心脏病死亡的五年风险与初始严重程度相关,以及心肌梗塞后抑郁症症状的一年变化
François Lespérance1, Nancy Frasure-Smith, Mario Talajic
1Department of Psychiatry, University of Montreal and McGill University, Canada. francois.lesperance@umontreal.ca
Circulation
|March 6, 2002
概括
心肌梗塞 (MI) 后的抑郁症状与长期的心脏死亡率有关. 较高的初始抑郁水平预示着更糟糕的结果,无论随着时间的推移症状的变化.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 以前的研究将抑郁症状与心肌梗塞 (MI) 后的心脏病死亡率联系起来.
- 之前的研究没有评估剂量反应关系或纵向评估抑郁症.
研究的目的:
- 调查心脏病发作后抑郁症状和长期心脏病死亡率之间的剂量反应关系.
- 为了比较住院期间评估的抑郁症症状的预后值与1年随访时的预后值.
主要方法:
- 在入院时和1年后给896名心脏病后心脏病患者使用贝克抑郁症库存.
- 使用医疗保险数据确定了5年生存期.
- 对心脏病严重程度的测量进行控制.
主要成果:
- 在入院抑郁症症状和心脏病死亡率之间观察到显著的长期剂量反应关系.
- 住院抑郁症得分与长期死亡率的关联比1年得分更强.
- 症状改善只对轻度抑郁症患者有好处;较高的初始得分预测预后更差.
结论:
- 入院后的抑郁水平对于心脏病后的长期存活比1年的水平更为关键,特别是在中度至重度抑郁症中.
- 心血管机制将抑郁症与死亡率联系起来,对一些患者来说可能是永久性的.
- 早期评估和治疗心脏病发作后的抑郁症对于改善长期心脏病结果至关重要.
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