Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Guangdong Pharmaceutical University, Guangzhou, China.
J Int Med Res. 2021 Mar;49(3):300060521990984. doi: 10.1177/0300060521990984.
The deleterious effects of psychological problems on coronary heart disease (CHD) are not satisfactorily explained. We explored influential factors associated with mortality in psycho-cardiological disease in a Chinese sample.
Of 7460 cardiac patients, we selected 132 patients with CHD and mental illness. Follow-up was conducted via telephone. We analyzed clinical characteristics, clinical outcomes, and survival.
The clinical detection rate of psycho-cardiological disease in the overall patient population was 1.8%. Of these, 113 patients completed follow-up; 18 died owing to cardiovascular diseases during follow-up. Kaplan-Meier analysis showed dysphagia, limb function, self-care ability, percutaneous coronary intervention, low-density lipoprotein, total cholesterol, pro-brain natriuretic peptide and high-sensitivity (hs) troponin T had significant associations with cumulative survival. Cox regression analysis showed total cholesterol (hazard ratio [HR]: 2.765, 95% confidence interval [CI]: 1.001-7.641), hs troponin T (HR: 4.668, 95% CI: 1.293-16.854), and percutaneous coronary intervention (HR: 3.619, 95% CI: 1.383-9.474) were independently associated with cumulative survival.
The clinical detection rate of psycho-cardiological disease was far lower than expected. Normal total cholesterol and hs troponin T were associated with reduced cardiovascular disease mortality over 2 years. Percutaneous coronary intervention is a prognostic risk factor in patients with psycho-cardiological disease.
心理问题对冠心病(CHD)的不良影响尚未得到充分解释。我们在中国样本中探讨了与心理心脏病学疾病死亡率相关的影响因素。
在 7460 例心脏病患者中,我们选择了 132 例患有 CHD 和精神疾病的患者。通过电话进行随访。我们分析了临床特征、临床结局和生存情况。
整体患者人群中心理心脏病学疾病的临床检出率为 1.8%。其中,113 例患者完成了随访;18 例在随访期间因心血管疾病死亡。Kaplan-Meier 分析显示吞咽困难、肢体功能、自理能力、经皮冠状动脉介入治疗、低密度脂蛋白、总胆固醇、脑利钠肽前体和高敏(hs)肌钙蛋白 T 与累积生存率显著相关。Cox 回归分析显示总胆固醇(危险比 [HR]:2.765,95%置信区间 [CI]:1.001-7.641)、hs 肌钙蛋白 T(HR:4.668,95% CI:1.293-16.854)和经皮冠状动脉介入治疗(HR:3.619,95% CI:1.383-9.474)与累积生存率独立相关。
心理心脏病学疾病的临床检出率远低于预期。正常总胆固醇和 hs 肌钙蛋白 T 与 2 年内降低心血管疾病死亡率相关。经皮冠状动脉介入治疗是心理心脏病学疾病患者的预后危险因素。