College of Public Health, The University of Arizona, Tucson, AZ, USA.
Department of Medicine, St. Joseph Hospital, Chicago, IL, USA.
J Cardiovasc Transl Res. 2021 Aug;14(4):685-705. doi: 10.1007/s12265-020-09985-4. Epub 2020 Mar 20.
To assess causal association of depression with subclinical coronary atherosclerosis, we performed computer-based and manual search of literature for studies which had assessed relationship of depression disorder with coronary atherosclerosis. All studies had diagnosed depression with validated tools in patients without diagnosed coronary artery disease. The Bradford Hill criteria of cause-effect association was consistently fulfilled by those studies which achieved statistical significance and further showed incremental strength of association with one or more of the following attributes: (1) prospective cohort study, met cause-effect criteria of "temporality"; (2) relatively severe and/or longer period of depression, met cause-effect criteria of "dose-response"; (3) depression with predominantly somatic symptoms cluster, met cause-effect criteria of "scientific plausibility"; (4) multiethnic larger sample, met cause-effect criteria of "population equivalence"; and (5) multicenter study, met criteria of "environmental equivalence." Our results show that there is a significant association of depression with coronary atherosclerosis at its subclinical stages.
为了评估抑郁与亚临床冠状动脉粥样硬化之间的因果关系，我们进行了基于计算机和手动的文献检索，以评估抑郁障碍与冠状动脉粥样硬化之间的关系。所有研究均使用经过验证的工具在未确诊冠状动脉疾病的患者中诊断抑郁。那些达到统计学意义并进一步显示与以下一个或多个属性的关联强度增加的研究，符合因果关系的布拉德福德·希尔标准：（1）前瞻性队列研究，符合因果关系的“时间顺序”标准；（2）抑郁程度相对严重和/或持续时间较长，符合因果关系的“剂量反应”标准；（3）以躯体症状为主的抑郁，符合因果关系的“科学合理性”标准；（4）多民族大样本，符合因果关系的“人群等效性”标准；（5）多中心研究，符合“环境等效性”标准。我们的研究结果表明，抑郁与亚临床阶段的冠状动脉粥样硬化之间存在显著的关联。
