Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica
The leading cause of death in patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) is cardiovascular disease. The objective of this study was to determine whether the use of selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) in...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1509941/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850155805267984384 |
|---|---|
| author | Tianyu Zhang Chris A. Gentry Nicole M. Kuderer Gary H. Lyman Gary H. Lyman Bernard Ng Despina Michailidou Despina Michailidou |
| author_facet | Tianyu Zhang Chris A. Gentry Nicole M. Kuderer Gary H. Lyman Gary H. Lyman Bernard Ng Despina Michailidou Despina Michailidou |
| author_sort | Tianyu Zhang |
| collection | DOAJ |
| description | The leading cause of death in patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) is cardiovascular disease. The objective of this study was to determine whether the use of selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) in veterans with GCA and PMR could have a cardio-modulatory effect as compared to nonuse. Patients with GCA and PMR were identified through the Veterans Affairs Informatics and Computing Infrastructure. After a 2:1 propensity score matching for SSRI or SNRI users, we identified nonusers with similar covariates. We then applied a multivariate logistic regression (MLR), to calculate the odds ratio (OR) for cardiovascular event (CVE) outcomes within 5 years after the index date. Related hazard ratios (HR) were also calculated to validate the discovery of our findings. We identified 2249 patients with GCA and 3906 patients with PMR. Among patients with GCA, 174 (27%) SSRI users had incident cardiovascular disease as compared to 47 (28%) SNRI users and 277 (19%) nonusers; in the PMR cohort, 108 (13%) were SSRI users compared to 71 (15%) SNRI users and 255 (11%) nonusers. The adjusted ORs of the CVE outcome associated with venlafaxine (2.44, p=0.01) and sertraline (1.45, p=0.04) were significantly greater than 1 in GCA, with similar results observed in the PMR cohort (2.01, p=0.02, and 1.45, p=0.04, respectively). Cox-regression analysis was also conducted, and the hazard ratios were qualitatively consistent with the MLR analysis. In conclusion, the adjusted risk of CVE in patients with GCA or PMR using either venlafaxine or sertraline was higher than that in the non-exposed groups. |
| format | Article |
| id | doaj-art-5689635b742e4d7bb844199fc46f1967 |
| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-5689635b742e4d7bb844199fc46f19672025-08-20T02:24:46ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-04-011610.3389/fimmu.2025.15099411509941Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumaticaTianyu Zhang0Chris A. Gentry1Nicole M. Kuderer2Gary H. Lyman3Gary H. Lyman4Bernard Ng5Despina Michailidou6Despina Michailidou7Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, United StatesPharmacy Service, Oklahoma City VA Health Care System, Oklahoma City, OK, United StatesAdvanced Cancer Research Group, Kirkland, WA, United StatesDepartment of Medicine, Duke University School of Medicine, Durham, NC, United StatesPublic Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Center, Seattle, WA, United StatesVA National Rheumatology Program, Lexington, KY, United StatesDivision of Rheumatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United StatesDivision of Rheumatology, Oklahoma City VA Health Care System, Oklahoma City, OK, United StatesThe leading cause of death in patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) is cardiovascular disease. The objective of this study was to determine whether the use of selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) in veterans with GCA and PMR could have a cardio-modulatory effect as compared to nonuse. Patients with GCA and PMR were identified through the Veterans Affairs Informatics and Computing Infrastructure. After a 2:1 propensity score matching for SSRI or SNRI users, we identified nonusers with similar covariates. We then applied a multivariate logistic regression (MLR), to calculate the odds ratio (OR) for cardiovascular event (CVE) outcomes within 5 years after the index date. Related hazard ratios (HR) were also calculated to validate the discovery of our findings. We identified 2249 patients with GCA and 3906 patients with PMR. Among patients with GCA, 174 (27%) SSRI users had incident cardiovascular disease as compared to 47 (28%) SNRI users and 277 (19%) nonusers; in the PMR cohort, 108 (13%) were SSRI users compared to 71 (15%) SNRI users and 255 (11%) nonusers. The adjusted ORs of the CVE outcome associated with venlafaxine (2.44, p=0.01) and sertraline (1.45, p=0.04) were significantly greater than 1 in GCA, with similar results observed in the PMR cohort (2.01, p=0.02, and 1.45, p=0.04, respectively). Cox-regression analysis was also conducted, and the hazard ratios were qualitatively consistent with the MLR analysis. In conclusion, the adjusted risk of CVE in patients with GCA or PMR using either venlafaxine or sertraline was higher than that in the non-exposed groups.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1509941/fullgiant cell arteritispolymyalgia rheumaticaSSRISNRIischemic strokeTIA |
| spellingShingle | Tianyu Zhang Chris A. Gentry Nicole M. Kuderer Gary H. Lyman Gary H. Lyman Bernard Ng Despina Michailidou Despina Michailidou Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica Frontiers in Immunology giant cell arteritis polymyalgia rheumatica SSRI SNRI ischemic stroke TIA |
| title | Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| title_full | Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| title_fullStr | Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| title_full_unstemmed | Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| title_short | Association of SSRI and SNRI use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| title_sort | association of ssri and snri use with incidence of cardiovascular events in veterans with giant cell arteritis and polymyalgia rheumatica |
| topic | giant cell arteritis polymyalgia rheumatica SSRI SNRI ischemic stroke TIA |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1509941/full |
| work_keys_str_mv | AT tianyuzhang associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT chrisagentry associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT nicolemkuderer associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT garyhlyman associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT garyhlyman associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT bernardng associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT despinamichailidou associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica AT despinamichailidou associationofssriandsnriusewithincidenceofcardiovasculareventsinveteranswithgiantcellarteritisandpolymyalgiarheumatica |