CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
Am J Cardiol. 2013 Apr 15;111(8):1169-74. doi: 10.1016/j.amjcard.2012.12.047. Epub 2013 Jan 26.
Statin therapy is an important secondary prevention measure in cardiovascular disease. However, the side effects associated with statin use could potentially affect patients' quality of life. Little is known about the influence of statin therapy on the well-being and health status of cardiac patients, in general, and patients with an implantable cardioverter defibrillator (ICD), in particular. We investigated the association between statin therapy and symptoms of anxiety and depression and patients' health status during the 12 months after implantation, reckoning with statin type and dosage. Consecutively implanted ICD patients (n = 409; 78.2% men) completed the Hospital Anxiety and Depression Scale and the Medical Outcomes Study Short Form 36-item Health Survey at baseline and 3, 6, and 12 months after implantation. The data were analyzed using general linear mixed modeling repeated measures multivariate analysis of variance. Of the 409 patients, 60% were prescribed statins. Statin use was independently associated with poorer role limitations-physical (p = 0.001), social functioning (p = 0.007), and role limitations-emotional (p = 0.006) during the 12 months after implantation, independent of statin type, dosage, and other potential confounders. The associations between statin therapy and depression (p = 0.06) and statin therapy and physical functioning (p = 0.05) were borderline significant, and no association was found with anxiety (p >0.05). In conclusion, statin therapy was associated with impaired health status on 3 of the 8 Medical Outcomes Study Short Form 36-item Health Survey health status subdomains. This is the first study of ICD patients to examine the association between statin therapy and patient well-being. Future research is warranted to replicate these findings.
他汀类药物治疗是心血管疾病的重要二级预防措施。然而,他汀类药物使用相关的副作用可能会影响患者的生活质量。目前对于他汀类药物治疗对一般心脏患者,尤其是植入式心脏复律除颤器(ICD)患者的幸福感和健康状况的影响知之甚少。我们研究了他汀类药物治疗与焦虑和抑郁症状以及植入后 12 个月内患者健康状况之间的关系,同时考虑了他汀类药物的类型和剂量。连续植入 ICD 的患者(n = 409;78.2%为男性)在基线和植入后 3、6 和 12 个月时完成了医院焦虑和抑郁量表以及医疗结果研究短式 36 项健康调查。使用一般线性混合模型重复测量多变量方差分析对数据进行分析。在 409 名患者中,有 60%的患者被开了他汀类药物。在植入后 12 个月内,无论他汀类药物的类型、剂量和其他潜在的混杂因素如何,他汀类药物的使用与角色限制-身体(p = 0.001)、社会功能(p = 0.007)和角色限制-情感(p = 0.006)方面的健康状况较差独立相关。他汀类药物治疗与抑郁(p = 0.06)和他汀类药物治疗与身体功能(p = 0.05)之间存在边缘显著的相关性,而与焦虑之间无相关性(p > 0.05)。总之,他汀类药物治疗与医疗结果研究短式 36 项健康调查的 8 个健康状况子域中的 3 个方面的健康状况受损有关。这是第一项研究他汀类药物治疗与 ICD 患者患者幸福感之间关系的研究。需要进一步的研究来复制这些发现。