Depression or anxiety and all-cause mortality in adults with atrial fibrillation--A cohort study in Swedish primary care.
Depression or anxiety and all-cause mortality in adults with atrial fibrillation--A cohort study in Swedish primary care.
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DOI：
10.3109/07853890.2015.1132842
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发表时间：
2016
影响因子：
4.4
通讯作者：
Sundquist K
中科院分区：
文献类型：
--
作者：
Wändell P;Carlsson AC;Gasevic D;Wahlström L;Sundquist J;Sundquist K
我们的目的是研究抑郁和焦虑在房颤（AF）患者中作为全因死亡率的危险因素在初级保健环境。研究人群包括瑞典75家初级保健中心诊断为AF的45岁及以上成人（n = 12 283）。采用考克斯回归分析探讨了抑郁或焦虑与全因死亡率之间的关系，包括风险比（HR）和95%置信区间（95% CI）。分析在男性和女性中进行，调整了年龄，教育水平，婚姻状况，邻里社会经济地位（SES），邻里地位的变化和焦虑或抑郁，分别和心血管合并症。作为次要分析，探讨了背景因素及其与抑郁或焦虑的关系。即使在完全调整后，抑郁症男性的全因死亡风险也高于无抑郁症的男性（HR = 1.28，95%CI 1.08-1.53）。对于男性房颤患者的焦虑和女性房颤患者的焦虑或抑郁，没有发现相关性。需要提高对房颤和随后的抑郁症患者死亡率较高的认识。我们建议在临床实践中密切随访和治疗这两种疾病。
Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting. The study population included adults (n = 12 283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis, background factors and their association with depression or anxiety were explored. The risk of all-cause mortality was higher among men with depression compared to their counterparts without depression even after full adjustment (HR = 1.28, 95% CI 1.08–1.53). For anxiety among men and anxiety or depression among women with AF, no associations were found. Cerebrovascular disease was more common among depressed AF patients. Increased awareness of the higher mortality among men with AF and subsequent depression is called for. We suggest a tight follow-up and treatment of both ailments in clinical practice.