Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Int J Cardiol. 2022 Sep 1;362:85-92. doi: 10.1016/j.ijcard.2022.05.048. Epub 2022 May 23.
Multiple studies have shown that mental disorders are common risk factors for cardiovascular diseases (CVD). However, the relationship between psychological factors and atrial fibrillation (AF) incidence remains unclear. Therefore, we performed a systematic review and meta-analysis to assess the risk of AF due to psychological factors.
PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to January 2022. Relevant and eligible cohort studies were included. Random or fixed effect model was used to estimate the pooled hazard ratios (HRs) and 95% confidence intervals (CIs). For non-randomized studies, the risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).
Thirteen publications, including 5,329,908 participants, met our inclusion criteria. The incidence of AF was increased by 10% (HR = 1.10, 95% CI 1.02 to 1.19, I = 33.6%, P = 0.013, n = 235,599 in 6 studies) for patients with anxiety, by 15% (HR = 1.15, 95% CI 1.04 to 1.26, I = 40.2%, P = 0.04, n = 21,791 in 3 studies) for patients with anger, by 25% (HR = 1.25, 95% CI 1.12 to 1.39, I = 57.4%, P < 0.001, n = 5,160,247 in 6 studies) for patients with depression, and by 18% (HR = 1.18, 95% CI 1.05 to 1.32, I = 19.2%, P = 0.004, n = 51,664 in 4 studies) for people under work stress.
Adverse psychological factors such as anxiety, anger, depression, and work stress may increase the risk of AF. Interventions to prevent mental disorders may reduce the growing global burden of AF and its associated healthcare costs. Given the current study's limitations, our findings need to be further confirmed by a larger prospective study.
多项研究表明，精神障碍是心血管疾病（CVD）的常见危险因素。然而，心理因素与心房颤动（AF）发病率之间的关系尚不清楚。因此，我们进行了系统评价和荟萃分析，以评估心理因素导致 AF 的风险。
从建库到 2022 年 1 月，我们检索了 PubMed、Embase、Web of Science 和 Cochrane Library。纳入相关且符合条件的队列研究。使用随机或固定效应模型来估计合并的危险比（HR）和 95%置信区间（CI）。对于非随机研究，使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。
有 13 篇文献，包括 5329908 名参与者，符合纳入标准。与无焦虑者相比，焦虑患者的 AF 发病率增加 10%（HR=1.10，95%CI 1.02 至 1.19，I²=33.6%，P=0.013，n=235599 人，6 项研究）；与无愤怒者相比，愤怒患者的 AF 发病率增加 15%（HR=1.15，95%CI 1.04 至 1.26，I²=40.2%，P=0.04，n=21791 人，3 项研究）；与无抑郁者相比，抑郁患者的 AF 发病率增加 25%（HR=1.25，95%CI 1.12 至 1.39，I²=57.4%，P<0.001，n=5160247 人，6 项研究）；与无工作压力者相比，工作压力者的 AF 发病率增加 18%（HR=1.18，95%CI 1.05 至 1.32，I²=19.2%，P=0.004，n=51664 人，4 项研究）。
焦虑、愤怒、抑郁和工作压力等不良心理因素可能会增加 AF 的发病风险。预防精神障碍的干预措施可能会降低不断增长的全球 AF 负担及其相关的医疗保健费用。鉴于本研究的局限性，我们的发现需要更大规模的前瞻性研究进一步证实。
