ArticleThe American journal of medicine2026
Inflammation-Associated Cardiovascular Risk Differs According to SSRI Use in Patients with Chronic Kidney Disease.
Article in The American journal of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients with chronic kidney disease experience cardiovascular mortality rates 2-5 times higher than the general population, partly driven by chronic inflammation. Selective serotonin reuptake inhibitors (SSRIs) possess anti-inflammatory properties, but whether their use is associated with lower levels of inflammation-associated cardiovascular disease in chronic kidney disease is unclear.
methodsWe analyzed 5,500 participants from the Chronic Renal Insufficiency Cohort using Cox regression to evaluate whether associations of inflammation (high-sensitivity C-reactive protein, hsCRP, and a composite inflammation score) with a composite of all-cause death, myocardial infarction, or stroke differed by SSRI use. Models adjusted for demographics, cardiovascular comorbidities, estimated glomerular filtration rate, albumin, hemoglobin, high-sensitivity troponin T, N-terminal pro-B-type natriuretic peptide, log-transformed 24-hour urine protein, cardiovascular medications, depression severity, and healthcare utilization and engagement.
resultsMean age was 60 ±11 years, 44% were female, and 43% were Black, and 11% used SSRIs. Over mean follow-up of 9.2 years, 2,506 (46%) experienced the composite outcome. Higher log-transformed hsCRP was associated with increased risk (per 1-unit increase: adjusted hazard ratio (aHR) 1.10, 95% confidence interval (CI) 1.06, 1.15), differing by SSRI use (P-interaction <0.01; aHR 1.12; 95%CI 1.08, 1.17 among non-users vs 0.91; 95%CI 0.80, 1.05 among SSRI users). Similar patterns were noted for a composite inflammatory score (P-interaction=0.04; aHR 1.15; 95%CI 1.09, 1.20 among non-users vs 0.95; 95%CI 0.81, 1.11 among SSRI users).
conclusionInflammatory markers were associated with cardiovascular risk in chronic kidney disease only among non-users of SSRIs. Future studies should explore the mechanisms underlying this differential association and whether SSRIs could be leveraged to reduce cardiovascular risk.
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