Use of antidepressant serotoninergic medications and cardiac valvulopathy: a nested case-control study in the health improvement network (thin) database

British Journal of Clinical Pharmacology, 05/07/2012

These results would suggest that antidepressant serotoninergic medications (SMs) exposure is not associated with an increased risk of cardiac Valvulopathy (CV) .


  • Authors conducted a case–control study nested in a cohort of antidepressant SMs users selected from The Health Improvement Network database.
  • Patients who experienced a CV (index date) event during follow–up were cases.
  • Cases were ascertained in a random sample of them.
  • Up to 10 controls were matched to each case by sex, age, month and year of the study entry.
  • Antidepressant SMs use during follow–up was defined as current (the last antidepressant SMs prescription occurred in the 2 months before the index date), recent (in the 2–12 months before the index date) and past (≥ 12 months before the index date).
  • They fitted a conditional regression model to estimate the association between antidepressant SMs use and the risk of CV by means of Odds Ratios (OR) and corresponding 95% Confidence Intervals (CI).
  • Sensitivity analyses were conducted to test the robustness of the results.


  • The study cohort included 752,945 subjects aged 18–89 years.
  • Throughout follow–up 1663 (3.4 per 10,000 person–years) cases of CV were detected and were matched to 16566 controls.
  • The adjusted OR (95% CI) for current and recent users compared to past users of antidepressant SMs were 1.16 (0.96–1.40) and 1.06 (0.93–1.22), respectively.
  • Consistent effect estimates were obtained when considering cumulative exposure to antidepressant SMs during follow–up.

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