Use of serotonin reuptake inhibitors is not associated with increased bleeding after CABG.

• Published in: General Thoracic and Cardiovascular Surgery
• Main Authors: Heimisdottir, Alexandra A, Enger, Eric, Morelli, Simon, Johannesdottir, Hera, Helgadottir, Solveig, Sigurðsson, Engilbert, Gudbjartsson, Tomas
• Other Authors: 1Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. 2Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 3Department of Medicine and Health, Linköping University, Linköping, Sweden. 4Anesthesiology and Intensive Care, Akademiska University Hospital, Uppsala, Sweden. 5Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland. 6Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. [e-mail]. 7Faculty of Medicine, University of Iceland, Reykjavik, Iceland. [e-mail].
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer 2020
• Subjects: Bleeding; CABG; Depression; SNRI; SSRI; Þunglyndislyf; Hjarta- og æðaskurðlækningar; Hjartaaðgerðir; Blæðingar (áverkar); Serotonin Uptake Inhibitors; Hemorrhage; Coronary Artery Bypass; Cardiovascular Surgical Procedures; Hjarta; Iceland
• Online Access: http://hdl.handle.net/2336/621390; https://doi.org/10.1007/s11748-020-01353-y

To access publisher's full text version of this article click on the hyperlink below 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/m2, 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. Scientific Foundation of Landspitali and University of Iceland Research Foundation