Selective serotonin reuptake inhibitors, Venlafaxine and Duloxetine are associated with in hospital morbidity but not bleeding or late mortality after coronary artery bypass graft surgery
Date
2012
Authors
Tully, P.
Cardinal, T.
Bennetts, J.
Baker, R.
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Journal article
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Heart Lung and Circulation, 2012; 21(4):206-214
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Phillip J. Tully, Tess Cardinal, Jayme S. Bennetts, and Robert A. Baker
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Abstract
<h4>Background</h4>No Australian study has reported the association between selective-serotonin reuptake inhibitor (SSRI) and serotonin noradrenaline reuptake inhibitor (SNRI) with coronary artery bypass graft (CABG) surgery morbidity and mortality.<h4>Methods</h4>4136 patients underwent CABG surgery between January 1996 and December 2008 and 105 (2.5%) were SSRI/SNRI users. Bleeding events included platelet, fresh frozen plasma and packed red blood cell transfusion, reoperation for bleeding and gastrointestinal bleeding. In-hospital morbidity included renal failure, stroke, ventilation >24h, deep sternal wound infection, reoperation (any cause), myocardial infarction and mortality.<h4>Results</h4>Median follow-up was 4.7 years (interquartile range, 2.3-7.9 years) and there were 727 deaths (17.6% of total). Use of SSRI/SNRI was associated with new requirement for renal dialysis (adjusted OR = 2.18; 95% CI, 1.06-4.45, p = .03) and ventilation >24h (adjusted OR = 1.69; 95% CI, 1.03-2.78, p = .04). Neither SSRI/SNRI use nor SSRI/SNRI and concomitant anti-platelet medication increased the odds for any bleeding events (all p>.20). No association was evident with all-cause mortality (adjusted hazard ratio = 1.60; 95% CI .59-4.35, p = .36), or cardiac mortality (adjusted hazard ratio = .31; 95% CI, .04-2.26, p = .25).<h4>Conclusions</h4>SSRI/SNRI users experienced an increased risk of renal dysfunction and prolonged ventilation, but not bleeding events or long-term mortality after CABG surgery.
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Crown copyright © 2012 Published by Elsevier Ltd. on behalf of The Australasian Society of Cardiac and Thoracic Surgeons and The Cardiac Society of Australia and New Zealand All rights reserved.