Association Between Panic Disorder and Risk of Atrial Fibrillation: A Nationwide Study
Association Between Panic Disorder and Risk of Atrial Fibrillation: A Nationwide Study
复制标题
DOI：
10.1097/psy.0b013e318273393a
复制
发表时间：
2013-01-01
影响因子：
3.3
通讯作者：
Chan, Wan-Leong
中科院分区：
文献类型：
--
作者：
Cheng, Ya-Fen;Leu, Hsin-Bang;Chan, Wan-Leong
目的：本研究的目的是探讨惊恐障碍（PD）与心房颤动（AF）之间的关联。方法：我们使用了台湾全国范围内的人口数据集。研究组纳入了 1,000,000 名样本队列数据集中的 3888 名 PD 且未诊断为 AF 的患者。研究组中每1名患者选择10名无PD和AF的患者，根据入组时间、年龄、性别和合并症进行倾向评分匹配。我们进行了对数秩检验来分析两组之间累积的无房颤生存率的差异。进行 Cox 比例风险回归来评估决定 AF 纵向风险的独立因素。结果：在最长 7 年的随访期间，研究组中有 48 名患者（占 PD 患者的 1.2%）和对照组中的 358 名患者（占无 PD 患者的 0.9%）新诊断为 AF。 PD 患者的 AF 发生率显着较高（风险比 [HR] = 1.54 [1.14-2.09]；对数秩检验，p = .004）。对危险因素和合并症进行 Cox 模型调整后，PD（HR = 1.73，95% 置信区间 [Cl] = 1.26-2.37）、年龄（HR = 1.07，95% CI = 1.06-1.08）、男性（HR = 1.26，95% CI = 1.03-1.55）、高血压（HR 2.00，95%） Cl = 1.55-2.56）、冠状动脉疾病史（HR = 1.45，95% CI = 1.15-1.82）、充血性心力衰竭（HR = 2.46；95% CI，1.84-3.30）和瓣膜性心脏病（HR = 2.83，95% CI = 1.85-4.42）与以下风险增加独立相关： AF。结论：PD 与未来诊断的 AF 发生率较高独立相关。建议进行更大规模的前瞻性研究或荟萃分析来证实这些发现。
Objective: The aim of the present study was to investigate the association between panic disorder (PD) and atrial fibrillation (AF). Methods: We used a nationwide population-based data set from Taiwan. A total of 3888 patients with PD and without a diagnosis of AF from a sampled cohort data set of 1,000,000 were included in the study group. Ten people without PD and AF were selected for every 1 patient in the study group, matched by propensity score matching according to time of enrollment, age, sex, and comorbidities. We performed log-rank tests to analyze differences in accumulated AF-free survival rates between the two groups. Cox proportional hazard regressions were performed to evaluate the independent factors determining the longitudinal hazard of AF. Results: During a maximal 7-year follow-up, 48 patients from the study group (1.2% of the patients with PD) and 358 from the control group (0.9% of the patients without PD) were newly diagnosed as having AF. Patients with PD had a significantly higher incidence of AF (hazard ratio [HR] = 1.54 [1.14-2.09]; log-rank test, p = .004). After Cox model adjustment for risk factors and comorbidities, PD (HR = 1.73, 95% confidence interval [Cl] = 1.26-2.37), age (HR = 1.07, 95% CI = 1.06-1.08), male sex (HR = 1.26, 95% CI = 1.03-1.55), hypertension (HR 2.00, 95% Cl = 1.55-2.56), history of coronary artery disease (HR = 1.45, 95% CI = 1.15-1.82), congestive heart failure (HR = 2.46; 95% CI, 1.84-3.30), and valvular heart disease (HR = 2.83, 95% CI = 1.85-4.42) were independently associated with increased risk of AF. Conclusions: PD is independently associated with higher incidence of AF to be diagnosed in the future. Larger prospective studies or meta-analysis are suggested to confirm the findings.