Major depressive disorder (MDD) is a common comorbidity among patients with ST-segment elevation myocardial infarction (STEMI) and has been associated with poorer cardiovascular outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacologic treatment for MDD, but their impact on outcomes following STEMI remains incompletely understood.

In a study published in the International Journal of Cardiology, investigators conducted a retrospective cohort study using data from the TriNetX Research Network to evaluate the association between baseline SSRI use and clinical outcomes among patients with STEMI and MDD. Propensity score matching was used to balance demographic characteristics, cardiovascular risk factors, psychiatric comorbidities, and cardiac medications.

Findings

• Among 22,427 patients with STEMI and MDD, approximately 19% had documented SSRI use before or at the time of the index STEMI event.
• Baseline SSRI therapy was associated with lower all-cause mortality at 30 days, 1 year, and 3 years following STEMI in propensity-matched analyses.
• SSRI use was not associated with an increased risk of recurrent myocardial infarction during follow-up.
• No association was observed between baseline SSRI therapy and ischemic stroke at any evaluated time point.
• Patients receiving SSRIs experienced higher rates of major bleeding at 3 years and increased hospital readmissions at 1 year after STEMI.

Investigators concluded that baseline SSRI use was associated with improved survival among patients with STEMI and comorbid MDD, without an accompanying increase in recurrent myocardial infarction or ischemic stroke.