Selective Serotonin Reuptake Inhibitors Increase Gastrointestinal but Not Other Site Bleeding Risk in Left Ventricular Assist Device Patients: A Systematic Review and Meta-Analysis
Pooled result · GI bleedingResult — go to the resultRelative risk 1.61 95% CI 1.19–2.17Authors' conclusion
In patients with LVADs, SSRI use is associated with a significantly increased risk of GI bleeding.
Study context
- Population
- Adults with implanted left ventricular assist devices (LVADs), tertiary care academic hospitals in the US and Europe
- Participants
- 1,108 adults
- Comparison
- Selective serotonin reuptake inhibitor (SSRI) exposure prior to or during LVAD support vs no SSRI therapy
- SSRIn = 431
- Controlsn = 677reference
- Outcome
- Gastrointestinal (GI) bleeding
Methodological detailsmulticentre
- Multicentre
Pooled result
As reported in the abstract
Relative risk
1.61
95% CI 1.19–2.17
P = 0.0019
SSRI vs Controls
RR 1.61 (95% CI 1.19–2.17); P = 0.0019
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Bleeding from any anatomical site | 1.44 (0.86–2.39) | P = 0.16 | |
| 0.512Relative risk (log scale) |
| Outcome | Mean difference (95% CI) | P value | |
|---|---|---|---|
| INR at time of GI bleeding | 0.22 (−0.71 to 1.16) | P = 0.64 | |
| −1−0.500.511.5Difference (linear scale) |
Sensitivity analyses and publication bias assessments
- Supported the robustness of the findings
Original publication
Selective Serotonin Reuptake Inhibitors Increase Gastrointestinal but Not Other Site Bleeding Risk in Left Ventricular Assist Device Patients: A Systematic Review and Meta-Analysis. J Cardiothorac Vasc Anesth. Published 16 July 2025. doi:10.
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