Adults with depression as identified by the use of antidepressants may be at greater risk for atrial fibrillation than those without depression, with the risk being especially high before the initiation of depression treatment, according to a study published in the European Journal of Preventive Cardiology.
“It is common knowledge that there is a connection between the mind and the heart,” Morten Fenger-Grøn, MSc, senior statistician of the research unit for general practice at Aarhus University, Denmark, said in a press release. “Depression predicts the development of coronary artery disease and worsens its prognosis. Our study investigated whether depression is also linked with atrial fibrillation.”
Researchers conducted a nationwide registry-based cohort study in which all patients initiating antidepressant treatment from 2000 to 2013 (n = 785,254; 40.8% men) were compared with a reference group in which they were matched 1:5.
The primary outcome was incidence of AF, and Cox regression models were used to estimate adjusted HRs for the association between depression, antidepressant treatment and AF.
Researchers found that, after adjusting for baseline characteristics, the use of antidepressants was associated with a threefold greater risk for AF in the first month after treatment initiation (adjusted HR = 3.18; 95% CI, 2.98-3.39) and that the association gradually lessened to a 37% (95% CI, 31-44) higher risk 2 to 6 months after the initiation of antidepressant therapy and lessened again to an 11% (95% CI, 6-16) higher risk 6 to 12 months after initiation.
The researchers also found that the association between depression and AF risk was very high in the month before starting antidepressant treatment (30 to 15 days before: aHR = 7.65; 95% CI, 7.05-8.3; 15 or fewer days before: aHR = 4.29; 95% CI, 3.94-4.67).
“Filling a prescription for antidepressants, which we used as an indicator of depression, was associated with a threefold greater risk of atrial fibrillation,” Fenger-Grøn said in the release. “The decrease with time could suggest that treatment may alleviate this risk. If you are depressed, there is no reason to worry that taking drug treatment will cause atrial fibrillation.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.