Ahmed Amjad M, Qureshi Waqas T, Sakr Sherif, Blaha Michael J, Brawner Clinton A, Ehrman Jonathan K, Keteyian Steven J, Al-Mallah Mouaz H
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
Clin Cardiol. 2018 Apr;41(4):532-538. doi: 10.1002/clc.22923. Epub 2018 Apr 17.
Exercise capacity is associated with survival in the general population. Whether this applies to patients with treated depression is not clear.
High exercise capacity remains associated with lower risk of all-cause mortality (ACM) and nonfatal myocardial infraction (MI) among patients with treated depression.
We included 5128 patients on antidepressant medications who completed a clinically indicated exercise stress test between 1991 and 2009. Patients were followed for a median duration of 9.4 years for ACM and 4.5 years for MI. Exercise capacity was estimated in metabolic equivalents of tasks (METs). Cox proportional hazards regression models were used.
Patients with treated depression who achieved ≥12 METs (vs those achieving <6 METs) were younger (age 46 ± 9 vs 61 ± 12 years), more often male (60% vs 23%), less often black (10% vs 27%), and less likely to be hypertensive (51% vs 86%), have DM (9% vs 38%), or be obese (11% vs 36%) or dyslipidemic (45% vs 54%). In the fully adjusted Cox proportional hazard regression model, exercise capacity was associated with a lower ACM (HR per 1-MET increase in exercise capacity: 0.82, 95% CI: 0.79-0.85, P < 0.001) and nonfatal MI (HR: 0.92, 95% CI: 0.87-0.97, P = 0.004).
Exercise capacity had an inverse association with both ACM and nonfatal MI in patients with treated depression, independent of cardiovascular risk factors. These results highlight the potential impact of assessing exercise capacity to identify risk, as well as promoting an active lifestyle among treated depression patients.
运动能力与普通人群的生存率相关。这是否适用于接受治疗的抑郁症患者尚不清楚。
在接受治疗的抑郁症患者中，高运动能力仍与全因死亡率（ACM）和非致命性心肌梗死（MI）风险较低相关。
我们纳入了5128例服用抗抑郁药物且在1991年至2009年间完成临床指示运动应激试验的患者。对患者进行ACM随访的中位时间为9.4年，MI随访的中位时间为4.5年。运动能力以代谢当量（METs）来估计。使用Cox比例风险回归模型。
运动能力达到≥12 METs的接受治疗的抑郁症患者（与运动能力<6 METs的患者相比）更年轻（年龄46±9岁对61±12岁），男性比例更高（60%对23%），黑人比例更低（10%对27%），高血压、糖尿病、肥胖或血脂异常的可能性更低（高血压：51%对86%；糖尿病：9%对38%；肥胖：11%对36%；血脂异常：45%对54%）。在完全调整的Cox比例风险回归模型中，运动能力与较低的ACM（运动能力每增加1 MET的风险比：0.82，95%置信区间：0.79 - 0.85，P < 0.001）和非致命性MI（风险比：0.92，95%置信区间：0.87 - 0.97，P = 0.004）相关。
在接受治疗的抑郁症患者中，运动能力与ACM和非致命性MI均呈负相关，且独立于心血管危险因素。这些结果凸显了评估运动能力以识别风险以及在接受治疗的抑郁症患者中促进积极生活方式的潜在影响。
