Seung-Won
authors.initials: SW
authors.lastname: Oh
authors.forename: Joonseok
authors.initials: J
authors.lastname: Kim
authors.forename: Seung-Kwon
authors.initials: SK
authors.lastname: Myung
authors.forename: Seung-Sik
authors.initials: SS
authors.lastname: Hwang
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Yoon
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects; D003327:Coronary Disease / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects
chemical_list: D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors
keywords: antidepressant; coronary heart disease; meta-analysis; myocardial infarction; selective serotonin reuptake inhibitor; tricyclic antidepressant