Inhibitory effect of SSRIs on platelets may contribute to benefit in cardiac patients

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Last Updated: 2001-07-10 17:16:04 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – Chronic therapy with selective serotonin reuptake inhibitors (SSRIs) significantly inhibits baseline platelet characteristics in patients with coronary artery disease, according to a report in the June 15th issue of The American Journal of Cardiology.

Dr. Victor L. Serebruany, of Sinai Hospital of Baltimore, in Maryland, and colleagues suggest that this finding may explain why SSRIs are beneficial for the survival of patients who experience ischemic events.

The investigators note that "it has been established that serotonin not only has a role in the neuropathophysiology of depression, but also participates in hemostasis by affecting platelet aggregation."

The researchers studied the effects of SSRI therapy on platelet characteristics in 126 patients undergoing coronary artery stenting, including 34 patients being treated with SSRI and 92 SSRI-free patients. All subjects had received at least 81 mg of aspirin for at least 1 week before the procedure, 325 mg on the day of the procedure and every day after. "No patient received thienopyridines or glycoprotein IIb/IIIa inhibitors."

Overall, patients receiving SSRIs had less platelet activation than patients not receiving SSRIs. "These differences reached statistical significance for adenosine diphosphate- and collagen-induced aggregation, glycoprotein IIb/IIIa, P-selectin, and CD 107a expression," the team says.

"The inhibitory effects of SSRIs on platelet function observed in our study may be directly related to the association between treatment of depression and improved outcomes in patients with coronary artery disease," Dr. Serebruany and colleagues conclude.

"In recognizing antiplatelet properties of SSRIs, their combination with thienopyridines and glycoprotein IIb/IIIa inhibitors should be considered with caution," they point out. "Future strategies must consider safe approaches to protect platelets from extensive activation, and for these purposes SSRIs may represent an optimal class of dual agents treating depression and simultaneously inhibiting platelets."

Am J Cardiol 2001;87:1398-1400.

-Westport Newsroom 203 319 2700

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