Association of depression and survival in patients with chronic heart failure over 12 Years.
Association of depression and survival in patients with chronic heart failure over 12 Years.
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DOI：
10.1016/j.psym.2011.12.002
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发表时间：
2012-07
期刊：
影响因子：
3.4
通讯作者：
Jiang, Wei
中科院分区：
文献类型：
--
作者：
Adams, Julie;Kuchibhatla, Maragatha;Christopher, Eric J.;Alexander, Jude D.;Clary, Greg L.;Cuffe, Michael S.;Califf, Robert M.;Krishnan, Ranga R.;O'Connor, Christopher M.;Jiang, Wei
在12年的随访期间研究慢性心力衰竭（HF）患者的抑郁与生存之间的关系。
在心力衰竭患者中，抑郁与生存的关联已在长达7年的研究中得到证实。抑郁对这些患者生存的长期影响仍然未知。
前瞻性观察研究，研究对象为1997年3月至2003年6月期间在杜克大学医学中心心内科住院并完成贝克抑郁量表（BDI）测评的成年心力衰竭患者。通过查询国家死亡索引了解生存状况。采用Cox比例风险模型确定生存与抑郁的关联。
在平均随访1792.33±1372.82天（中位数1600天；范围0 - 4683天）期间，985名心力衰竭参与者中有733人死于各种原因，其中抑郁患者（BDI>10）占80%，无抑郁患者占73%（p = 0.01）。在随访过程中，抑郁与生存率降低显著且持续相关（风险比[HR]1.35，95%置信区间[CI]1.15 - 1.57），并且独立于常规风险因素（HR1.40，95%CI1.16 - 1.68）。此外，生存率与抑郁严重程度呈负相关（BDI连续变量HR1.02，95%CI1.006 - 1.025，p = 0.001）。
在首次住院期间合并的抑郁对心力衰竭患者死亡率显著增加的影响很大，并持续12年以上。这些研究结果表明，需要更多的研究来了解抑郁的发展轨迹、抑郁影响的潜在机制，以及确定心力衰竭患者抑郁的有效管理策略。
To examine the relationship of depression and survival of patients with chronic heart failure (HF) over a 12-year follow-up period. The survival associated with depression has been demonstrated in HF patients for up to 7 years. Longer-term impact of depression on survival of these patients remains unknown. Prospectively conducted observational study examining adult HF patients who were admitted to a cardiology service at Duke University Medical Center between March 1997 and June 2003 and completed the Beck Depression Inventory (BDI) scale. The National Death Index was queried for vital status. Cox proportional hazards modeling was used to determine association of survival and depression. During a mean follow-up of 1792.33±1372.82 days (median 1600; range 0–4683), 733 of 985 HF participants died of all causes, representing 80% of those with depression (BDI>10) and 73% of those without (p=0.01). Depression was significantly and persistently associated with decreased survival over follow-up (Hazard Ratio [HR] 1.35, 95% Confidence Interval [CI] 1.15–1.57) and was independent of conventional risk factors (HR 1.40, 95% CI 1.16–1.68). Furthermore, survival was inversely associated with depression severity (BDIcontinuous HR 1.02, 95% CI 1.006–1.025, p=0.001). The impact of co-morbid depression during index hospitalization on significantly increased mortality of HF patients is strong and persists over12 years. These findings suggest that more investigation is needed to understand the trajectory of depression and the mechanisms underlying the impact of depression as well as to identify effective management strategies for depression of patients with HF.
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影响因子：
4.8
作者：
Jiang, Wei;O'Connor, Christopher;Silva, Susan G.;Kuchibhatla, Maragatha;Cuffe, Michael S.;Callwood, Dwayne D.;Zakhary, Bosh;Henke, Elizabeth;Arias, Rebekka M.;Krishnan, Ranga
通讯作者：
Krishnan, Ranga
影响因子：
--
作者：
Glassman, Alexander H.;Bigger, J. Thomas, Jr.;Gaffney, Michael
通讯作者：
Gaffney, Michael
影响因子：
3.3
作者：
Carney, RM;Blumenthal, JA;Jaffe, AS
通讯作者：
Jaffe, AS
影响因子：
--
作者：
DiMatteo, MR;Lepper, HS;Croghan, TW
通讯作者：
Croghan, TW
影响因子：
37.8
作者：
Frasure-Smith, Nancy;Lesperance, Francois;Roy, Denis
通讯作者：
Roy, Denis