Cao Hongfu, Zhao Hui, Shen Li
Gulou Hospital of Traditional Chinese Medicine of Beijing, Beijing, China.
Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2022 Aug 30;9:913888. doi: 10.3389/fcvm.2022.913888. eCollection 2022.
Depression, as an independent risk factor, can lead to a substantially increased risk of coronary heart disease (CHD). The overall body of evidence involving depression and CHD is not consistent. Therefore, we performed an update meta-analysis to evaluate the association between depression and the risk of patients with CHD.
Studies were identified through a comprehensive literature search of the PubMed, Embase, and the Cochrane Library database from its inception to 28 September 2021 for titles/abstracts with restricted to English language articles. The literature was screened according to the inclusion and exclusion criteria. Along with data extraction, we evaluated the quality of eligible studies using the Newcastle-Ottawa Scale (NOS). The primary outcome was fatal or non-fatal CHD. We calculated relative risk (RR) with 95% confidence intervals (CIs) using a random-effects models. The protocol was registered in the PROSPERO registration (registration number CRD42021271259).
From 9,151 records, we included 26 prospective cohort studies published from 1998 to 2018, consisting of 402,597 patients. Either in depression-exposured group or non-depression-exposured group, the mean age of all participants ranged from 18 to 99 years. Moreover, the NOS scores of these studies are eventually indicated that the quality of these eligible studies was reliable. In general, the pooled results showed that patients with depression had a higher risk of CHD compared to patients without depression (RR = 1.21, 95% CI: 1.14-1.29). Additionally, the funnel plot appeared to be asymmetry, indicating there existing publication bias for the pooled results between depression and CHD. A sensitivity analysis was used to assess the stability of the relationship between depression and CHD that indicating the results robust (RR = 1.15, 95% CI: 1.09-1.21).
Depression may increase risk of CHD. Future studies on the share pathogenic mechanisms of both depression and CHD may develop novel therapies.
抑郁症作为一个独立的风险因素，可导致冠心病（CHD）风险大幅增加。关于抑郁症与冠心病的总体证据并不一致。因此，我们进行了一项更新的荟萃分析，以评估抑郁症与冠心病患者风险之间的关联。
通过全面检索PubMed、Embase和Cochrane图书馆数据库，从数据库建立至2021年9月28日，查找标题/摘要仅限于英文文章的研究。根据纳入和排除标准筛选文献。在进行数据提取时，我们使用纽卡斯尔-渥太华量表（NOS）评估符合条件的研究质量。主要结局是致命或非致命性冠心病。我们使用随机效应模型计算相对风险（RR）及95%置信区间（CI）。该方案已在PROSPERO注册库注册（注册号CRD42021271259）。
从9151条记录中，我们纳入了1998年至2018年发表的26项前瞻性队列研究，共402597例患者。在抑郁症暴露组和非抑郁症暴露组中，所有参与者的平均年龄在18至99岁之间。此外，这些研究的NOS评分最终表明这些符合条件的研究质量可靠。总体而言，汇总结果显示，与无抑郁症患者相比，抑郁症患者患冠心病的风险更高（RR = 1.21，95%CI：1.14 - 1.29）。此外，漏斗图似乎不对称，表明抑郁症与冠心病汇总结果之间存在发表偏倚。使用敏感性分析评估抑郁症与冠心病之间关系的稳定性，结果表明该关系稳健（RR = 1.15，95%CI：1.09 - 1.21）。
抑郁症可能会增加冠心病风险。未来关于抑郁症和冠心病共同致病机制的研究可能会开发出新的治疗方法。
