Santos Itamar S, Bittencourt Marcio S, Rocco Priscila T, Pereira Alexandre C, Barreto Sandhi M, Brunoni André R, Goulart Alessandra C, Blaha Michael J, Lotufo Paulo A, Bensenor Isabela M
Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Centro de Pesquisa Clínica do Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
Centro de Pesquisa Clínica do Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil.
Am J Cardiol. 2016 Jul 15;118(2):183-7. doi: 10.1016/j.amjcard.2016.04.048. Epub 2016 May 4.
Previous studies of the association between symptoms of anxiety or depression and coronary artery calcium (CAC) have produced heterogeneous results. Our aim was to investigate whether psychopathological symptoms were associated with CAC in a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. We analyzed data from 4,279 ELSA-Brasil subjects (aged 35 to 74 years) from the São Paulo site without previous cardiovascular disease who underwent CAC score assessment at baseline. Prevalent CAC was defined as a CAC score >0. Anxiety and depressive symptoms were assessed using the Clinical Interview Schedule-Revised (CIS-R). We built binary logistic regression models to determine whether CIS-R scores, anxiety, or depression were associated with prevalent CAC. Prevalent CAC was found in 1,211 subjects (28.3%). After adjustment for age and gender, a direct association between CIS-R scores and prevalent CAC was revealed (odds ratio for 1-SD increase: 1.12; 95% confidence interval [CI] 1.04 to 1.22). This association persisted after multivariate adjustment (odds ratio for 1-SD increase 1.11; 95% CI 1.02 to 1.20). No independent associations were found for specific diagnoses of anxiety or depression and prevalent CAC. In post hoc models, a significant interaction term (p = 0.019) suggested a stronger association in older subjects. In conclusion, psychopathological symptoms were directly associated with coronary atherosclerosis in the ELSA-Brasil baseline in adjusted models, and this association seems to be stronger in older subjects.
先前关于焦虑或抑郁症状与冠状动脉钙化（CAC）之间关联的研究结果并不一致。我们的目的是在巴西成人健康纵向研究（ELSA - Brasil）基线的横断面分析中，调查心理病理症状是否与CAC相关。我们分析了来自圣保罗站点的4279名ELSA - Brasil受试者（年龄在35至74岁之间）的数据，这些受试者在基线时未患心血管疾病且接受了CAC评分评估。将CAC评分>0定义为存在CAC。使用修订版临床访谈时间表（CIS - R）评估焦虑和抑郁症状。我们构建二元逻辑回归模型来确定CIS - R评分、焦虑或抑郁是否与存在的CAC相关。在1211名受试者（28.3%）中发现存在CAC。在对年龄和性别进行调整后，发现CIS - R评分与存在的CAC之间存在直接关联（1个标准差增加的优势比：1.12；95%置信区间[CI]为1.04至1.22）。在多变量调整后，这种关联仍然存在（1个标准差增加的优势比为1.11；95%CI为1.02至1.20）。未发现焦虑或抑郁的特定诊断与存在的CAC之间存在独立关联。在事后模型中，一个显著的交互项（p = 0.019）表明在老年受试者中关联更强。总之，在调整模型中，心理病理症状与ELSA - Brasil基线中的冠状动脉粥样硬化直接相关，并且这种关联在老年受试者中似乎更强。
