在治疗耐药或严重抑郁症中发生重大心血管不良事件的风险
Adam Nygren1, Johan Reutfors1, Pär Karlsson1
1Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Journal of affective disorders
|May 17, 2025
概括
患有耐治疗抑郁症 (TRD) 或重度抑郁症的患者整体上不会面临更高的重大心血管不良事件 (MACE) 风险. 然而,患有严重抑郁症的年轻人和患有心血管死亡的TRD患者的MACE风险增加.
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:
- 抑郁症是主要心血管不良事件 (MACE) 的已知危险因素.
- 患有耐治疗抑郁症 (TRD) 或严重抑郁症的患者的特定心血管风险尚不清楚.
- 了解这些风险对于患者管理和公共卫生战略至关重要.
研究的目的:
- 调查治疗耐药性抑郁症 (TRD) 和严重抑郁症与重大心血管不良事件 (MACE) 风险之间的关联.
- 将TRD和重度抑郁症患者的MACE风险与匹配的对照组进行比较.
- 确定特定的心血管结果和高风险的人口群体.
主要方法:
- 利用瑞典国家登记册来识别患有抑郁症的18-75岁患者.
- 将患有抑郁症,TRD和严重抑郁症的患者与各自的对照组进行了匹配.
- 对MACE的计算危险比率,调整为社会人口统计学和临床因素.
主要成果:
- 确定了143731名患有抑郁症的患者,包括23335名TRD和45217名严重抑郁症患者.
- 与对照组相比,抑郁症患者 (aHR 1.50) 的MACE总体风险较高,但在TRD (aHR 1.06) 或严重抑郁症 (aHR 1.04) 组中没有显著增加.
- 严重抑郁症患者的心血管死亡风险较高 (aHR 1.32),严重抑郁症的年轻成年人 (18-29岁) 的MACE风险显著增加 (aHR 2.82).
结论:
- 与其他抑郁症患者相比,患有TRD或严重抑郁症的患者没有MACE的整体风险增加.
- 在TRD患者中存在心血管死亡的特定风险增加.
- 患有严重抑郁症的年轻人可能面临更高的MACE风险,需要进一步调查和有针对性的干预措施.
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