{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:39:33Z","timestamp":1778503173957,"version":"3.51.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"published-print":{"date-parts":[[2018]]},"abstract":"<b><i>Background:<\/i><\/b> To assess use of antidepressants by class in relation to cardiology practice recommendations, and the association of antidepressant use with the occurrence of major adverse cardiovascular events (MACE) including death. <b><i>Methods:<\/i><\/b> This is a historical cohort study of all patients who completed cardiac rehabilitation (CR) between 2002 and 2012 in a major CR center. Participants completed the Patient Health Questionnaire (PHQ-9) at the start and end of the program. A linkage system enabled ascertainment of antidepressant use and MACE through 2014. <b><i>Results:<\/i><\/b> There were 1,694 CR participants, 1,266 (74.7%) of whom completed the PHQ-9 after the program. Depressive symptoms decreased significantly from pre- (4.98 \u00b1 5.20) to postprogram (3.57 \u00b1 4.43) (<i>p<\/i> &#x3c; 0.001). Overall, 433 (34.2%) participants were on antidepressants, most often selective serotonin reuptake inhibitors (SSRI; <i>n<\/i> = 299; 23.6%). The proportion of days covered was approximately 70% for all 4 major antidepressant classes; discontinuation rates ranged from 37.3% for tricyclics to 53.2% for serotonin-norepinephrine reuptake inhibitors (SNRI). Antidepressant use was significantly associated with lower depressive symptoms after CR (before, 7.33 \u00b1 5.94 vs. after, 4.69 \u00b1 4.87; <i>p<\/i> &#x3c; 0.001). After a median follow-up of 4.7 years, 264 (20.9%) participants had a MACE. After propensity matching based on pre-CR depressive symptoms among other variables, participants taking tricyclics had significantly more MACE than those not taking tricyclics (HR = 2.46; 95% CI 1.37\u20134.42), as well as those taking atypicals versus not (HR = 1.59; 95% CI 1.05\u20132.41) and those on SSRI (HR = 1.45; 95% CI 1.07\u20131.97). There was no increased risk with use of SNRI (HR = 0.89; 95% CI 0.43\u20131.82). <b><i>Conclusion:<\/i><\/b> The use of antidepressants was associated with lower depression, but the use of all antidepressants except SNRI was associated with more adverse events.<\/jats:p>","DOI":"10.1159\/000486794","type":"journal-article","created":{"date-parts":[[2018,3,13]],"date-time":"2018-03-13T22:03:56Z","timestamp":1520978636000},"page":"85-94","source":"Crossref","is-referenced-by-count":36,"title":["Antidepressant Use by Class: Association with Major Adverse Cardiac Events in Patients with Coronary Artery Disease"],"prefix":"10.1159","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-3610","authenticated-orcid":false,"given":"Sherry\u00a0L.","family":"Grace","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose\u00a0R.","family":"Medina-Inojosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randal\u00a0J.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Krause","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin\u00a0S.","family":"Vickers-Douglas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian\u00a0A.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Lopez-Jimenez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2018,3,13]]},"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/486794","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/486794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:37:36Z","timestamp":1745426256000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000486794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,3,23]]},"published-print":{"date-parts":[[2018,4,5]]}},"URL":"https:\/\/doi.org\/10.1159\/000486794","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.5977024","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"value":"0033-3190","type":"print"},{"value":"1423-0348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}