Department of Critical Care Medicine and West China Biomedical Big Data Center West China Hospital Sichuan University Chengdu China.
West China Biomedical Big Data Center West China Hospital Sichuan University Chengdu China.
J Am Heart Assoc. 2024 Aug 6;13(15):e031280. doi: 10.1161/JAHA.123.031280. Epub 2024 Jul 31.
The associations between cardiovascular disease (CVD) and multiple psychiatric disorders and suicide attempt, and whether different genetic susceptibilities affect such links, have not been investigated clearly.
Based on the UK Biobank, we conducted a matched cohort study involving 63 923 patients who were first hospitalized with a CVD diagnosis between 1997 and 2020, and their 127 845 matched unexposed individuals. Cox models were used to examine the subsequent risk of psychiatric disorders and suicide attempt (ie, anxiety, depression, stress-related disorder, substance misuse, psychotic disorder, and suicide behaviors) following CVD. We further performed stratified analyses by polygenic risk score for each studied psychiatric condition to detect the possible effects of genetic susceptibility on the observed associations. We found an increased risk of any psychiatric disorders and suicide attempt among CVD patients, compared with matched unexposed individuals, particularly within 1 year following the CVD (fully adjusted hazard ratio [HR] within 1 year, 1.83 [95% CI, 1.58-2.12]; HR after 1 year, 1.24 [95% CI, 1.16-1.32]). By subtype, the risk elevations existed for any psychiatric disorders and suicide attempt following most categories of CVDs. Analyses stratified by polygenic risk score revealed little impact of genetic predisposition to studied psychiatric conditions on these observed links.
Patients hospitalized for CVD were at increased subsequent risk of multiple types of psychiatric disorders and suicide attempt, especially in the first year after hospitalization, irrespective of their genetic susceptibilities to studied psychiatric conditions, and these findings underscore the necessity of developing timely psychological interventions for this vulnerable population.
心血管疾病（CVD）与多种精神障碍和自杀未遂之间的关联，以及不同的遗传易感性是否会影响这些关联，尚未得到明确研究。
基于英国生物银行，我们进行了一项匹配队列研究，纳入了 63923 名在 1997 年至 2020 年间首次因 CVD 住院的患者，以及他们的 127845 名匹配的未暴露个体。使用 Cox 模型来评估 CVD 后随后发生精神障碍和自杀未遂（即焦虑、抑郁、应激相关障碍、物质使用障碍、精神病性障碍和自杀行为）的风险。我们进一步通过每种研究精神疾病的多基因风险评分进行分层分析，以检测遗传易感性对观察到的关联的可能影响。我们发现，与匹配的未暴露个体相比，CVD 患者发生任何精神障碍和自杀未遂的风险增加，尤其是在 CVD 后 1 年内（完全调整后的 1 年内 HR，1.83[95%CI，1.58-2.12]；1 年后的 HR，1.24[95%CI，1.16-1.32]）。按亚型分析，大多数 CVD 类别后均存在任何精神障碍和自杀未遂风险增加。按多基因风险评分分层分析显示，研究精神疾病的遗传易感性对这些观察到的关联影响不大。
因 CVD 住院的患者在随后发生多种类型的精神障碍和自杀未遂的风险增加，尤其是在住院后 1 年内，无论他们对研究精神疾病的遗传易感性如何，这些发现强调了为这一脆弱人群及时开展心理干预的必要性。
