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心脏病患者的抑郁症是主要的心血管事件风险因素:一项为期12个月的观察性研究。

Depression in Cardiac Patients Is a Major Cardiovascular Event Risk Factor: A 12-Month Observational Study.

作者信息

Podolec Jakub, Kleczyński Paweł, Piechocki Marcin, Okarski Michał, Lizończyk Katarzyna, Szkodoń Kornelia, Silczuk Andrzej, Przewłocki Tadeusz, Legutko Jacek, Kabłak-Ziembicka Anna

机构信息

Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-007 Kraków, Poland.

Department of Interventional Cardiology, The St. John Paul II Hospital, 31-202 Kraków, Poland.

出版信息

J Clin Med. 2024 Nov 16;13(22):6911. doi: 10.3390/jcm13226911.

Abstract

: Depression is a known factor in poor cardiovascular outcomes but is often underassessed in cardiac units. This study evaluates the impact of depression on cardiovascular outcomes in patients undergoing cardiac interventions. The study included 133 patients who underwent uncomplicated procedures for degenerative aortic valve stenosis (n = 40), acute coronary syndrome (n = 29), or chronic coronary artery disease (n = 64). Depression was assessed using the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D). The primary endpoint was a major adverse cardiac and cerebrovascular event (MACCE). Patients were followed up for 12 months. Cox proportional hazards analysis was used to identify MACCE risk factors. : Depression was more frequently screened by HAM-D than BDI (42.9% vs. 30.8%, < 0.001). During follow-up, 26 (19.5%) MACCEs occurred. In univariate analysis, risk factors included BDI score ≥ 11, HAM-D score ≥ 8, diabetes on insulin, anticoagulant use, atrial fibrillation, and serum creatinine level ≥ 130 µmol/L. Depression in the BDI increased the risk of the MACCE 3.6-fold (95%CI: 1.64-8.0, = 0.001), whereas in the HAM-D, it increased the risk 4.9-fold (95%CI: 1.97-12.24, < 0.001). Multivariate analysis showed HAM-D score ≥ 8 as the strongest predictor of MACCE (HR: 3.08, 95%CI: 1.18-8.08). : Depression is a common finding in cardiovascular patients, and it is a strong risk factor for one-year cardiovascular mortality and adverse event risk. Therefore, we believe that common guidelines should be elaborated between relevant psychiatry and cardiology scientific societies.

摘要

抑郁症是心血管不良预后的一个已知因素,但在心脏科往往未得到充分评估。本研究评估抑郁症对接受心脏介入治疗患者心血管预后的影响。该研究纳入了133例因退行性主动脉瓣狭窄(n = 40)、急性冠状动脉综合征(n = 29)或慢性冠状动脉疾病(n = 64)接受非复杂性手术的患者。使用贝克抑郁量表(BDI)和汉密尔顿抑郁评定量表(HAM-D)评估抑郁症。主要终点是主要不良心血管和脑血管事件(MACCE)。对患者进行了12个月的随访。采用Cox比例风险分析来确定MACCE的危险因素。:与BDI相比,HAM-D更常筛查出抑郁症(42.9%对30.8%,P < 0.001)。随访期间,发生了26例(19.5%)MACCE。单因素分析中,危险因素包括BDI评分≥11、HAM-D评分≥8、使用胰岛素治疗的糖尿病、使用抗凝剂、心房颤动以及血清肌酐水平≥130 μmol/L。BDI中的抑郁症使MACCE风险增加3.6倍(95%CI:1.64 - 8.0,P = 0.001),而在HAM-D中,风险增加4.9倍(95%CI:1.97 - 12.24,P < 0.001)。多因素分析显示,HAM-D评分≥8是MACCE的最强预测因素(HR:3.08,95%CI:1.18 - 8.08)。:抑郁症在心血管疾病患者中很常见,并且是一年心血管死亡率和不良事件风险的强危险因素。因此,我们认为相关精神病学和心脏病学科学学会之间应制定通用指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85c/11594284/4085b9d7e03e/jcm-13-06911-g001.jpg

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