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Increase in heart surgery mortality from SSRIs or depression?

DURHAM, N.C. Duke University Medical Center researchers have found that patients who were using a class of anti-depression drugs known as selective serotonin reuptake inhibitors (SSRI) prior to undergoing coronary artery bypass surgery have significantly higher death and rehospitalization rates up to five years after the procedure than patients who were not on SSRIs.

The researchers said that, based on the results of their analysis of more than 4,700 heart patients, that physicians treating heart surgery patients should not only screen for depression prior to surgery, but that they should also pay closer attention to the long-term psychiatric care of patients deemed to be depressed.

"While many studies have shown that depression is just as important a cardiac risk factor as hypertension and smoking, there are still many in the field who do not fully appreciate this mind-body link," said Glen Xiong, M.D., who presented the results of the Duke study May 25, 2005, during the annual scientific sessions of the American Psychiatric Association in Atlanta.

"This under-appreciation may be because of the stigma associated with mental health issues," said Xiong, a resident in Duke's Medicine-Psychiatry program. "Many think that patients who have just had a heart attack are depressed and that with time, they'll get over it. Our study would indicate that these are the very patients who need to be followed more closely."

Their analysis of 4,794 heart surgery patients at Duke from 1999 to 2003 found that 5.1 percent of patients were taking SSRIs prior to surgery. When the researchers then checked survival rates four years later, they found that 75.1 percent of patients taking SSRIs were still alive, compared to 84.9 percent who weren't taking SSRIs.

"However, when we looked at the 30 days mortality following the operation, both groups were about the same," Xiong said. "It's only when patients get farther out from surgery that the mortality
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
25-May-2005


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