Depression increases the risk of mortality in patients with heart failure: A meta-analysis
Depression increases the risk of mortality in patients with heart failure: A meta-analysis
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DOI：
10.1016/j.jpsychores.2017.01.010
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发表时间：
2017-03-01
影响因子：
4.7
通讯作者：
Hughes, Joel W.
中科院分区：
文献类型：
--
作者：
Gathright, Emily C.;Goldstein, Carly M.;Hughes, Joel W.
背景：抑郁症是心血管疾病死亡的危险因素。先前的研究证实，抑郁症可预测心力衰竭（HF）患者的不良结局。然而，关于抑郁症对死亡率的影响，数据并不确定。本荟萃分析探讨了抑郁症和死亡率之间的关系在hf.Methods：前瞻性研究的抑郁症和死亡率在HF之间发表的1999年和2016年4月使用PubMed，PsychINFO，和MEDLINE。综合Meta分析软件被用来计算风险比的总效应量估计，并进行亚组analysis.Results：18篇研究符合纳入标准。对于8个汇总的单变量和14个多变量估计，抑郁症状与全因死亡率相关。3项多变量分析的合并HR表明抑郁症状与心血管死亡率无关。在亚组分析中，抑郁症预测了平均年龄>65岁的样本的全因死亡率。抑郁症对全因死亡率的影响也不同的随访时间，与样本的随访时间较短，表现出较大的effect.Conclusions：在HF，抑郁症与增加全因死亡率的风险，具有较强的影响，在样本较短的后续行动和老年人。在老年人中，抑郁可能是更严重HF的标志。然而，由于HF严重程度的调整不一致，这种可能性难以检查。其他研究可能有助于确定抑郁症和心血管死亡率之间的关系，因为研究心血管死亡率的研究数量很少，可能无法检测到这种影响。(C)2017爱思唯尔公司All rights reserved.
Background: Depression is a risk factor for mortality in cardiovascular diseases. Prior studies confirm that depression predicts adverse outcomes in patients with heart failure (HF). However, data were inconclusive regarding the effect of depression on mortality. This meta-analysis examines the relationship between depression and mortality in HF.Methods: Prospective studies of depression and mortality in HF published between 1999 and April 2016 were located using PubMed, PsychINFO, and MEDLINE. Comprehensive Meta-Analysis software was used to compute an aggregated effect size estimates of hazard ratios and to conduct subgroup analyses.Results: Eighteen studies met inclusion criteria. For 8 aggregated univariate and 14 multivariate estimates, depressive symptoms were related to all-cause mortality. A pooled HR of 3 multivariate analyses indicated that depressive symptoms were not linked to cardiovascular mortality. In subgroup analyses, depression predicted all cause mortality in samples with a mean age >65. The impact of depression on all-cause mortality also differed by follow-up duration, with samples with shorter follow-up durations demonstrating a larger effect.Conclusions: In HF, depression is related to increased all-cause mortality risk, with stronger effects in samples with shorter follow-up and in older adults. In older adults, depression may serve as a marker of more severe HF. However, this possibility is difficult to examine given inconsistent adjustment for HF severity. Additional studies may assist in determining the relationship between depression and cardiovascular mortality, as the low number of studies examining cardiovascular mortality may have precluded detection of an effect. (C) 2017 Elsevier Inc. All rights reserved.