抑郁症症状升高预测心房动和心力衰竭患者的长期心血管死亡率
Nancy Frasure-Smith1, François Lespérance, Martine Habra
1Montreal Heart Institute Research Centre, Montreal, Quebec, Canada. nancy.frasure-smith@umontreal.ca
Circulation
|July 1, 2009
概括
抑郁症在患有心房动 (AF) 和充血性心力衰竭 (CHF) 的患者中显著增加心血管死亡风险. 患有抑郁症的未婚患者面临着最高的死亡风险,这凸显了进一步研究的必要性.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 临床研究 临床研究
背景情况:
- 抑郁症是众所周知的预测性因素,可以预测心脏病的不良结果,例如充血性心力衰竭 (CHF).
- 抑郁症在患有并发性心房动 (AF) 和心房的患者的预后影响仍未得到充分研究.
- 这项副研究分析了AF-CHF试验的数据,重点是患有减排分数,CHF症状和AF病史的患者接受最佳医疗护理.
研究的目的:
- 调查抑郁症是否预测AF和CHF同时存在的患者的长期心血管死亡率.
- 评估抑郁症与不同死亡原因之间的关联,包括心血管,心律失常和全因死亡率.
- 检查这种患者群体中抑郁症和婚姻状况对死亡率的综合风险.
主要方法:
- 利用了AF-CHF试验副研究中的974名参与者的数据.
- 使用贝克抑郁症目录-II (BDI-II) 评估抑郁症症状,较高的得分定义为BDI-II >=14.
- 采用考克斯的比例风险模型,调整多个预后因素,分析抑郁症和死亡结果之间的关系,平均随访时间为39个月.
主要成果:
- 32.0%的参与者表现出较高的抑郁症评分.
- 抑郁症得分升高显著预测了心血管死亡率 (HR 1.57),心律失常死亡率 (HR 1.69) 和全因死亡率 (HR 1.38).
- 与抑郁症和婚姻状况相关的风险是相加的,未婚抑郁症患者面临的风险最高.
结论:
- 抑郁症症状的升高与伴随性AF和CHF患者心血管死亡率的增加独立相关,即使治疗优化.
- 未婚状况进一步提高了患有AF和CHF的抑郁患者的死亡风险.
- 需要进一步研究这种关联和潜在的治疗策略背后的机制.
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