Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
BMJ Open. 2019 Aug 20;9(8):e026445. doi: 10.1136/bmjopen-2018-026445.
The objective of this meta-analysis was to assess whether depression in percutaneous coronary intervention (PCI) patients is associated with higher risk of adverse outcomes.
Systematic review and meta-analysis.
EMBASE, PubMed, CINAHL and PsycINFO were searched as data sources. We selected prospective cohort studies evaluating the relationship between depression and any adverse medical outcome, including all-cause mortality, cardiac mortality and non-fatal events, from inception to 28 February 2019. Two reviewers independently extracted information and calculated the risk of cardiovascular events in patients with preoperative or postoperative depression compared with non-depressed patients.
Eight studies (n=3297) met our inclusion criteria. Most studies found a positive association between depression and adverse cardiovascular outcomes. Meta-analysis yielded an aggregate risk ratio of 1.57 (95% CI 1.28 to 1.92, p<0.0001) for the magnitude of the relation between depression and adverse outcomes.
Our systematic review and meta-analysis suggests that depression is associated with an increased risk of worse clinical outcome or mortality in patients undergoing PCI. Assessment time and length of follow-up do not have a significant effect on this conclusion.
本荟萃分析旨在评估经皮冠状动脉介入治疗 (PCI) 患者的抑郁是否与不良结局风险增加相关。
系统评价和荟萃分析。
检索 EMBASE、PubMed、CINAHL 和 PsycINFO 作为数据源。我们选择了前瞻性队列研究，评估了从研究开始到 2019 年 2 月 28 日期间，抑郁与任何不良医疗结局（包括全因死亡率、心脏死亡率和非致命事件）之间的关系。两名审查员独立提取信息，并计算了术前或术后抑郁患者与非抑郁患者的心血管事件风险。
八项研究（n=3297）符合我们的纳入标准。大多数研究发现抑郁与不良心血管结局之间存在正相关。荟萃分析得出，抑郁与不良结局之间的关系强度的综合风险比为 1.57（95%CI 1.28 至 1.92，p<0.0001）。
我们的系统评价和荟萃分析表明，抑郁与接受 PCI 的患者临床结局恶化或死亡风险增加相关。评估时间和随访长度对这一结论没有显著影响。
