Wong C-K, Tang E W, Herbison P, Birmingham B, Barclay L, Fu S Y F
Department of Cardiology, Dunedin School of Medicine, University of Otago, Dunedin Public Hospital, New Zealand.
QJM. 2008 Feb;101(2):137-44. doi: 10.1093/qjmed/hcm153. Epub 2008 Jan 10.
Depression is common among patients with acute coronary syndrome (ACS).
To examine how depression may alter outcome of ACS.
Observational study on how ongoing depression influences the time delay to seeking help and its effects on subsequent treatment compliance after discharge.
Depression was measured by Beck Depression Inventory (BDI) 2 weeks prior to presentation on consecutive patients with ACS.
Of the 276 patients, 81 had BDI > or =10 and 195 had BDI score <10. The time from onset of the predominant symptom to seeking help tended to be longer in those with BDI > or =10 than in those with BDI <10 [180 (IQR 37.5-1042.5) min vs. 120 (IQR 30-735) min, P = 0.099]. Results were similar for the 68 with ST elevation myocardial infarction (MI) [238 (IQR 49-709) min vs. 60 (IQR 20-352) min, P = 0.071]. Each point increase of BDI predicted an approximately 4.2% [95% confidence interval (CI) 0.4-8.0%] increase in the time duration, P = 0.029. On multivariable analysis, the effect of BDI persisted (6.0% increase in duration per each point increase in BDI, 95% CI 2.4-9.7%, P = 0.001). Among the 68 patients who had ST elevation MI, results were similar with an 8.0% (95%CI 1.7-14.7%, P = 0.013) increase in time duration for each unit increase in BDI. Results were also similar when BDI was evaluated as a dichotomous variable. Small differences were observed for subsequent treatment compliance.
Ongoing depression delays the presentation of ACS.
抑郁症在急性冠脉综合征（ACS）患者中很常见。
研究抑郁症如何改变急性冠脉综合征的预后。
关于持续性抑郁症如何影响寻求帮助的时间延迟及其对出院后后续治疗依从性影响的观察性研究。
在连续的急性冠脉综合征患者就诊前2周，通过贝克抑郁量表（BDI）测量抑郁症。
276例患者中，81例BDI≥10，195例BDI评分＜10。BDI≥10的患者从主要症状出现到寻求帮助的时间往往比BDI＜10的患者更长[180（四分位间距37.5 - 1042.5）分钟对120（四分位间距30 - 735）分钟，P = 0.099]。68例ST段抬高型心肌梗死（MI）患者的结果相似[238（四分位间距49 - 709）分钟对60（四分位间距20 - 352）分钟，P = 0.071]。BDI每增加1分，预计持续时间增加约4.2%[95%置信区间（CI）0.4 - 8.0%]，P = 0.029。多变量分析时，BDI的影响仍然存在（BDI每增加1分，持续时间增加6.0%，95%CI 2.4 - 9.7%，P = 0.001）。在68例ST段抬高型心肌梗死患者中，结果相似，BDI每增加1个单位，持续时间增加8.0%（95%CI 1.7 - 14.7%，P = 0.013）。将BDI作为二分变量评估时结果也相似。在后续治疗依从性方面观察到小的差异。
持续性抑郁症会延迟急性冠脉综合征的就诊。
