Increased burden of cardiovascular risk among youth suicide attempters.
Increased burden of cardiovascular risk among youth suicide attempters.
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DOI：
10.1017/s0033291720003736
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发表时间：
2022-07
影响因子：
6.9
通讯作者：
Melhem NM
中科院分区：
文献类型：
--
作者：
Zhong Y;Pham S;Porta G;Douaihy A;Marsland A;Brent D;Melhem NM
自杀和心血管疾病是全世界残疾和过早死亡的主要原因之一。与患有严重抑郁障碍的人相比，年轻的成年自杀未遂者死于心血管疾病的风险也增加了，这表明心血管危险因素的负担增加。我们比较了青年戒毒者和其他高危个体的心血管风险负担。参与者来自美国人群研究协作精神病学流行病学调查(CPES)，年龄18至30岁(SA：303；SI：451；对照：N=3671)；因自杀未遂(SA；n=38)或意念(SI；n=40)而住院的精神科住院患者(SA；n=38)和15-30岁的健康对照组(n=37)。我们根据高血压、肥胖和吸烟的危险因素计算了心血管风险评分和高风险和低风险潜在类别。与对照组相比，自杀未遂者的心血管危险评分[CPES：B=0.43，95%CI0.31-0.54，p<；0.001；住院样本：B=1.61，95%CI0.53-2.68，p=0.004]明显升高。与有自杀意念的患者[CPES：OR=1.15，95%CI0.55~2.39，P=0.71；住院样本：OR=1.91，95%CI0.25~15.00，P=0.53]相比，更易被归入心血管高危人群[CPES：OR=3.36，95%CI1.67~6.78，P=0.001；住院样本：OR=9.89，95%CI1.38~85.39，P=0.03]。在住院和基于人群的样本中，与其他高危个体相比，青年尝试者显示出更多的心血管风险负担。临床医生应特别注意自杀未遂者的心血管危险因素，以降低他们发生心血管事件的风险。
Suicide and cardiovascular disease rank among the leading causes of disability and premature mortality worldwide. Young adult suicide attempters are at increased risk of mortality from cardiovascular disease even compared to those with major depressive disorder suggesting an increased burden of cardiovascular risk factors. We compared the cardiovascular risk burden between youth attempters and other high-risk individuals. Participants were from the Collaborative Psychiatric Epidemiology Surveys (CPES), a U.S population-based study, aged 18 to 30 years (SA: n=303; SI: n=451; Controls: n=3671); and psychiatric inpatients admitted for a suicide attempt (SA; n=38) or ideation (SI; n=40) and healthy controls (n=37) aged 15–30 years. We computed a cardiovascular risk score and high- and low-risk latent classes based on risk factors of high blood pressure, obesity, and smoking. Suicide attempters showed an increased cardiovascular risk score [CPES: B=0.43, 95% CI 0.31–0.54, p<0.001; Inpatient sample: B=1.61, 95% CI 0.53–2.68, p=0.004] compared to controls. They were also more likely to be classified in the high cardiovascular risk group [CPES: OR=3.36, 95% CI 1.67–6.78, p=0.001; Inpatient sample: OR=9.89, 95% CI 1.38–85.39, p=0.03] compared to those with suicidal ideation [CPES: OR=1.15, 95% CI 0.55–2.39, p=0.71; Inpatient sample: OR=1.91, 95% CI 0.25–15.00, p=0.53). Youth attempters show an increased burden for cardiovascular risk compared to other high-risk individuals in inpatient and population-based samples. Clinicians should pay particular attention to cardiovascular risk factors among suicide attempters in order to reduce their risk for cardiovascular events.