Fu Yonghui, Feng Shenghui, Gu Zhenbang, Liu Xiao, Zhu Wengen, Wei Bo, Guo Linjuan
Department of Psychiatry, Jiangxi Mental Hospital, 330029 Nanchang, Jiangxi, China.
Medical Department, Queen Mary School, Nanchang University, 330006 Nanchang, Jiangxi, China.
Rev Cardiovasc Med. 2024 Oct 22;25(10):370. doi: 10.31083/j.rcm2510370. eCollection 2024 Oct.
Studies dedicated to exploring the incidence of atrial fibrillation (AF) in patients with concurrent depression and heart failure with preserved ejection fraction (HFpEF) are scarce. The impact of antidepressant therapy on AF risk within this population remains unclear. Our current study aimed to investigate the link between depression and AF risk in HFpEF patients and to assess the influence of antidepressant medication on the development of AF.
We utilized Kaplan-Meier estimates to determine the event-free status for AF and applied the Log-rank test for comparative analysis between groups. The associations were quantified using univariate and multivariate Cox proportional hazards regression models, with results expressed as hazard ratios (HR) and 95% confidence intervals (CI).
Among the 784 patients in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, 29.1% (228) were identified with major depression. After adjusting for significant confounders, compared with mild depression, major depression at baseline was not linked to the incidence of AF (adjusted HR = 0.82, 95% CI: 0.46-1.49). Additionally, compared with controls, antidepressant use at baseline did not significantly influence the risk of incident AF in patients with HFpEF and major depression (adjusted HR = 0.41, 95% CI: 0.08-2.10).
The presence of major depression at baseline did not elevate the risk of incident AF among individuals with HFpEF. Additionally, the use of antidepressants showed no correlation with an increased rate of AF among HFpEF patients with comorbid major depression.
URL: https://clinicaltrials.gov/study/NCT00094302. Unique identifier: NCT00094302.
专门探讨合并抑郁症和射血分数保留的心力衰竭（HFpEF）患者中房颤（AF）发病率的研究较少。抗抑郁治疗对该人群房颤风险的影响尚不清楚。我们当前的研究旨在调查HFpEF患者抑郁症与房颤风险之间的联系，并评估抗抑郁药物对房颤发生的影响。
我们使用Kaplan-Meier估计法确定房颤的无事件状态，并应用对数秩检验进行组间比较分析。使用单变量和多变量Cox比例风险回归模型对关联进行量化，结果以风险比（HR）和95%置信区间（CI）表示。
在醛固酮拮抗剂治疗射血分数保留的心力衰竭（TOPCAT）试验的784例患者中，29.1%（228例）被确定为重度抑郁症。在调整了显著的混杂因素后，与轻度抑郁症相比，基线时的重度抑郁症与房颤发病率无关（调整后HR = 0.82，95%CI：0.46 - 1.49）。此外，与对照组相比，基线时使用抗抑郁药物对HFpEF和重度抑郁症患者发生房颤的风险没有显著影响（调整后HR = 0.41，95%CI：0.08 - 2.10）。
基线时存在重度抑郁症并未增加HFpEF患者发生房颤的风险。此外，在合并重度抑郁症的HFpEF患者中，使用抗抑郁药物与房颤发生率增加无关。
网址：https://clinicaltrials.gov/study/NCT00094302。唯一标识符：NCT00094302。
