Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Division of Cardiology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Prev Med. 2022 Oct;163:107177. doi: 10.1016/j.ypmed.2022.107177. Epub 2022 Jul 25.
Smoking and depression are risk factors for acute coronary syndrome (ACS) that often co-exist. We investigated the evolution of depression according to smoking cessation one-year after ACS. Data from 1822 ACS patients of the Swiss multicenter SPUM-ACS cohort study were analyzed over a one-year follow-up. Participants were classified in three groups based on smoking status one-year post-ACS - continuous smokers, smokers who quit within the year, and non-smokers. Depression status at baseline and one-year was assessed with the Center for Epidemiologic Studies Depression scale (CES-D) and antidepressant drug use. A CES-D score ≥ 16 defined depression. A multivariate-adjusted logistic regression model was used to calculate odds ratios (OR) between groups. The study sample mean age was 62.4 years and females represented 20.8%. At baseline, 22.6% were depressed, 40.9% were smokers, and 47.5% of these quit smoking over the year post-ACS. In comparison to depressed continuous smokers, depressed smokers who quit had an adjusted OR 2.59 (95% confidence interval (CI) 1.27-5.25) of going below a CES-D score of 16 or not using antidepressants. New depression at one-year was found in 24.4% of non-depressed smokers who quit, and in 27.1% of non-depressed continuous smokers, with an adjusted OR 0.85 (95% CI 0.55-1.29) of moving to a CES-D score of ≥16 or using antidepressants. In conclusion, smokers with depression at time of ACS who quit smoking improved their depression more frequently compared to continuous smokers. The incidence of new depression among smokers who quit after ACS was similar compared to continuous smokers.
吸烟和抑郁是急性冠状动脉综合征（ACS）的危险因素，且常同时存在。我们研究了 ACS 后一年戒烟对抑郁演变的影响。对瑞士多中心 SPUM-ACS 队列研究的 1822 例 ACS 患者的一年随访数据进行了分析。根据 ACS 后一年的吸烟状态，将参与者分为三组 - 持续吸烟者、一年内戒烟者和非吸烟者。使用流行病学研究中心抑郁量表（CES-D）和抗抑郁药物评估基线和一年时的抑郁状况。CES-D 评分≥16 定义为抑郁。使用多变量调整逻辑回归模型计算组间比值比（OR）。研究样本的平均年龄为 62.4 岁，女性占 20.8%。基线时，22.6%的患者抑郁，40.9%的患者吸烟，其中 47.5%的患者在 ACS 后一年内戒烟。与持续吸烟且抑郁的患者相比，戒烟且抑郁的患者调整后 OR 为 2.59（95%置信区间（CI）1.27-5.25），其 CES-D 评分低于 16 分或未使用抗抑郁药的可能性更高。24.4%戒烟且不抑郁的吸烟者和 27.1%不抑郁且持续吸烟的吸烟者在一年时出现新的抑郁，调整后 OR 为 0.85（95%CI 0.55-1.29），即 CES-D 评分≥16 或使用抗抑郁药的可能性更低。综上所述，ACS 时患有抑郁的吸烟者戒烟后更频繁地改善抑郁状况，而 ACS 后戒烟的吸烟者新发抑郁的发生率与持续吸烟者相似。
