Wednesday, December 01, 2010

Tricyclics Increase CVD Risk

Quanto haverá nesta diferença de efeito de pré-seleção amostral ou de interesse da indústria?!...

By Nancy Walsh, Staff Writer, MedPage Today
Published: November 30, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor 
University of Pennsylvania School of Medicine.

Action Points  
  • Point out that since this was an observational study, it cannot determine causality, and the results could possibly be explained by residual confounding due to unmeasured or unknown risk factors.
Growing concern that patients taking tricyclic antidepressants are at increased risk for cardiovascular disease has been proven out in a large European study.
In a prospective cohort study that included 14,784 adults, those using tricyclics had a 35% increased cardiovascular risk after adjustment for potential confounders including symptoms of depression and anxiety, which are known risk factors for cardiovascular disease (HR 1.35, 95% CI 1.03 to 1.77).
In contrast, the use of selective serotonin reuptake inhibitors (SSRIs) was not associated with an elevated risk (HR 1.11, 95% CI 0.77 to 1.60), Mark Hamer, PhD, of University College London, and colleagues reported online in the European Heart Journal/.../

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