Rahmani Reza, Rahimi Leila, Shafiee Akbar
Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Indian Heart J. 2018 Nov-Dec;70(6):783-787. doi: 10.1016/j.ihj.2017.12.006. Epub 2017 Dec 16.
Depression is a common condition in cardiac patients. We investigated the effect of cardiac rehabilitation on depressive symptoms as detected by Beck depression inventory II score (BDI) in patients who underwent percutaneous coronary intervention (PCI).
In this cohort, 95 patients met our criteria. Patients were then studied in two groups based on their participation in the rehabilitation program to rehabilitation (exposure) and the control (non-exposure) groups. The control group consisted of those who only participated in the introductory session and decided not to continue the program. Finally, demographic and clinical parameters as well as the BDI scores were compared between the study groups.
Data of 35 patients who completed rehabilitation program was compared with 60 patients who did not. There was no significant difference between the study groups regarding the demographic and clinical variables, except for a higher frequency of family history for CAD in the control group (p<0.001). The frequency of the patients with no or mild depression was significantly higher in the rehabilitation group than the controls (p=0.02). There was also a significant increase in the BDI score of the control group and a significant decrease in the rehabilitation group (p<0.001). After adjustment for confounders (family history and severity of CAD), not attending the rehabilitation program was a strong risk factor for depression (OR=10.8, 95% CI: 1.3, 88.5; P=0.027).
Overall, this study showed that not attending cardiac rehabilitation program following elective PCI was a risk factor for depression.
抑郁症是心脏病患者的常见病症。我们调查了心脏康复对接受经皮冠状动脉介入治疗(PCI)患者的抑郁症状(通过贝克抑郁量表II评分[BDI]检测)的影响。
在这个队列中,95名患者符合我们的标准。然后根据患者参与康复计划的情况将其分为康复(暴露)组和对照组(非暴露)组进行研究。对照组由那些只参加了入门课程并决定不继续该计划的患者组成。最后,比较了研究组之间的人口统计学和临床参数以及BDI评分。
将35名完成康复计划的患者的数据与60名未完成的患者的数据进行了比较。除对照组中CAD家族史的频率较高外(p<0.001),研究组在人口统计学和临床变量方面没有显著差异。康复组中无抑郁或轻度抑郁患者的频率显著高于对照组(p=0.02)。对照组的BDI评分也显著增加,而康复组则显著降低(p<0.001)。在对混杂因素(家族史和CAD严重程度)进行调整后,未参加康复计划是抑郁的一个强风险因素(OR=10.8,95%CI:1.3,88.5;P=0.027)。
总体而言,本研究表明,选择性PCI后不参加心脏康复计划是抑郁的一个风险因素。