SSRI Link to Bleeding After Heart Surgery Analyzed

SSRI and non-SSRI medications have similar incidence of postoperative bleeding and mortality

17 june 2009-- Selective serotonin reuptake inhibitor (SSRI) antidepressants pose no greater bleeding risk after coronary artery bypass graft (CABG) than non-SSRI antidepressants, according to a study in the May 15 American Journal of Cardiology.

Dae Hyun Kim, M.D., of Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a retrospective analysis of 1,380 adults, who received any antidepressant before CABG between 2003 and 2006, to evaluate incidents of bleeding and mortality and their association with the use of an SSRI antidepressant. The primary study end point was a composite percentage score incorporating bleeding events, including postoperative hemorrhage or hematoma; gastrointestinal hemorrhage; in-hospital mortality; and the need to reopen the surgical site.

Of the study group, 1,076 adults had received an SSRI antidepressant and 304 had received a non-SSRI antidepressant. Researchers found no significant differences in the composite score outcome (9.4 percent for SSRI versus 8.2 percent for non-SSRI). The groups were similar for any bleeding events (6.5 percent for SSRI versus 7.2 percent for non-SSRI) and in-hospital mortality (3.1 percent for SSRI versus 2.3 percent for non-SSRI). Subgroup analysis found no increased risk with SSRI antidepressants for patients undergoing antiplatelet and anticoagulant therapy for acute coronary syndromes or for a variety of other factors, including age, gender, nonsteroidal anti-inflammatory drug use, and whether CABG was performed on- or off-pump.

"In conclusion, compared with non-SSRIs, the preoperative use of SSRIs does not seem to increase the risk for bleeding or in-hospital mortality after CABG," the authors write.

Abstract
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