Relationship of depressive symptoms with hospitalization and death in Japanese patients with heart failure.
Relationship of depressive symptoms with hospitalization and death in Japanese patients with heart failure.
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DOI：
10.1016/j.cardfail.2009.06.442
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发表时间：
2009-12-01
影响因子：
6
通讯作者：
Kazuma, Keiko
中科院分区：
文献类型：
--
作者：
Kato, Naoko;Kinugawa, Koichiro;Kazuma, Keiko
背景技术背景：抑郁症状是心力衰竭（HF）患者预后不良的危险因素，与疾病严重程度呈正相关。然而，对日本人群中的这种关联知之甚少。因此，我们评估了抑郁症状的患病率和抑郁症状是否预测住院HF和死亡独立的疾病严重程度和其他因素在HF patient.METHODS和结果：一项为期2年的前瞻性队列研究进行了115例HF门诊患者（73.9%男性，平均年龄64.7岁）在东京。其中，27例患者（23.5%）被归类为有抑郁症状（流行病学研究中心抑郁量表评分≥ 16）。有抑郁症状的患者2年心源性死亡或HF住院率（34.0% vs. 10.3%; P <0.01）、HF住院率（27.4% vs. 9.2%; P = 0.01）和全因死亡率（27.4% vs. 7.2%; P <0.01）较高。多变量考克斯回归分析表明，抑郁症状是心源性死亡或HF住院的预测因子（风险比[HR]，3.29; P = .02），HF住院（HR，3.36; P = 0.04）和全因死亡（HR，5.52; P = .01），与年龄和脑钠肽无关。抑郁症状是日本HF患者预后不良的常见和独立预测因素。
BACKGROUND: Depressive symptoms are risk factors for poor outcomes and are positively associated with disease severity in patients with heart failure (HF). However, little is known about this association in the Japanese population. Therefore, we evaluated the prevalence of depressive symptoms and whether depressive symptoms predicted hospitalization for HF and death independent of disease severity and other factors in HF patients.METHODS AND RESULTS: A 2-year prospective cohort study was conducted on 115 outpatients with HF (73.9% males; mean age 64.7 years) in Tokyo. Of these, 27 patients (23.5%) were classified as having depressive symptoms (Center for Epidemiologic Studies Depression Scale score >or=16). Patients with depressive symptoms had higher rates of 2-year cardiac death or HF hospitalization (34.0% vs. 10.3%; P < .01), HF hospitalization (27.4% vs. 9.2%; P = .01), and all-cause death (27.4% vs. 7.2%; P < .01). Multivariate Cox regression analyses indicated that depressive symptoms were predictors of cardiac death or HF hospitalization (hazard ratio [HR], 3.29; P = .02), HF hospitalization (HR, 3.36; P = .04), and all-cause death (HR, 5.52; P = .01), independent of age and brain natriuretic peptide.CONCLUSIONS: Depressive symptoms were common and independent predictors of poor outcomes in Japanese patients with HF.