Impact of cardiac rehabilitation on depression and its associated mortality
Impact of cardiac rehabilitation on depression and its associated mortality
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DOI：
10.1016/j.amjmed.2007.03.026
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发表时间：
2007-09-01
影响因子：
5.9
通讯作者：
Lavie, Carl J.
中科院分区：
文献类型：
--
作者：
Milani, Richard V.;Lavie, Carl J.
目得：主要心脏事件后的抑郁与较高的死亡率相关，但很少有人知道这是否可以通过包括心脏康复和运动训练在内的治疗来降低。我们评估了心脏康复对抑郁症及其相关的死亡率在coronarypatients.PATIENTS和方法的影响：我们评估了522个连续冠状动脉患者（381名男性，141名女性，年龄64 +/- 10岁）参加心脏康复从2000年1月至2005年7月和对照组的179例患者没有完成康复。在基线和康复后通过问卷调查评估抑郁症状，并在平均随访1296 +/- 551 day.Results后评估死亡率：康复后抑郁症状的患病率下降了63%，从17%下降到6%（P < .0001）。康复治疗后抑郁症患者的死亡率比非抑郁症患者高4倍以上（22%比5%，P = 0.0004）。与未完成康复的对照组抑郁受试者相比，完成康复的抑郁患者死亡率降低73%（8% vs 30%; P = 0.0005）。抑郁症状的减少及其相关的死亡率与健身的改善有关;然而，在运动能力适度或显著增加的患者中也发现了类似的减少。在发生严重冠状动脉事件的患者中，心脏康复与抑郁症状的减少和与之相关的死亡率增加有关。似乎只需要轻微的健身水平的改善就可以对抑郁症状及其相关的死亡率产生这些益处。(C)2007爱思唯尔公司All rights reserved.
PURPOSE: Depression following major cardiac events is associated with higher mortality, but little is known about whether this can be reduced through treatment including cardiac rehabilitation and exercise training. We evaluated the impact of cardiac rehabilitation on depression and its associated mortality in coronary patients.PATIENTS AND METHODS: We evaluated 522 consecutive coronary patients (381 men, 141 women; aged 64 +/- 10 years) enrolled in cardiac rehabilitation from January 2000 to July 2005 and a control group of 179 patients not completing rehabilitation. Depressive symptoms were assessed by questionnaire at baseline and following rehabilitation, and mortality was evaluated after a mean follow-up of 1296 +/- 551 days.RESULTS: Prevalence of depressive symptoms decreased 63% following rehabilitation, from 17% to 6% (P < .0001). Depressed patients following rehabilitation had an over 4-fold higher mortality than nondepressed patients (22% vs 5%, P = .0004). Depressed patients who completed rehabilitation had a 73% lower mortality (8% vs 30%; P = .0005) compared with control depressed subjects who did not complete rehabilitation. Reductions in depressive symptoms and its associated mortality were related to improvements in fitness; however, similar reductions were noted in those with either modest or marked increases in exercise capacity.CONCLUSION: In patients following major coronary events, cardiac rehabilitation is associated with both reductions in depressive symptoms and the excess mortality associated with it. Moreover, only mild improvements in levels of fitness appear to be needed to produce these benefits on depressive symptoms and its associated mortality. (C) 2007 Elsevier Inc. All rights reserved.