Konrad Marcel, Jacob Louis, Rapp Michael A, Kostev Karel
Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany.
World J Cardiol. 2016 Sep 26;8(9):547-552. doi: 10.4330/wjc.v8.i9.547.
To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices.
Longitudinal data from nationwide general practices in Germany ( = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1:1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders.
Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9% of patients were men. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression ( < 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95%CI: 1.49-1.59, < 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively.
The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.
确定在德国初级医疗诊所接受治疗的冠心病(CHD)患者中抑郁症的患病率及其风险因素。
分析了来自德国全国范围内1072家普通诊所的纵向数据。确定了最初在2009年至2013年期间被诊断为冠心病的个体,纳入了59992名患者并将其与59992名对照进行1:1匹配。主要结局指标是在索引日期后五年内冠心病患者和非冠心病患者中抑郁症的初始诊断。使用Cox比例风险模型对混杂因素进行调整。
平均年龄为68.0岁(标准差=11.3)。共有55.9%的患者为男性。经过五年的随访,冠心病组中有21.8%被诊断为抑郁症,对照组中有14.2%被诊断为抑郁症(P<0.001)。在多变量回归模型中,冠心病是发生抑郁症的一个强风险因素(风险比=1.54,95%置信区间:1.49-1.59,P<0.001)。既往抑郁发作、痴呆和其他八种慢性病与发生抑郁症的较高风险相关。有趣的是,与年轻患者和男性相比,老年患者和女性也分别更有可能被诊断为抑郁症。
与在德国初级医疗诊所接受治疗的非冠心病患者相比,冠心病患者患抑郁症的风险显著增加。应对冠心病患者进行抑郁症的常规筛查,以确保改善治疗和管理。