Troubled Minds, Broken Hearts: Women, Depression and Myocardial Infarction

困扰的心灵、破碎的心：女性、抑郁症和心肌梗塞

• 批准号: 7457656
• 负责人: SUSMITA Parashar
• 金额: $ 14.15万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7457656
• 关键词: Accounting; Acute myocardial infarction; Adverse event; Advisory Committees; African American; Aftercare; Antidepressive Agents; Award; Behavioral; Behavioral Research; Biological Factors; Cardiac; Cardiovascular Diseases; Caring; Cause of Death; Cities; Clinical Investigator; Clinical Research; Clinical Trials; Collaborations; Coronary heart disease; Data; Development; Development Plans; Diagnosis; Disease; Disease Outcome; Economic Burden; Enrollment; Environment; Fostering; Frequencies; Funding; Gender; Goals; Health; Health Services; Health Status; Healthy People 2010; Heart; Home environment; Hospitalization; Hospitals; Institute of Medicine (U.S.); Institution; Intervention; Kansas; Knowledge; Lead; Life; Mental Depression; Mental Health; Mentored Clinical Scientist Development Program; Mentors; Mind; Missouri; Myocardial Infarction; Outcome; Outcome Measure; Outcome Study; Patients; Pharmacological Treatment; Population; Predisposition; Prevention; Prospective Studies; Public Health; Purpose; Quality of life; Race; Randomized; Rate; Recovery; Registries; Reporting; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Risk Factors; Role; Selective Serotonin Reuptake Inhibitor; Sertraline; Sex Characteristics; Specialized Center; Statistical Models; Testing; Time; Training; Translational Research; United States; United States National Institutes of Health; United States Public Health Service; Universities; Woman; career; design; disability burden; drug efficacy; health economics; improved; member; men; mortality; multidisciplinary; novel; outcome forecast; patient oriented; patient oriented research; programs; prospective; psychologic; treatment effect; trend

DESCRIPTION (provided by Applicant): US Public Health Service's Healthy People 2010 initiative has highlighted the need for a greater research focus on remedying the race and gender disparity in mental health and outcome of coronary heart disease (CHD). While CHD mortality has declined among men, it has continued to increase among women, claiming the lives of more than half a million women every year. Depression predicts adverse outcomes after myocardial infarction (Ml) and is far more prevalent among women than men post-MI. Therefore, it is possible that depression is an important determinant of women's poorer prognosis post-MI. However, there is limited information on this issue. There is also paucity of clinical trials examining pharmacological treatment of depression in post-MI patients. Since African-Americans have a major burden of unmet mental health needs, it is relevant to conduct such a trial in an African-American population. Accordingly, the specific aims for the research plan are: 1) to examine to what extent depression accounts for women's higher rates of adverse outcomes post-MI; 2) to determine whether the association between depression and outcome is the same or differs in men and women; and 3) to examine, in a preliminary fashion, the efficacy of drug treatment of depression in improving outcome in post-MI men and women in a predominantly African-American patient population. This study will be conducted in collaboration with the General Clinical Research Center (GCRC) at Emory. If successful, our study will advance understanding of the factors associated with the poorer outcome after Ml and provide novel effective ways to improve outcomes in women, as well as in men. Our study has the potential to demonstrate that treatment of depression improves outcomes after Ml and contribute to remedying race and gender differences in outcomes of Ml patients. The environment is ideal for the proposed career development. Emory University has an established infrastructure through NIH K30 and K12 programs and GCRC for career development of clinical investigators and is home to several original research projects on CHD. The Lead Mentor and Advisory Committee members are expert clinical investigators with commitment to fostering the candidate's career development. The candidate's long term goal is to become an independent patient-oriented investigator focusing on the role of psychological, behavioral and biological factors that influence cardiovascular disease (CVD) outcomes and the impact of novel interventions on eliminating disparity in outcomes. To meet these goals, the proposed individualized multidisciplinary career development plan integrates training in mentored patient-oriented research, advanced statistical, epidemiological and behavioral research methods, and collaboration with GCRC and CVD outcomes researchers both at Emory and other national institutions.

描述（由申请人提供）：美国公共卫生服务2010年的“健康人民”计划强调，需要更大的研究重点是弥补冠心病（CHD）的心理健康和成果的种族和性别差异。尽管男性的冠心病死亡率下降了，但女性的死亡率仍在增加，每年夺走了超过50万妇女的生活。抑郁症可以预测心肌梗塞（ML）后的不良结局，并且在女性中比男性更为普遍。因此，抑郁症可能是MI后妇女预后较差的重要决定因素。但是，有关此问题的信息有限。 还缺乏检查MI后患者抑郁症的药理治疗的临床试验。由于非裔美国人承担着未满足的心理健康需求的重大负担，因此在非裔美国人人口进行此类审判是很重要的。因此，研究计划的具体目的是：1）检查抑郁症在多大程度上说明了妇女在MI后较高的不良后果率； 2）确定男女抑郁和结果之间的关联是相同的还是不同的； 3）要以初步的方式检查抑郁症治疗抑郁症在改善主要是非裔美国人患者人群中MI后男女预后的功效。这项研究将与Emory的一般临床研究中心（GCRC）合作进行。 如果成功的话，我们的研究将进一步了解与ML后较差结果相关的因素，并提供新的有效方法来改善女性和男性的预后。我们的研究有可能证明抑郁症的治疗可改善ML后的预后，并在ML患者的结局中弥补种族和性别差异。 环境是拟议的职业发展的理想选择。埃默里大学（Emory University）通过NIH K30和K12计划建立了建立的基础设施，以及GCRC，用于临床研究人员的职业发展，并且是CHD上几项原始研究项目的所在地。首席导师和咨询委员会成员是专家临床研究人员，他们致力于促进候选人的职业发展。 候选人的长期目标是成为一名独立的面向患者的研究者，专注于影响心血管疾病（CVD）结果的心理，行为和生物学因素的作用，以及新的干预措施对消除结果差异的影响。为了实现这些目标，拟议的个性化多学科职业发展计划将培训纳入了指导的以患者为导向的研究，高级统计，流行病学和行为研究方法，以及与GCRC和CVD成果的合作，与Emory和其他国家机构的研究人员合作。