抑郁、抗抑郁药与高频心房颤动患者心房颤动风险的关系

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI:10.31083/j.rcm2510370
Yonghui Fu, Shenghui Feng, Zhenbang Gu, Xiao Liu, Wengen Zhu, Bo Wei, Linjuan Guo
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引用次数: 0

摘要

背景:专门探讨同时患有抑郁症和射血分数保留型心力衰竭(HFpEF)的患者心房颤动(房颤)发生率的研究很少。抗抑郁治疗对该人群房颤风险的影响仍不清楚。我们目前的研究旨在调查 HFpEF 患者中抑郁与房颤风险之间的联系,并评估抗抑郁药物对房颤发生的影响:我们采用卡普兰-梅耶估计值来确定房颤的无事件状态,并应用对数秩检验进行组间比较分析。使用单变量和多变量考克斯比例危险回归模型对相关性进行量化,结果以危险比(HR)和95%置信区间(CI)表示:在醛固酮拮抗剂治疗保留心功能心力衰竭(TOPCAT)试验的784名患者中,有29.1%(228人)被确认患有重度抑郁症。在对重要的混杂因素进行调整后,与轻度抑郁相比,基线重度抑郁与房颤的发生率无关(调整后 HR = 0.82,95% CI:0.46-1.49)。此外,与对照组相比,基线时服用抗抑郁药对HFpEF和重度抑郁症患者发生房颤的风险没有显著影响(调整后HR = 0.41,95% CI:0.08-2.10):结论:基线时存在重度抑郁并不会增加 HFpEF 患者发生房颤的风险。此外,使用抗抑郁药与合并重度抑郁症的高频血友病患者房颤发生率的升高没有相关性:URL: https://clinicaltrials.gov/study/NCT00094302.唯一标识符:NCT00094302。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associations of Depression, Antidepressants with Atrial Fibrillation Risk in HFpEF Patients.

Background: Studies dedicated to exploring the incidence of atrial fibrillation (AF) in patients with concurrent depression and heart failure with preserved ejection fraction (HFpEF) are scarce. The impact of antidepressant therapy on AF risk within this population remains unclear. Our current study aimed to investigate the link between depression and AF risk in HFpEF patients and to assess the influence of antidepressant medication on the development of AF.

Methods: We utilized Kaplan-Meier estimates to determine the event-free status for AF and applied the Log-rank test for comparative analysis between groups. The associations were quantified using univariate and multivariate Cox proportional hazards regression models, with results expressed as hazard ratios (HR) and 95% confidence intervals (CI).

Results: Among the 784 patients in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, 29.1% (228) were identified with major depression. After adjusting for significant confounders, compared with mild depression, major depression at baseline was not linked to the incidence of AF (adjusted HR = 0.82, 95% CI: 0.46-1.49). Additionally, compared with controls, antidepressant use at baseline did not significantly influence the risk of incident AF in patients with HFpEF and major depression (adjusted HR = 0.41, 95% CI: 0.08-2.10).

Conclusions: The presence of major depression at baseline did not elevate the risk of incident AF among individuals with HFpEF. Additionally, the use of antidepressants showed no correlation with an increased rate of AF among HFpEF patients with comorbid major depression.

Clinical trial registration: URL: https://clinicaltrials.gov/study/NCT00094302. Unique identifier: NCT00094302.

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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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