心力衰竭日本患者的抑郁症状与住院和死亡的关系。

Relationship of depressive symptoms with hospitalization and death in Japanese patients with heart failure.

机构信息

Department of Adult Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

出版信息

J Card Fail. 2009 Dec;15(10):912-9. doi: 10.1016/j.cardfail.2009.06.442. Epub 2009 Aug 21.

DOI:10.1016/j.cardfail.2009.06.442

PMID:19944369

Abstract

BACKGROUND

Depressive symptoms are risk factors for poor outcomes and are positively associated with disease severity in patients with heart failure (HF). However, little is known about this association in the Japanese population. Therefore, we evaluated the prevalence of depressive symptoms and whether depressive symptoms predicted hospitalization for HF and death independent of disease severity and other factors in HF patients.

METHODS AND RESULTS

A 2-year prospective cohort study was conducted on 115 outpatients with HF (73.9% males; mean age 64.7 years) in Tokyo. Of these, 27 patients (23.5%) were classified as having depressive symptoms (Center for Epidemiologic Studies Depression Scale score >or=16). Patients with depressive symptoms had higher rates of 2-year cardiac death or HF hospitalization (34.0% vs. 10.3%; P < .01), HF hospitalization (27.4% vs. 9.2%; P = .01), and all-cause death (27.4% vs. 7.2%; P < .01). Multivariate Cox regression analyses indicated that depressive symptoms were predictors of cardiac death or HF hospitalization (hazard ratio [HR], 3.29; P = .02), HF hospitalization (HR, 3.36; P = .04), and all-cause death (HR, 5.52; P = .01), independent of age and brain natriuretic peptide.

CONCLUSIONS

Depressive symptoms were common and independent predictors of poor outcomes in Japanese patients with HF.

摘要

背景

抑郁症状是心力衰竭（HF）患者预后不良的危险因素，与疾病严重程度呈正相关。然而，在日本人群中，对此相关性知之甚少。因此，我们评估了抑郁症状的患病率，以及抑郁症状是否独立于疾病严重程度和其他因素预测 HF 患者的 HF 住院和死亡。

方法和结果

在东京对 115 例 HF 门诊患者（73.9%为男性；平均年龄 64.7 岁）进行了为期 2 年的前瞻性队列研究。其中，27 例（23.5%）患者被归类为有抑郁症状（流行病学研究中心抑郁量表评分≥16）。有抑郁症状的患者 2 年内心脏死亡或 HF 住院的发生率更高（34.0%比 10.3%；P<0.01）、HF 住院（27.4%比 9.2%；P=0.01）和全因死亡（27.4%比 7.2%；P<0.01）。多变量 Cox 回归分析表明，抑郁症状是心脏死亡或 HF 住院（危险比 [HR]，3.29；P=0.02）、HF 住院（HR，3.36；P=0.04）和全因死亡（HR，5.52；P=0.01）的预测因素，独立于年龄和脑钠肽。