Vital exhaustion in women with chest pain and no obstructive coronary artery disease: the iPOWER study.

IF 6.6 2区医学 Q1 PSYCHIATRY

Evidence Based Mental Health Pub Date : 2021-05-01 DOI:10.1136/ebmental-2020-300175

Daria Frestad Bechsgaard, Ida Gustafsson, Marie Mide Michelsen, Naja Dam Mygind, Adam Pena, Hannah Elena Suhrs, Kira Bove, Jens Dahlgaard Hove, Eva Prescott

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引用次数: 3

Abstract

Background: More than half of women with symptoms suggestive of myocardial ischaemia have no obstructive coronary artery disease (CAD), yet they face a higher risk of cardiovascular mortality and morbidity. Both vital exhaustion (VE) and depression have been linked to adverse cardiovascular prognosis in patients with CAD. We aimed to assess whether symptomatic women with no obstructive CAD are more vitally exhausted compared with asymptomatic women. Furthermore, we investigated the overlap between the constructs of VE and depression.

Methods: Prevalence and burden of VE was assessed in symptomatic women with no obstructive CAD (n=1.266) and asymptomatic women (n=2.390). Among symptomatic women, we also assessed chest pain characteristics and symptoms of Hospital Anxiety and Depression Questionnaire.

Findings: Median (IQR) VE score was 4 (1-9) and 2 (0-5) in symptomatic and asymptomatic women, respectively (age adjusted, p<0.001). The risk of severe VE was significantly higher in symptomatic women compared with asymptomatic women (OR 3.3, 95% CI 2.5 to 4.4), independent of age and risk factors, and was associated with symptom severity. VE and depression scores were correlated but principal component cluster analysis (PCCA) showed clear distinctiveness between the two constructs.

Conclusions: Women with chest pain and no obstructive CAD are more vitally exhausted compared with asymptomatic women. PCCA showed that VE is distinct from depression in symptomatic women.

Clinical implications: Mental health screening focusing on depressive symptomatology in women with chest pain presenting with symptoms of mental and physical exhaustion may overlook VE in these patients.

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胸痛且无阻塞性冠状动脉疾病的女性生命衰竭:iPOWER研究

背景:超过一半的有心肌缺血症状的女性没有阻塞性冠状动脉疾病(CAD)，但她们面临着更高的心血管死亡率和发病率风险。肺活量衰竭(VE)和抑郁与冠心病患者不良心血管预后有关。我们的目的是评估无阻塞性CAD的有症状女性是否比无症状女性更有生命衰竭。此外，我们还研究了VE和抑郁的结构之间的重叠。方法:对无梗阻性CAD的有症状女性(n=1.266)和无症状女性(n=2.390)进行VE患病率和负担评估。在有症状的女性中，我们还评估了胸痛特征和医院焦虑抑郁问卷的症状。结果:有症状和无症状女性的中位(IQR) VE评分分别为4(1-9)和2(0-5)(年龄调整后)。结论:与无症状女性相比，胸痛且无阻塞性CAD的女性更有生命衰竭。PCCA显示VE不同于有症状女性的抑郁。临床意义:在以精神和身体疲惫为症状的胸痛女性中，关注抑郁症状的心理健康筛查可能会忽略这些患者的VE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Evidence Based Mental Health PSYCHIATRY-

CiteScore

18.10

自引率

7.70%

发文量

期刊介绍： Evidence-Based Mental Health alerts clinicians to important advances in treatment, diagnosis, aetiology, prognosis, continuing education, economic evaluation and qualitative research in mental health. Published by the British Psychological Society, the Royal College of Psychiatrists and the BMJ Publishing Group the journal surveys a wide range of international medical journals applying strict criteria for the quality and validity of research. Clinicians assess the relevance of the best studies and the key details of these essential studies are presented in a succinct, informative abstract with an expert commentary on its clinical application.Evidence-Based Mental Health is a multidisciplinary, quarterly publication.