Characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study).
Characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study).
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DOI：
10.1016/j.amjcard.2010.10.013
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发表时间：
2011-02-15
影响因子：
2.8
通讯作者：
O'Connor, Christopher M.
中科院分区：
文献类型：
--
作者：
Jiang, Wei;Krishnan, Ranga;Kuchibhatla, Maragatha;Cuffe, Michael S.;Martsberger, Carolyn;Arias, Rebekka M.;O'Connor, Christopher M.
抑郁症在心力衰竭（HF）患者中普遍存在，并且与住院和死亡的显著增加相关。SADHART-CHF（舍曲林治疗慢性心力衰竭患者抑郁和心脏病）试验的初步结果显示，舍曲林和安慰剂对抑郁和心血管结局的影响相当。在这项研究中，我们探讨了抑郁症的缓解是否与更好的生存率相关，并描述了在试验期间缓解的参与者。基于12周治疗期间的抑郁反应，将SADHART-CHF参与者分为2组：1）缓解，定义为末次测量的汉密尔顿抑郁评定量表（HDRS）评分<8的参与者; 2）非缓解，定义为末次测量的HDRS评分≥8的参与者。不包括在重复HDRS之前退出的患者。在469名SADHART-CHF参与者中，208名（44. 3%）达到缓解，194名（41. 4%）仍然抑郁，67名（14. 3%）脱落或死亡，未进行任何重复HDRS评估。缓解组患者的心血管事件发生率显著低于非缓解组（1.34±1.86 vs. 1.93±2.71; P调整后= 0.01）。男性患者比女性患者更容易缓解（56.5% vs. 44.8%，p=0.02）。与未缓解组相比，缓解组在基线时具有较轻的抑郁症状（HDRS：17.0±5.4 vs. 19.6±5.5; Beck抑郁量表：17.9±6.5 vs. 20.3±7.2; ps<0.001）。总之，这项研究表明，缓解抑郁症可能会改善心力衰竭患者的心血管结局。
Depression is prevalent among heart failure (HF) patients, and is associated with a significant increase in hospitalizations and death. Primary results of the SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic HF) trial revealed that sertraline and placebo had comparable effects on depression and cardiovascular outcomes. In this study, we explore whether remission from depression is associated with better survival and to characterize participants who remitted during the trial. Based on the depression response during the 12-week treatment phase, SADHART-CHF participants were divided into 2 groups: 1) remission, defined as participants whose last measured Hamilton Depression Rating Scale (HDRS) score was <8; 2) non-remission, defined as participants whose last measured HDRS score was ≥8. Patients who dropped out prior to having any repeat HDRS were not included. Baseline characteristics and survival differences up to 5 years were evaluated between the remission and the non-remission groups Of the 469 SADHART-CHF participants, 208 (44.3%) achieved remission, 194 (41.4%) remained depressed, and 67 (14.3%) dropped out or died without any repeat HDRS assessment. Patients in the remission group had significantly lower cardiovascular events than those in the non-remission group (1.34±1.86 vs. 1.93±2.71; Padjusted=.01). Male patients were more likely to remit than female patients (56.5 vs. 44.8%, p=0.02). The remission group had milder depressive symptoms at baseline compared to the non-remission group (HDRS: 17.0±5.4 vs. 19.6±5.5; Beck Depression Inventory scale: 17.9±6.5 vs. 20.3±7.2; ps<0.001). In conclusion, this study indicates that remission from depression may improve the cardiovascular outcome of HF patients.
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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：
Taylor, CB;Youngblood, ME;Jaffe, AS
通讯作者：
Jaffe, AS
影响因子：
6
作者：
Mueller-Tasch, Thomas;Peters-Klimm, Frank;Herzog, Wolfgang
通讯作者：
Herzog, Wolfgang