期刊
AMERICAN JOURNAL OF MEDICINE
卷 127, 期 1, 页码 87-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2013.09.026
关键词
Acute coronary syndrome; Depression; Disease severity; Epidemiology; Women
资金
- Canadian Institutes of Health Research
- Heart and Stroke Foundation of Quebec
- Heart and Stroke Foundation of Nova Scotia
- Heart and Stroke Foundation of Alberta
- Heart and Stroke Foundation of Ontario
- Heart and Stroke Foundation of Yukon
- Heart and Stroke Foundation of British Columbia
- Heart and Stroke Foundation of Canada
- Canadian Institute of Health Research Award
- Canadian Institutes of Health Research New Investigator award
- Fonds de recherche en sante Quebec chercheur-boursier award
- Fonds de recherche en sante Quebec chercheur-boursier clinicien junior I award
- Michael Smith Foundation for Health Research Career Scientist award
- Fonds de recherche en sante Quebec award
OBJECTIVES: The association between depression and cardiovascular disease severity in younger patients has not been assessed, and sex differences are unknown. We assessed whether major depression and depressive symptoms were associated with worse cardiovascular disease severity in patients with premature acute coronary syndrome, and we assessed sex differences in these relationships. METHODS: We enrolled 1023 patients (aged <= 55 years) hospitalized with acute coronary syndrome from 26 centers in Canada, the United States, and Switzerland, through the GENdEr and Sex determInantS of cardiovascular disease: From bench to beyond-Premature Acute Coronary Syndrome study. Left ventricular ejection fraction, Killip class, cardiac troponin I, and Global Registry of Acute Coronary Events score data were collected through chart review. RESULTS: The sample comprised 248 patients with major depression and 302 women. In univariate analyses, major depression was associated with a lower likelihood of having an abnormal left ventricular ejection fraction (odds ratio, 0.70; 95% confidence interval, 0.51-0.97; P = .03) and lower troponin I levels (estimate, -4.04; 95% confidence interval, -8.01 to -0.06; P = .05). After adjustment for sociodemographic and clinical characteristics, neither major depression nor depressive symptoms were associated with disease severity indices, and there were no sex differences. CONCLUSION: The increased risk of adverse events in depressed patients with premature acute coronary syndrome is not explained by disease severity. (C) 2014 Elsevier Inc. All rights reserved.
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