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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Trends in the prescribing of antidepressants following acute myocardial infarction, 1993-2002.
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Trends in the prescribing of antidepressants following acute myocardial infarction, 1993-2002.

机译：1993-2002年急性心肌梗死后抗抑郁药处方的趋势。

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OBJECTIVE: There has been a substantial increase in the prescribing of antidepressants on a population basis and in particular serotonin reuptake inhibitors (SSRIs). SSRIs have lower cardiac toxicity than tricyclic antidepressants (TCAs). We examined how the prescribing of antidepressants to patients post-myocardial infarction (MI) changed in the decade 1993 to 2002, including the proportion accounted for by TCAs. METHODS: A population-based study cross-sectional time series analysis was conducted in which quarterly antidepressant prescription data were obtained for 1993 to 2002 for elderly Ontarians who had experienced an MI, as well as for age- and sex-matched controls with no history of MI. The number of patients varied per quarter, for a total of 68,870 post-MI patients and an equal number of matched controls. Covariates included age, gender, income, and number of medications dispensed in the past year. RESULTS: Post-MI patients were more likely to receive an antidepressant relative to controls, with an overall odds ratio (OR) of 1.34; 95% confidence interval (CI), 1.29-1.38. However, with adjustment for the number of medications received, post-MI patients were 20% less likely to receive an antidepressant relative to controls, adjusted OR = 0.81; 95% CI, 0.78-0.84. The proportion of antidepressants prescribed to post-MI patients accounted for by TCAs decreased, but the proportion of post-MI patients receiving a TCA remained stable at approximately 6%. CONCLUSIONS: Increases in the prescription of antidepressants, and in particular SSRIs, to post-MI patients reflect general population trends rather than any special importance attached to treating post-MI depression. The apparent greater likelihood that post-MI patients will receive an antidepressant is reversed when total number of medications is controlled, a proxy for medical utilization and comorbidity.
机译：目的：基于人群的抗抑郁药，特别是血清素再摄取抑制剂（SSRIs）的处方已大大增加。 SSRIs的心脏毒性低于三环类抗抑郁药（TCA）。我们研究了1993年至2002年这十年间，抗抑郁药对心肌梗死（MI）患者开出的处方如何变化，包括三氯乙酸所占的比例。方法：进行了一项基于人群的研究横断面时间序列分析，其中获得了1993年至2002年每季度经历过MI的安大略老人的抗抑郁药处方数据，以及年龄和性别相匹配的无病史对照MI。患者的数量每季度变化一次，总共有68,870名MI后患者和相等数量的匹配对照。协变量包括年龄，性别，收入和过去一年分配的药物数量。结果：相对于对照组，心梗后患者更可能接受抗抑郁药，总比值比（OR）为1.34。 95％置信区间（CI）为1.29-1.38。然而，通过调整所接受的药物数量，相对于对照组，MI后患者接受抗抑郁药的可能性要低20％，调整后的OR = 0.81; 95％CI，0.78-0.84。由TCA占MI后患者开出的抗抑郁药的比例下降，但接受TCA的MI后患者的比例保持稳定在6％左右。结论：针对MI后患者的抗抑郁药，尤其是SSRIs的处方增加，反映了总体人群趋势，而不是对MI后抑郁症的特别重视。当控制药物的总数时，MI后患者接受抗抑郁药的更大可能性被逆转，这是医学利用和合并症的代表。

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