Goh Anne C H, Wong Stephanie, Zaroff Jonathan G, Shafaee Navid, Lundstrom Robert J
Department of Cardiology (Drs Goh, Zaroff, Shafaee, and Lundstrom), Kaiser Permanente Medical Center, San Francisco, California; and Department of Cardiology (Dr Wong), Ochsner Heart and Vascular Institute, New Orleans, Louisiana.
J Cardiopulm Rehabil Prev. 2016 Mar-Apr;36(2):106-11. doi: 10.1097/HCR.0000000000000152.
To determine whether anxiety or depression is associated with takotsubo stress cardiomyopathy (TSCM).
A retrospective case-control study was conducted among 73 TSCM cases and 111 acute coronary syndrome (ACS) controls matched for age, sex, and cardiac catheterization date. The study was conducted between May 1, 2009, and February 28, 2010. The Hospital Anxiety and Depression Scale was completed by all participants after hospital discharge. The Hospital Anxiety and Depression Scale was used to assess psychological distress with measurement of anxiety and depression scores. The presence of a stressful emotional or physical trigger before the TSCM presentation was determined. Univariate testing was performed to quantify the associations between anxiety and depression and TSCM trigger status. Multivariable logistic regression was used to quantify the independent associations between anxiety and depression and TSCM status after controlling for relevant covariates.
The mean anxiety score was 6.7 ± 4.7 for TSCM cases versus 5.4 ± 3.4 for ACS controls (P = .06). The mean depression score was 4.3 ± 3.7 for TSCM cases versus 4.0 ± 3.1 for controls (P = .61). Anxiety was particularly associated with TSCM status with an emotional trigger (P = .05). After multivariable adjustment, anxiety (OR = 1.13; 95% CI, 1.01-1.26; P = .03) was associated with TSCM status but depression was not (OR = 0.94; 95% CI, 0.83-1.05; P = .29).
In comparison with a control group with ACS, patients who presented with TSCM have higher levels of anxiety but not depression.
确定焦虑或抑郁是否与应激性心肌病（TSCM）相关。
进行一项回顾性病例对照研究，纳入73例TSCM患者及111例年龄、性别和心导管检查日期相匹配的急性冠脉综合征（ACS）对照。研究于2009年5月1日至2010年2月28日进行。所有参与者出院后完成医院焦虑抑郁量表（HADS）。HADS用于评估心理困扰，测量焦虑和抑郁得分。确定TSCM发病前是否存在应激性情绪或身体诱因。进行单因素检验以量化焦虑、抑郁与TSCM诱因状态之间的关联。多变量逻辑回归用于在控制相关协变量后量化焦虑、抑郁与TSCM状态之间的独立关联。
TSCM患者的平均焦虑得分为6.7±4.7，而ACS对照为5.4±3.4（P = 0.06）。TSCM患者的平均抑郁得分为4.3±3.7，对照为4.0±3.1（P = 0.61）。焦虑与有情绪诱因的TSCM状态尤其相关（P = 0.05）。多变量调整后，焦虑（OR = 1.13；95%CI，1.01 - 1.26；P = 0.03）与TSCM状态相关，而抑郁则不然（OR = 0.94；95%CI，0.83 - 1.05；P = 0.29）。
与ACS对照组相比，TSCM患者焦虑水平较高，但抑郁水平无差异。
