Rudisch Bruce, Nemeroff Charles B
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Biol Psychiatry. 2003 Aug 1;54(3):227-40. doi: 10.1016/s0006-3223(03)00587-0.
This article reviews the epidemiology of comorbid coronary artery disease and unipolar depression. Both major depression and subsyndromal depressive symptoms will be considered; unless otherwise specified, the term depression will be used to designate all depressive states, including major depressive disorder, minor depression, dysthymia, and other subsyndromal forms of depression. While 17% to 27% of patients with coronary artery disease have major depression, a significantly larger percentage has subsyndromal symptoms of depression. Patients with coronary artery disease and depression have a twofold to threefold increased risk of future cardiac events compared to patients without depression, independent of baseline cardiac dysfunction. The relative risk for the development of coronary artery disease conferred by depression in patients initially free of clinical cardiac disease is approximately 1.5, independent of other known risk factors for coronary disease. In the discussion, special attention will be paid to the interactions of both gender and age with depression and coronary artery disease risk. Scrutiny of the role of confounding risk factors is presented, such as global burden of comorbid medical illness and modification of traditional risk factors, which may, in part, mediate the effect of depression on coronary artery disease.
本文综述了合并冠状动脉疾病与单相抑郁症的流行病学。重度抑郁症和亚综合征抑郁症状均在考虑范围内；除非另有说明，术语“抑郁症”将用于指代所有抑郁状态，包括重度抑郁症、轻度抑郁症、心境恶劣障碍以及其他亚综合征形式的抑郁症。虽然17%至27%的冠状动脉疾病患者患有重度抑郁症，但有亚综合征抑郁症状的患者比例要高得多。与无抑郁症的患者相比，患有冠状动脉疾病和抑郁症的患者未来发生心脏事件的风险增加了两倍至三倍，且与基线心脏功能障碍无关。在最初无临床心脏病的患者中，抑郁症导致冠状动脉疾病发生的相对风险约为1.5，与其他已知的冠心病风险因素无关。在讨论中，将特别关注性别和年龄与抑郁症及冠状动脉疾病风险之间的相互作用。对混杂风险因素的作用进行了审查，如合并症的总体负担和传统风险因素的改变，这些因素可能部分介导了抑郁症对冠状动脉疾病的影响。
