Relationship between antidepressant therapy and risk for cardiovascular events in patients with and without cardiovascular disease.
Identifieur interne : 000712 ( Main/Corpus ); précédent : 000711; suivant : 000713Relationship between antidepressant therapy and risk for cardiovascular events in patients with and without cardiovascular disease.
Auteurs : Kim L. Lavoie ; Nicola J. Paine ; Roxanne Pelletier ; André Arsenault ; Jean G. Diodati ; Tavis S. Campbell ; Louise Pilote ; Simon L. BaconSource :
- Health psychology : official journal of the Division of Health Psychology, American Psychological Association [ 1930-7810 ] ; 2018.
English descriptors
- KwdEn :
- Antidepressive Agents (adverse effects), Cardiovascular Diseases (chemically induced), Cardiovascular Diseases (complications), Cardiovascular Diseases (epidemiology), Depressive Disorder (drug therapy), Female (MeSH), Humans (MeSH), Incidence (MeSH), Male (MeSH), Middle Aged (MeSH), Myocardial Infarction (chemically induced), Myocardial Infarction (epidemiology), Proportional Hazards Models (MeSH), Prospective Studies (MeSH), Psychiatric Status Rating Scales (MeSH), Quebec (epidemiology), Risk Factors (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , adverse effects : Antidepressive Agents.
- chemically induced : Cardiovascular Diseases, Myocardial Infarction.
- complications : Cardiovascular Diseases.
- drug therapy : Depressive Disorder.
- epidemiology : Cardiovascular Diseases, Myocardial Infarction, Quebec.
- Female, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Treatment Outcome.
Abstract
OBJECTIVE
The American Heart Association has endorsed depression as a cardiac risk factor and recommends screening as part of routine practice. This has been met with controversy due to inconsistencies in the data linking depression treatment to better cardiovascular outcomes. Our objective was to prospectively assess the association between depression treatment (defined as being prescribed antidepressant medication) and major adverse cardiovascular events (MACE) in patients referred for exercise stress tests.
METHOD
Two thousand three hundred eighty-five consecutive patients presenting for myocardial perfusion exercise stress tests underwent a sociodemographic, medical, and psychiatric interview (Primary Care Evaluation of Mental Disorders [PRIME-MD]) and completed the Beck Depression Inventory (BDI). History of cardiovascular disease (CVD) and antidepressant use was self-reported and verified via chart review. Participants followed over an 8.8-year follow up, and information regarding MACE incidence (including cardiac mortality, nonfatal myocardial infarction, revascularization procedures, cerebrovascular events) was obtained from provincial administrative databases.
RESULTS
8% (n = 190) of the sample were taking antidepressants at baseline, 41% (n = 916) had a history of CVD, and 38.7% (n = 921) had depression according to the PRIME-MD or BDI. Antidepressant treatment was associated with a 30% reduced risk of MACE (Hazard ratio [HR] = 0.697; 95% confidence interval [CI] = [0.504, 0.964]; p = .029). A 46% reduction in risk was associated with antidepressant treatment among those without CVD (HR = 0.542; 95% CI [0.299, 0.981]; p = .043). In depressed patients, a 33% reduction in risk of MACE associated with antidepressant use was seen (adjusted HR = 0.674; 95% CI [0.440, 1.033]; p = .07).
CONCLUSIONS
Antidepressants may be cardio-protective among patients presenting for stress testing independent of risk factors including CVD and depression. Results support treating depression with antidepressants in this population to reduce risk of MACE. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
DOI: 10.1037/hea0000602
PubMed: 30247064
Links to Exploration step
pubmed:30247064Le document en format XML
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Paine</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Pelletier, Roxanne" sort="Pelletier, Roxanne" uniqKey="Pelletier R" first="Roxanne" last="Pelletier">Roxanne Pelletier</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Arsenault, Andre" sort="Arsenault, Andre" uniqKey="Arsenault A" first="André" last="Arsenault">André Arsenault</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Diodati, Jean G" sort="Diodati, Jean G" uniqKey="Diodati J" first="Jean G" last="Diodati">Jean G. 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Lavoie</name><affiliation><nlm:affiliation>Department of Psychology, University of Québec at Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Paine, Nicola J" sort="Paine, Nicola J" uniqKey="Paine N" first="Nicola J" last="Paine">Nicola J. Paine</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Pelletier, Roxanne" sort="Pelletier, Roxanne" uniqKey="Pelletier R" first="Roxanne" last="Pelletier">Roxanne Pelletier</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Arsenault, Andre" sort="Arsenault, Andre" uniqKey="Arsenault A" first="André" last="Arsenault">André Arsenault</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Diodati, Jean G" sort="Diodati, Jean G" uniqKey="Diodati J" first="Jean G" last="Diodati">Jean G. Diodati</name><affiliation><nlm:affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Campbell, Tavis S" sort="Campbell, Tavis S" uniqKey="Campbell T" first="Tavis S" last="Campbell">Tavis S. Campbell</name><affiliation><nlm:affiliation>Department of Psychology, University of Calgary.</nlm:affiliation></affiliation></author><author><name sortKey="Pilote, Louise" sort="Pilote, Louise" uniqKey="Pilote L" first="Louise" last="Pilote">Louise Pilote</name><affiliation><nlm:affiliation>Division of Clinical Epidemiology, McGill University Health Centre.</nlm:affiliation></affiliation></author><author><name sortKey="Bacon, Simon L" sort="Bacon, Simon L" uniqKey="Bacon S" first="Simon L" last="Bacon">Simon L. Bacon</name><affiliation><nlm:affiliation>Department of Health, Kinesiology and Applied Physiology, Concordia University.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Health psychology : official journal of the Division of Health Psychology, American Psychological Association</title><idno type="eISSN">1930-7810</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antidepressive Agents (adverse effects)</term><term>Cardiovascular Diseases (chemically induced)</term><term>Cardiovascular Diseases (complications)</term><term>Cardiovascular Diseases (epidemiology)</term><term>Depressive Disorder (drug therapy)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Myocardial Infarction (chemically induced)</term><term>Myocardial Infarction (epidemiology)</term><term>Proportional Hazards Models (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Psychiatric Status Rating Scales (MeSH)</term><term>Quebec (epidemiology)</term><term>Risk Factors (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antidepressive Agents</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Cardiovascular Diseases</term><term>Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Depressive Disorder</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cardiovascular Diseases</term><term>Myocardial Infarction</term><term>Quebec</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Proportional Hazards Models</term><term>Prospective Studies</term><term>Psychiatric Status Rating Scales</term><term>Risk Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>The American Heart Association has endorsed depression as a cardiac risk factor and recommends screening as part of routine practice. This has been met with controversy due to inconsistencies in the data linking depression treatment to better cardiovascular outcomes. Our objective was to prospectively assess the association between depression treatment (defined as being prescribed antidepressant medication) and major adverse cardiovascular events (MACE) in patients referred for exercise stress tests.</p></div><div type="abstract" xml:lang="en"><p><b>METHOD</b></p><p>Two thousand three hundred eighty-five consecutive patients presenting for myocardial perfusion exercise stress tests underwent a sociodemographic, medical, and psychiatric interview (Primary Care Evaluation of Mental Disorders [PRIME-MD]) and completed the Beck Depression Inventory (BDI). History of cardiovascular disease (CVD) and antidepressant use was self-reported and verified via chart review. Participants followed over an 8.8-year follow up, and information regarding MACE incidence (including cardiac mortality, nonfatal myocardial infarction, revascularization procedures, cerebrovascular events) was obtained from provincial administrative databases.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>8% (n = 190) of the sample were taking antidepressants at baseline, 41% (n = 916) had a history of CVD, and 38.7% (n = 921) had depression according to the PRIME-MD or BDI. Antidepressant treatment was associated with a 30% reduced risk of MACE (Hazard ratio [HR] = 0.697; 95% confidence interval [CI] = [0.504, 0.964]; p = .029). A 46% reduction in risk was associated with antidepressant treatment among those without CVD (HR = 0.542; 95% CI [0.299, 0.981]; p = .043). In depressed patients, a 33% reduction in risk of MACE associated with antidepressant use was seen (adjusted HR = 0.674; 95% CI [0.440, 1.033]; p = .07).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Antidepressants may be cardio-protective among patients presenting for stress testing independent of risk factors including CVD and depression. Results support treating depression with antidepressants in this population to reduce risk of MACE. (PsycINFO Database Record (c) 2018 APA, all rights reserved).</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">30247064</PMID><DateCompleted><Year>2018</Year><Month>11</Month><Day>26</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1930-7810</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>11</Issue><PubDate><Year>2018</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Health psychology : official journal of the Division of Health Psychology, American Psychological Association</Title><ISOAbbreviation>Health Psychol</ISOAbbreviation></Journal><ArticleTitle>Relationship between antidepressant therapy and risk for cardiovascular events in patients with and without cardiovascular disease.</ArticleTitle><Pagination><MedlinePgn>989-999</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1037/hea0000602</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The American Heart Association has endorsed depression as a cardiac risk factor and recommends screening as part of routine practice. This has been met with controversy due to inconsistencies in the data linking depression treatment to better cardiovascular outcomes. Our objective was to prospectively assess the association between depression treatment (defined as being prescribed antidepressant medication) and major adverse cardiovascular events (MACE) in patients referred for exercise stress tests.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">Two thousand three hundred eighty-five consecutive patients presenting for myocardial perfusion exercise stress tests underwent a sociodemographic, medical, and psychiatric interview (Primary Care Evaluation of Mental Disorders [PRIME-MD]) and completed the Beck Depression Inventory (BDI). History of cardiovascular disease (CVD) and antidepressant use was self-reported and verified via chart review. Participants followed over an 8.8-year follow up, and information regarding MACE incidence (including cardiac mortality, nonfatal myocardial infarction, revascularization procedures, cerebrovascular events) was obtained from provincial administrative databases.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">8% (n = 190) of the sample were taking antidepressants at baseline, 41% (n = 916) had a history of CVD, and 38.7% (n = 921) had depression according to the PRIME-MD or BDI. Antidepressant treatment was associated with a 30% reduced risk of MACE (Hazard ratio [HR] = 0.697; 95% confidence interval [CI] = [0.504, 0.964]; p = .029). A 46% reduction in risk was associated with antidepressant treatment among those without CVD (HR = 0.542; 95% CI [0.299, 0.981]; p = .043). In depressed patients, a 33% reduction in risk of MACE associated with antidepressant use was seen (adjusted HR = 0.674; 95% CI [0.440, 1.033]; p = .07).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Antidepressants may be cardio-protective among patients presenting for stress testing independent of risk factors including CVD and depression. Results support treating depression with antidepressants in this population to reduce risk of MACE. (PsycINFO Database Record (c) 2018 APA, all rights reserved).</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lavoie</LastName><ForeName>Kim L</ForeName><Initials>KL</Initials><AffiliationInfo><Affiliation>Department of Psychology, University of Québec at Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paine</LastName><ForeName>Nicola J</ForeName><Initials>NJ</Initials><Identifier Source="ORCID">0000-0001-9988-9310</Identifier><AffiliationInfo><Affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pelletier</LastName><ForeName>Roxanne</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arsenault</LastName><ForeName>André</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Diodati</LastName><ForeName>Jean G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Montreal Behavioural Medicine Centre, Research Center, CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Campbell</LastName><ForeName>Tavis S</ForeName><Initials>TS</Initials><AffiliationInfo><Affiliation>Department of Psychology, University of Calgary.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pilote</LastName><ForeName>Louise</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Division of Clinical Epidemiology, McGill University Health Centre.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bacon</LastName><ForeName>Simon L</ForeName><Initials>SL</Initials><AffiliationInfo><Affiliation>Department of Health, Kinesiology and Applied Physiology, Concordia University.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Canadian Institutes of Health Research</Agency><Country></Country></Grant><Grant><Agency>Heart and Stroke Foundation of Canada</Agency><Country></Country></Grant><Grant><Agency>Fonds de la recherche du Quebec-santé</Agency><Country></Country></Grant><Grant><Agency>Social Sciences and Humanities Research Council of Canada</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>09</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Health Psychol</MedlineTA><NlmUniqueID>8211523</NlmUniqueID><ISSNLinking>0278-6133</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000928">Antidepressive Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000928" MajorTopicYN="N">Antidepressive Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003866" MajorTopicYN="N">Depressive Disorder</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="N">Myocardial Infarction</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011569" MajorTopicYN="N">Psychiatric Status Rating Scales</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011792" MajorTopicYN="N">Quebec</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>9</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>11</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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