Gender, depression, and one-year prognosis after myocardial infarction
Gender, depression, and one-year prognosis after myocardial infarction
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DOI：
10.1097/00006842-199901000-00006
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发表时间：
1999-01-01
影响因子：
3.3
通讯作者：
Bourassa, MG
中科院分区：
文献类型：
--
作者：
Frasure-Smith, N;Lespérance, F;Bourassa, MG
目的：本研究的目的是评估抑郁对急性心肌梗死（MI）住院患者1年心源性死亡率影响的性别差异。方法：对两项研究的数据进行二次分析，这些研究使用贝克抑郁量表（BDI）评估住院期间的抑郁症状：一项MI后风险的前瞻性研究和一项心理社会干预的随机试验（仅对照组）。样本包括896名患者（283名女性），他们存活到出院并接受常规的出院后护理。采用多变量logistic回归分析评估与基线BDI评分相关的1年心源性死亡风险。结果如下：有290名患者（133名女性）的BDI评分大于或等于10分（至少有轻度至中度抑郁症状）：8.3%的抑郁症女性死于心脏原因，而非抑郁症女性为2.7%。对于抑郁症患者，心脏病死亡率为7.0%，而非抑郁症患者为2.4%。BDI评分增加与两种性别的心源性死亡率显著相关[女性的比值比为3.29（95%置信区间（CI）= 1.02-10.59）;男性的比值比为3.05（95% CI = 1.29-7.17）]。控制数据集中的其他多变量死亡率预测因子（年龄、Killip分级、性别与非Q波MI、性别与左心室射血分数、性别与吸烟的相互作用）并没有改变BDI对两种性别的影响。结论：MI后住院抑郁是女性和男性1年心源性死亡率的重要预测因素，其影响在很大程度上独立于其他MI后风险。
Objective: The purpose of this study was to assess gender differences in the impact of depression on 1-year cardiac mortality in patients hospitalized for an acute myocardial infarction (MI), Methods: Secondary analysis was performed on data from two studies that used the Beck Depression Inventory (BDI) to assess depression symptoms during hospitalization: a prospective study of post-MI risk and a randomized trial of psychosocial intervention (control group only). The sample included 896 patients (283 women) who survived to discharge and received usual posthospital care. Multivariate logistic regression analysis was used to assess the risk of 1-year cardiac mortality associated with baseline BDI scores. Results: There were 290 patients (133 women) with BDI scores greater than or equal to 10 (at least mild to moderate symptoms of depression): 8.3% of the depressed women died of cardiac causes in contrast to 2.7% of the nondepressed. For depressed men, the rate of cardiac death was 7.0% in contrast to 2.4% of the nondepressed. Increased BDI scores were significantly related to cardiac mortality for both genders [the odds ratio for women was 3.29 (95% confidence interval (CI) = 1.02-10.59); for men, the odds ratio was 3.05 (95% CI = 1.29-7.17)]. Control for other multivariate predictors of mortality in the data set (age, Killip class, the interactions of gender by non-Q wave MI, gender by left ventricular ejection fraction, and gender by smoking) did not change the impact of the BDI for either gender. Conclusions: Depression in hospital after MI is a significant predictor of 1-year cardiac mortality for women as well as for men, and its impact is largely independent of other post-MI risks.