急性冠脉综合征并抑郁患者冠状动脉介入术后舍曲林治疗研究

Effect of sertraline on cardiovascular events and restenosis after coronary stenting in depression patients with acute coronary syndrome

目的:观察舍曲林干预急性冠脉综合征合并抑郁患者冠状动脉介入术后的疗效。方法:对急性冠脉综合征合并抑郁接受支架置入的115例患者随机分成两组,一组在基础治疗上加用舍曲林进行干预作为治疗组,另一组为基础治疗组作为对照组。主要观察术后1年的心血管事件(心绞痛、心肌梗死、充血性心力衰竭、心因性死亡)及支架内再狭窄的发生率。次要指标观察治疗1年后血浆一氧化氮、内皮素、去甲肾上腺素、皮质醇、血小板聚集率、高敏C反应蛋白、正常RR间期的标准差、Zung抑郁自评量表评分情况。结果:术后1年11例失访,剩下104例患者,治疗组发生心绞痛6例,对照组为10例;3例心肌梗死均为对照组,充血性心力衰竭治疗组1例,对照组2例;心源性猝死1例为对照组。104例患者复查冠状动脉造影,治疗组再狭窄6例,再狭窄率11.8%(6/51);对照组再狭窄9例,再狭窄率17%(9/53)。心血管事件总发生率治疗组与对照组比较差异有统计学意义(13.7%vs30.2%),但支架内再狭窄发生率治疗组和对照组相比,差异无统计学意义(11.8%vs17%)。结论:急性冠脉综合征合并抑郁患者支架置入术后应用舍曲林进行干预可以降低患者的心血管事件,对冠脉支架再狭窄发生率无影响。

Objective To investigate the clinical effects of sertraline on cardiovascular events and restenosis after coronary stenting in depression patients with acute coronary syndrome. Methods Depression patients with acute coronary syndromes reffered for coronary stenting were randomly divided into two groups ,in which one group received oral sertraline and base therapy（therapy group）, and the other received base therapy only （control group）. The cardiovascular events（angina pectoris, myocardia infarction, congestive heart failure and death） and stenting restenosis were carefully observed for 1 year. Results （1）Baseline patametres had no statistic difference between two groups （P〈0.05）. （2）Cardiovascular events after coronary stenting were significantly lower in therapy group than control group （13.7.8%vs 30.2%）, but restenosis had no statistic difference between therapy group and control group （11.8% vs 17.0% ）. Conclusion Sertraline can decrease cardiovascular events after coronary stenting in depression patients with acute coronary syndrome but no difference on stenting restenosis.