Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Cleve Clin J Med. 2010 Jul;77 Suppl 3(Suppl 3):S20-6. doi: 10.3949/ccjm.77.s3.04.
We systematically searched published empirical research on depression and cardiovascular disease (CVD) and found 494 unique articles published in 2009. Several particularly notable and provocative findings and controversies emerged from this survey of the 2009 literature. First, multiple large observational studies found that antidepressant use was associated with increased risk of incident stroke, CVD, or sudden cardiac death. Second, four randomized controlled trials on depression interventions in CVD patients reported important efficacy results that should guide future trials. Finally, the vigorous debate on whether patients with CVD should be routinely screened (and subsequently treated) for depression continued in 2009 even as some observed that routine screening for CVD in depressed patients is more evidence-based and appropriate. This article reviews these selected provocative findings and controversies from our search and explores their clinical implications.
我们系统地检索了已发表的关于抑郁症和心血管疾病(CVD)的实证研究,发现 2009 年共发表了 494 篇独特的文章。从对 2009 年文献的调查中,出现了一些特别值得注意和有争议的发现。首先,多项大型观察性研究发现,使用抗抑郁药与中风、CVD 或心源性猝死的发生率增加有关。其次,四项关于 CVD 患者抑郁干预的随机对照试验报告了重要的疗效结果,这些结果应指导未来的试验。最后,即使一些人认为对抑郁患者进行 CVD 常规筛查更有证据支持和更合适,2009 年仍在继续关于 CVD 患者是否应常规筛查(随后进行治疗)的激烈争论。本文回顾了我们搜索到的这些有争议的发现,并探讨了它们的临床意义。