惊恐障碍与冠心病发病：系统评价与荟萃分析方案
Panic disorder and incident coronary heart disease: a systematic review and meta-analysis protocol.
作者信息
Tully Phillip J, Wittert Gary A, Turnbull Deborah A, Beltrame John F, Horowitz John D, Cosh Suzanne, Baumeister Harald
机构信息
Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, 79085, Germany.
Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, 254 North Terrace, Adelaide, Australia.
出版信息
Syst Rev. 2015 Mar 25;4:33. doi: 10.1186/s13643-015-0026-2.
BACKGROUND
The clinical presentation of panic disorder and panic attack overlaps many symptoms typically experienced in coronary heart disease (CHD). Etiological links between panic disorder and CHD are controversial and remain largely tenuous. This systematic review aims to pool together data regarding panic disorder with respect to incident CHD or myocardial infarction.
METHODS/DESIGN: Electronic databases (MEDLINE, EMBASE, PsycINFO and SCOPUS) will be searched using a search strategy exploding the topics for CHD and panic disorder. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows:
POPULATION
persons without CHD who meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; Comparison: persons without CHD who do not meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms;
OUTCOME
verified fatal and non-fatal CHD at follow-up; including coronary revascularization procedure, coronary artery disease, and myocardial infarction. Studies adopting self-report CHD will be ineligible. Screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, risk ratios, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the CHD outcomes with Cochrane Review Manager 5.3.
DISCUSSION
This systematic review aims to clarify whether panic disorder is associated with elevated risk for subsequent CHD. An evaluation of the etiological links between panic disorder with incident CHD might inform evidence-based clinical practice and policy concerning triaging chest pain patients, diagnostic assessment, and psychiatric intervention with panic disorder patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42014014891 .
背景
惊恐障碍和惊恐发作的临床表现与冠心病（CHD）中常见的许多症状重叠。惊恐障碍与冠心病之间的病因联系存在争议，且大多仍很薄弱。本系统评价旨在汇总有关惊恐障碍与冠心病或心肌梗死发病情况的数据。
方法/设计：将使用扩展冠心病和惊恐障碍主题的检索策略对电子数据库（MEDLINE、EMBASE、PsycINFO和SCOPUS）进行检索。还将联系纳入研究的作者和参考文献列表，以识别其他已发表和未发表的研究。纳入标准如下：
研究对象
符合惊恐障碍、惊恐发作、焦虑神经症或惊恐障碍症状加重标准的无冠心病患者；对照：不符合惊恐障碍、惊恐发作、焦虑神经症或惊恐障碍症状加重标准的无冠心病患者；
结局
随访时确诊的致命和非致命性冠心病；包括冠状动脉血运重建术、冠状动脉疾病和心肌梗死。采用自我报告冠心病情况的研究不符合要求。将由两名独立的评审员进行筛选，如有分歧将通过讨论解决。数据提取将包括指定为风险比、危险比的原始数据，以及如有可用的原始单元格数据。将由两名独立的评审员进行偏倚风险评估。将使用荟萃分析方法，通过Cochrane系统评价软件5.3对收集到的与冠心病结局相关的数据进行综合分析。
讨论
本系统评价旨在阐明惊恐障碍是否与随后发生冠心病的风险增加有关。对惊恐障碍与冠心病发病之间病因联系的评估可能为胸痛患者的分诊、诊断评估以及惊恐障碍患者的精神科干预等循证临床实践和政策提供依据。
系统评价注册
PROSPERO CRD42014014891 。
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