Elevated Depression Symptoms Predict Long-Term Cardiovascular Mortality in Patients With Atrial Fibrillation and Heart Failure
Elevated Depression Symptoms Predict Long-Term Cardiovascular Mortality in Patients With Atrial Fibrillation and Heart Failure
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DOI：
10.1161/circulationaha.109.851675
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发表时间：
2009-07-14
期刊：
影响因子：
37.8
通讯作者：
Roy, Denis
中科院分区：
文献类型：
--
作者：
Frasure-Smith, Nancy;Lesperance, Francois;Roy, Denis
背景-抑郁症可以预测许多心脏疾病的预后，包括充血性心力衰竭（CHF）。尽管合并心房颤动 (AF) 和 CHF 的患者心脏风险较高，但尚未在该组中研究抑郁症。这项子研究来自 AF-CHF 心率控制策略与心律控制策略试验，研究抑郁症是否预测左心室射血分数 = 14 的患者的长期心血管死亡率。在平均 39 个月的随访期间，有 246 例心血管死亡（111 例推测为心律失常；302 例全因死亡）。针对其他预后因素（包括年龄、婚姻状况、CHF 原因、肌酐水平、左心室射血分数、阵发性 AF、既往 AF 住院、既往电转换和基线药物）调整的 Cox 比例风险模型显示，抑郁评分升高可显着预测心血管死亡率（主要结局）、心律失常死亡和全因死亡率。调整后的风险比为 1.57（95% 置信区间 1.20 至 2.07，P
Background-Depression predicts prognosis in many cardiac conditions, including congestive heart failure (CHF). Despite heightened cardiac risk in patients with comorbid atrial fibrillation (AF) and CHF, depression has not been studied in this group. This substudy, from the AF-CHF Trial of rate- versus rhythm-control strategies, investigated whether depression predicts long-term cardiovascular mortality in patients with left ventricular ejection fraction = 14). Over a mean follow-up of 39 months, there were 246 cardiovascular deaths (111 presumed arrhythmic; 302 all-cause deaths). Cox proportional hazards models adjusted for other prognostic factors (including age, marital status, cause of CHF, creatinine level, left ventricular ejection fraction, paroxysmal AF, previous AF hospitalization, previous electrical conversion, and baseline medications) showed that elevated depression scores significantly predicted cardiovascular mortality (primary outcome), arrhythmic death, and all-cause mortality. The adjusted hazard ratios were 1.57 (95% confidence interval 1.20 to 2.07, P