Exercise and Escitalopram in the Treatment of Anxiety in Patients with Coronary Heart Disease: One Year Follow-Up of the UNWIND Randomized Clinical Trial.
Exercise and Escitalopram in the Treatment of Anxiety in Patients with Coronary Heart Disease: One Year Follow-Up of the UNWIND Randomized Clinical Trial.
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DOI：
10.3390/jcdd9100320
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发表时间：
2022-09-22
影响因子：
2.4
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中科院分区：
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焦虑在冠心病（CHD）患者中很常见，并与较差的预后相关。UNWIND是一项为期12周的随机临床试验，比较运动和艾司西酞普兰与安慰剂对焦虑、抑郁和冠心病生物标志物的影响。该试验的主要结果表明，使用艾司西酞普兰治疗，而不是运动，与焦虑和抑郁的显著减少有关。在1年的随访中，参与者完成了医院焦虑-抑郁量表-焦虑（HADS-A）以及hads -抑郁（HADS-D）、贝克抑郁量表- ii （BDI-II）和戈丁休闲时间运动调查，以评估身体活动。结果显示，随机分配到艾司西酞普兰组的患者的HADS-A得分低于随机分配到运动组的患者（P = 0.006），抑郁程度低于运动组的HADS-D （P = 0.004）和BDI-II （P = 0.004）。与随机分配到安慰剂组的参与者相比，随机分配到运动组的参与者在一年内报告的身体活动水平更高（P = 0.039）。然而，尽管报告说他们更活跃，那些随机分配到运动组的人与安慰剂对照组相比，焦虑或抑郁并没有减少。艾司西酞普兰似乎是一种安全有效的治疗焦虑症的药物；运动对健康有很多好处，但对治疗焦虑似乎没有效果。
Anxiety is common among patients with coronary heart disease (CHD) and is associated with a worse prognosis. UNWIND was a 12-week randomized clinical trial comparing exercise and escitalopram to placebo on measures of anxiety, depression, and CHD biomarkers. Primary results of the trial reported that treatment with escitalopram, but not exercise, was associated with significant reductions in anxiety and depression. At 1-year follow-up, participants completed the Hospital Anxiety-Depression Scale-Anxiety (HADS-A) along with the HADS-Depression (HADS-D), the Beck Depression Inventory-II (BDI-II), and the Godin Leisure Time Exercise survey to assess physical activity. Results showed that those patients randomized to escitalopram had lower scores on the HADS-A compared to those randomized to exercise (P = 0.006) and had less depression compared to exercise on the HADS-D (P = 0.004) and BDI-II (P = 0.004). Participants randomized to exercise reported higher levels of physical activity at 1-year compared to those randomized to Placebo (P = 0.039). However, despite reporting being more physically active, those randomized to exercise did not have less anxiety or depression compared to placebo controls. Escitalopram appears to be a safe and effective treatment for anxiety; exercise has many health benefits, but does not appear to be effective in treating anxiety.