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Use of serotonin reuptake inhibitors is not associated with increased bleeding after CABG
Landspitali Univ Hosp, Iceland; Univ Iceland, Iceland.
Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Landspitali Univ Hosp, Iceland.
Landspitali Univ Hosp, Iceland.
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2020 (English)In: General Thoracic and Cardiovascular Surgery, ISSN 1863-6705 , E-ISSN 1863-6713, Vol. 68, p. 1312-1318Article in journal (Refereed) Published
Abstract [en]

Objectives Selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs) are the most commonly prescribed antidepressants worldwide. Studies suggest that SSRI/SNRIs can increase bleeding following different surgical procedures, including open heart surgery, but results are conflicting. The objective of this study was to analyse their effects on bleeding after coronary artery bypass grafting (CABG). Methods Of 1237 patients that underwent CABG in Iceland in 2007-2016, 97 (7.8%) used SSRIs/SNRIs preoperatively and were compared to a reference group (n = 1140). Bleeding was assessed using 24-h chest-tube output, number of RBC units transfused and reoperation for bleeding. Thirty-day mortality rates and incidence of complications were also compared. Results The two groups were comparable with respect to preoperative and operative variables, with the exception of BMI being significantly higher in the SSRI/SNRI group (30.2 vs. 28.3 kg/m(2), p < 0.001). No significant differences were observed between groups in 24-h chest-tube output [815 (SSRI/SNRI) vs. 877 ml (reference), p = 0.26], number of RBC units transfused (2.2 vs. 2.2, p = 0.99) or the rate of reoperation for bleeding (4.1% vs. 6.0%, p = 0.61). The incidences of complications and 30-day mortality rate were also similar. Conclusions Using three different criteria, preoperative use of SSRIs/SNRIs was not shown to increase bleeding after CABG. Furthermore, short-term complications as well as 30-day mortality rates did not differ from those of controls. Thus, temporary cessation of SSRI/SNRI treatment prior to CABG to decrease the risk of bleeding is unwarranted.

Place, publisher, year, edition, pages
SPRINGER JAPAN KK , 2020. Vol. 68, p. 1312-1318
Keywords [en]
CABG; SSRI; SNRI; Bleeding; Depression
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-165407DOI: 10.1007/s11748-020-01353-yISI: 000525147500002PubMedID: 32279198OAI: oai:DiVA.org:liu-165407DiVA, id: diva2:1427738
Note

Funding Agencies|Scientific Foundation of Landspitali and University of Iceland Research Foundation

Available from: 2020-04-30 Created: 2020-04-30 Last updated: 2021-04-14

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