心肌梗死后抗抑郁治疗的效果。
Effects of antidepressant treatment following myocardial infarction.
作者信息
van Melle Joost P, de Jonge Peter, Honig Adriaan, Schene Aart H, Kuyper Astrid M G, Crijns Harry J G M, Schins Annique, Tulner Dorien, van den Berg Maarten P, Ormel Johan
机构信息
Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, The Netherlands.
出版信息
Br J Psychiatry. 2007 Jun;190:460-6. doi: 10.1192/bjp.bp.106.028647.
BACKGROUND
Depression following myocardial infarction is associated with poor cardiac prognosis. It is unclear whether antidepressant treatment improves long-term depression status and cardiac prognosis.
AIMS
To evaluate the effects of antidepressant treatment compared with usual care in an effectiveness study.
METHOD
In a multicentre randomised controlled trial, 2177 myocardial infarction patients were evaluated for ICD-10 depression and randomised to intervention (n=209) or care as usual (n=122). Both arms were evaluated at 18 months post-myocardial infarction for long-term depression status and new cardiac events.
RESULTS
No differences were observed between intervention and control groups in mean scores on the Beck Depression Inventory (11.0, s.d.=7.5 v.10.2, s.d.=5.1, P=0.45) or presence of ICD-10 depression (30.5 v. 32.1%, P=0.68). The cardiac event rate was 14% among the intervention group and 13% among controls (OR=1.07, 95% CI 0.57-2.00).
CONCLUSIONS
Antidepressant treatment did not alter long-term depression post-myocardial infarction status or improve cardiac prognosis.
背景
心肌梗死后的抑郁与不良心脏预后相关。目前尚不清楚抗抑郁治疗是否能改善长期抑郁状态和心脏预后。
目的
在一项有效性研究中评估抗抑郁治疗与常规护理相比的效果。
方法
在一项多中心随机对照试验中，对2177例心肌梗死患者进行ICD - 10抑郁评估，并随机分为干预组（n = 209）或常规护理组（n = 122）。两组均在心肌梗死后18个月时评估长期抑郁状态和新发心脏事件。
结果
干预组和对照组在贝克抑郁量表平均得分（11.0，标准差= 7.5对10.2，标准差= 5.1，P = 0.45）或ICD - 10抑郁存在情况（30.5%对32.1%，P = 0.68）方面未观察到差异。干预组心脏事件发生率为14%，对照组为13%（比值比= 1.07，95%可信区间0.57 - 2.00）。
结论
抗抑郁治疗未改变心肌梗死后的长期抑郁状态，也未改善心脏预后。
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