断続的なSTうつ病と心筋梗塞後の死亡率
W Ruberman1, R Crow, C R Rosenberg
1Department of Environmental Medicine, New York University School of Medicine, NY 10010-2598.
Circulation
|April 1, 1992
まとめ
断続的なSTうつ病 (STD) は,治療を受けていない心筋梗塞後の患者の死亡リスクを大幅に増加させます. プロプラノロルは,このリスクを軽減し,抗イシュケミアの保護効果を示唆する可能性があります.
科学分野:
- 心臓病学 心臓病学
- クリニック・リサーチ 臨床研究
- 罹病率と死亡率の研究
背景:
- 断続性STうつ病 (STD) が心筋梗塞 (MI) の後の患者の死亡率に与える影響を評価する.
- ベータブロッカー心臓発作試験のデータを用いて,症例対照分析を行いました.
研究 の 目的:
- 死亡率に対する中断性STうつ病の寄与を決定する.
- STDに関連する死亡率に対するプロプラノロルの潜在的な保護効果を調査する.
主な方法:
- STうつ病 (>= 0.1 mV >= 1 分間) を検出するために24時間のECGテープのコンピュータ解析.
- コンピューターで検出されたSTイベントの検証は,訓練された読者によるものです.
- 症例対照分析で,261人の死亡者を対照群と比較し,共変数を調整した.
主要な成果:
- 断続的なSTうつ病 (STD) は,死亡率に対する1.73の相対リスク (RR) と関連していました.
- 治療を受けていない患者では,STDのRRは2.56で高く,プロプラノロールを投与した患者ではRRは0.98.9でした.
- プラセボ群では用量依存関係が観察され,STD >30分でRRが4.33.3であった.
結論:
- 24時間モニタリングにおける一時的なSTうつ病は,治療を受けていない早期のポストMI生存者の死亡率に大きく寄与する.
- プロプラノロルの減少した効果は,抗発血メカニズムを示唆し,潜在的に死亡から保護します.
- STDを減らすことが生存率を改善するかどうかを調べるために,さらなる試験が必要である.
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