抑郁症和认知功能障碍与跨导管大动脉置换后以患者为中心的结果的关联
Bassim El-Sabawi1, Harrison Cloud1, Jay N Patel1
1Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (B.E.-S., H.C., J.N.P., S.P.B., R.N.P., A.V., N.J., B.R.L.).
Circulation. Cardiovascular interventions
|July 28, 2023
概括
抑郁和认知功能障碍在接受过导管大动脉置换 (TAVR) 的患者中很常见. 这些情况会增加死亡风险并恶化生活质量,这表明抑郁症可能是改善TAVR结果的目标.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 老年病的医生 老年病的医生
背景情况:
- 抑郁症和认知功能障碍 (CD) 在跨导管大动脉置换 (TAVR) 之前不会经常评估.
- 这些条件对TAVR后结果的影响尚不清楚.
研究的目的:
- 在接受TAVR的患者中确定抑郁症和CD的患病率.
- 评估抑郁症和CD与TAVR后死亡率和生活质量之间的关联.
主要方法:
- 对一个潜在的多中心TAVR注册表的分析.
- 在基线时对抑郁症 (患者健康问卷-2) 和CD (Mini-Cog) 进行系统查.
- 死亡率和生活质量的多变量顺序回归的Cox比例危险模型 (堪萨斯市心肌病问卷,EuroQol视觉模拟尺度).
主要成果:
- 在884名患者中,有19.6%患有抑郁症,31.8%在基线时患有CD.
- 抑郁症 (HR,1.45) 和慢性病 (HR,1.27) 都独立地与增加的死亡率有关.
- 患有抑郁症和CD的患者死亡风险最高 (HR,2.06).
- 抑郁症与TAVR后的生活质量得分明显降低有关.
结论:
- 抑郁症和CD在TAVR患者中很普遍,并且与更糟糕的结果有关.
- 针对抑郁症可能是一个可修改的策略,以提高TAVR后的结果.
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