Two-year prognosis after acute coronary syndrome in younger patients: Association with feeling depressed in the prior year, and BDI-II score and Endothelin-1.
Two-year prognosis after acute coronary syndrome in younger patients: Association with feeling depressed in the prior year, and BDI-II score and Endothelin-1.
复制标题
年轻患者急性冠状动脉综合征后的两年预后：与前一年感觉抑郁、BDI-II 评分和内皮素-1 的关联。
DOI：
10.1016/j.jpsychores.2017.05.017
复制
发表时间：
2017
影响因子：
4.7
通讯作者：
Burg,MatthewM
中科院分区：
文献类型：
--
作者：
Yammine,Luba;Frazier,Lorraine;Padhye,NikhilS;Sanner,JenniferE;Burg,MatthewM
目的探讨抑郁症状和内皮素（ET）-1对年轻急性冠脉综合征（ACS）患者2年预后的影响。抑郁症与ACS后不良预后相关;然而，很少有研究关注年轻患者。重要的是，强调年轻患者的研究表明，抑郁症对预后的影响在年轻亚组中可能更强。抑郁症与年轻患者预后不良之间的特定联系尚未明确确定。ET-1是一种强有力的内源性血管收缩剂，以前已链接到不良post-ACS outcomes.MethodsThe样本（n = 153）包括男性（年龄≤ 50岁）和女性（年龄≤ 55岁）ACS患者。在ACS入院后2-3 h内采集用于ET-1评估的血样。在入院后2-5天内用贝克抑郁量表（BDI）II评估抑郁症状。主要结果被定义为主要不良心血管事件（MACE）的复合，包括复发性心肌梗死，紧急冠状动脉血运重建术，和全因死亡率在2年内指数admission.ResultsDuring随访期间，23例患者经历了MACE。在未校正的分析中，或在根据人口统计学特征、合并症和肌钙蛋白水平校正的分析中，BDI-II评分和ET-1均不能预测MACE。在补充分析中，感觉抑郁的前一年ACS预测MACE.ConclusionsIn这个队列的年轻ACS患者，感觉抑郁的前一年ACS入院预测MACE在2年后基线ACS事件，而BDI-II评分，也没有循环ET-1水平预测这一结果。
ObjectiveTo examine the effects of depressive symptoms and Endothelin (ET)-1 on 2-year prognosis in younger patients with acute coronary syndrome (ACS). Depression is associated with poor post-ACS prognosis; however, few investigations have focused on younger patients. Importantly, the studies that did emphasize younger patients suggested that the influence of depression on prognosis could be more robust in younger subgroups. The particular links between depression and poor prognosis in younger patients have yet to be definitively determined. ET-1 is a potent endogenous vasoconstrictor that has been previously linked to adverse post-ACS outcomes.MethodsThe sample (n = 153) included male (age ≤ 50 years) and female (age ≤ 55 years) ACS patients. Blood samples for ET-1 assessment were collected within 2–3 h of ACS hospital admission. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) II within 2–5 days of admission. The primary outcome was defined as a composite of major adverse cardiovascular events (MACE), including recurrent myocardial infarction, emergent coronary revascularization, and all-cause mortality within 2 years after index admission.ResultsDuring the follow-up period, 23 patients experienced MACE. Neither the BDI-II score nor ET-1 predicted MACE in unadjusted analyses or in analyses adjusted for demographic characteristics, comorbidities and troponin levels. In the supplementary analyses, feeling depressed in the year preceding ACS predicted MACE.ConclusionsIn this cohort of younger ACS patients, feeling depressed in the year preceding ACS admission predicted MACE in the 2 years after baseline ACS event, while neither the BDI-II score, nor circulating ET-1 level predicted this outcome.