Psychiatric Characteristics Associated With Long-term Mortality Among 361 Patients Having an Acute Coronary Syndrome and Major Depression Seven-Year Follow-up of SADHART Participants
Psychiatric Characteristics Associated With Long-term Mortality Among 361 Patients Having an Acute Coronary Syndrome and Major Depression Seven-Year Follow-up of SADHART Participants
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DOI：
10.1001/archgenpsychiatry.2009.121
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发表时间：
2009-09-01
影响因子：
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通讯作者：
Gaffney, Michael
中科院分区：
文献类型：
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作者：
Glassman, Alexander H.;Bigger, J. Thomas, Jr.;Gaffney, Michael
背景：急性冠状动脉综合征（ACS）后的重度抑郁症（MDD）与死亡率增加相关。我们对舍曲林抗抑郁药治疗心脏病发作随机试验（SADHART）的参与者进行了观察，以确定与长期死亡率相关的MDD特征。
目的：确定以下变量是否与长期死亡率相关：基线抑郁严重程度、既往MDD发作情况、MDD在ACS事件之前还是之后发病、6个月的盐酸舍曲林治疗以及不依赖治疗的情绪改善情况。
设计：SADHART是一项双盲、安慰剂对照的随机试验，比较了舍曲林与安慰剂在369名符合MDD标准的ACS患者中的安全性和抗抑郁疗效。该试验于2000年6月完成，对生命状态的随访于2007年9月完成。
地点：学术研究。
参与者：SADHART参与者。
主要观察指标：在中位随访6.7年期间，确定了361名参与者（97.8%）的生命状态。
结果：在研究期间，75名参与者（20.9%）死亡。既往MDD发作情况、在索引ACS之前还是之后发病以及最初6个月的舍曲林治疗均与长期死亡率无关。Cox比例风险回归模型显示，基线MDD严重程度（风险比，2.30；95%置信区间，1.28 - 4.14；P<...（此处原文似乎不完整）
Context: Major depressive disorder (MDD) after acute coronary syndrome (ACS) is associated with an increased mortality rate. We observed the participants of the Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) to establish features of MDD associated with long-term mortality.Objectives: To determine whether the following variables were associated with long-term mortality: baseline depression severity, previous MDD episodes, onset of MDD before or after the ACS event, 6 months of sertraline hydrochloride therapy, and mood improvement independent of treatment.Design: SADHART was a double-blind, placebo-controlled, randomized trial comparing the safety and antidepressant efficacy of sertraline vs placebo in 369 patients with ACS who met criteria for MDD. The trial was completed in June 2000, and follow-up for vital status was completed in September 2007.Setting: Academic research.Participants: SADHART participants.Main Outcome Measures: Vital status was determined in 361 participants (97.8%) during a median follow-up of 6.7 years.Results: During the study, 75 participants (20.9%) died. Neither previous episodes of MDD, nor onset before or after the index ACS, nor an initial 6 months of sertraline treatment was associated with long-term mortality. Cox proportional hazards regression models showed that baseline MDD severity (hazard ratio, 2.30; 95% confidence interval, 1.28-4.14; P