Journal article
Association Between Propranolol Use and Suicidal Ideation in Patients with Coronary Artery Disease: A Retrospective Cohort Study
Asian Journal of Medical Principles and Clinical Practice, v 8(2), pp 972-979
08 Nov 2025
Abstract
Objective: To examine through large-scale hospital data analysis whether propranolol use, compared to losartan use, is associated with an increased incidence of suicidal ideation in patients with coronary artery disease (CAD).Methods: Our retrospective cohort study was performed using the TriNetX Research Network. Two cohorts were created using TriNetX by filtering for ages 18-75 with a diagnosis of coronary artery disease. Cohort 1 was created by inclusion of losartan use and exclusion of propranolol use, resulting in 505,728 total patients while cohort 2 was created by inclusion of propranolol use and exclusion of losartan use, resulting in 56,284 total patients. These cohorts were compared for the outcome of suicidal ideation, narrowing our final groups to 4,796 patients in cohort 1 and 1,666 patients in cohort 2. The cohorts were comprised of predominantly male, white participants. The average age in the losartan cohort and the propranolol cohort was 65.3 and 62.7, respectively.Results: Risk analysis demonstrated a 3% elevated risk of a suicidal ideation diagnosis in the propranolol cohort and a 0.90% risk in the losartan cohort. The risk difference was -0.20 (95% CI: -0.022, -0.019, z= -42.465, p < 0.001) with a risk ratio of 0.320 (95% CI: 0.303, 0.339) and an odds ratio of 0.314 (95% CI: 0.297, 0.332). Survival analysis was conducted using the Kaplan-Meier curves, resulting in 98.37% survival for the losartan cohort and 95.31% survival for the propranolol cohort. It also calculated a hazard ratio of 0.317 (95% CI: 0.300,0.335, χ² = 35.044, df = 1, and p-value <0.001).Conclusion: We found a significant link between propranolol use and the incidence of suicidal ideation in patients. However, there is a need for further investigation because current literature is inconclusive regarding this issue. Physicians should carefully consider a patient’s history of suicidal ideation before prescribing the drug.
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Details
- Title
- Association Between Propranolol Use and Suicidal Ideation in Patients with Coronary Artery Disease: A Retrospective Cohort Study
- Creators
- Jiwon Kim - Drexel UniversityEduardo Espiridion - Reading Hospital
- Publication Details
- Asian Journal of Medical Principles and Clinical Practice, v 8(2), pp 972-979
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychiatry
- Other Identifier
- 991022132902704721