Busch Andrew M, Borrelli Belinda, Leventhal Adam M
Centers for Behavioral and Preventive Medicine, Program in Nicotine and Tobacco, Alpert Medical School of Brown University and The Miriam Hospital.
Curr Cardiovasc Risk Rep. 2012 Feb 1;5(6):510-518. doi: 10.1007/s12170-011-0198-9.
The purpose of the current paper is to review research on the relationship between smoking cessation and depressed mood post-Acute Coronary Syndrome (Myocardial infarction or unstable angina; ACS). Emerging evidence regarding the effect of anhedonia-a specific subcomponent of mood disturbance characterized by reduced pleasure-on post-ACS outcomes is also discussed. There is strong evidence that depression prospectively predicts post-ACS relapse to smoking. Weaker evidence suggests that smoking at the time of ACS is related to post-ACS depression. Bupropion is a particularly promising treatment for this population because of its smoking cessation and anti-depressant effects. Future research should focus on the relative risk of using nicotine replacement therapies post-ACS, the efficacy of bupropion for smoking cessation and depression reduction in post-ACS patients, the role of anhedonia in post-ACS smoking cessation, and the development and testing of integrated behavioral treatments (smoking cessation plus interventions targeting mood management) for ACS patients.
本文旨在综述关于急性冠脉综合征（心肌梗死或不稳定型心绞痛；ACS）后戒烟与情绪低落之间关系的研究。同时也讨论了关于快感缺失（一种以愉悦感降低为特征的情绪障碍特定子成分）对ACS后结局影响的新证据。有强有力的证据表明，抑郁可前瞻性地预测ACS后复吸。证据较弱的是，ACS时吸烟与ACS后抑郁有关。安非他酮对这一人群是一种特别有前景的治疗方法，因为它具有戒烟和抗抑郁作用。未来的研究应关注ACS后使用尼古丁替代疗法的相对风险、安非他酮对ACS后患者戒烟和减轻抑郁的疗效、快感缺失在ACS后戒烟中的作用，以及针对ACS患者的综合行为治疗（戒烟加针对情绪管理的干预措施）的开发和测试。
