抑郁对冠状动脉非阻塞性心肌梗死患者临床预后的影响

Association between depression and clinical outcomes in patients with myocardial infarction in the absence of ob⁃structive coronary artery disease

目的探讨抑郁情绪对冠状动脉非阻塞性心肌梗死(MINOCA)患者远期预后的影响。方法选取456例MINOCA患者,利用医院焦虑抑郁量表(HADS-D)对MINOCA患者抑郁情况进行评估,将患者分为抑郁组和非抑郁组,并随访3年。主要终点事件为全因死亡和主要心脏不良事件。结果在随访期间,共发生38例死亡和101起主要心脏不良事件,Kaplan-Meier生存曲线显示,抑郁情绪对全因死亡率和主要心脏不良事件发生率具有统计学意义(χ2分别=6.37、7.46,P均<0.05)。多因素Cox回归分析显示,抑郁情绪是MINOCA患者全因死亡率和主要心脏不良事件发生率的危险因素(HR分别=1.70、2.08,P均<0.05)。结论抑郁症状是MINOCA患者全因死亡率和主要心脏不良事件发生率的危险因素,影响远期预后。

Objective To explore the depression symptoms and clinical outcomes in patients with myocardial infarction in the absence of obstructive coronary artery disease(MINOCA).Methods Totally 456 hospitalized patients with MIN-OCA were enrolled.Depression was assessed using the hospital anxiety and depression scale.The patients were divided in-to depression group and without depression group,and follow up for three years.The primary endpoint was all-cause mor-tality and the secondary endpoint was major adverse cardiovascular event(MACE).Results Within three years,38 deaths and 101 MACE had occurred.Kaplan-Meier curves showed that the unadjusted rates of all-cause mortality and MACE were significantly higher in the depression group compared with the control group of patients without depression(χ2=6.37,7.46,P<0.05).Multiple Cox regression analysis indicated that depression was an independent prognostic factor for all-cause mortality as well as MACE(HR=1.70,2.08,P<0.05).Conclusion Depression is significantly associated with an increased risk of all-cause mortality and MACE in patients with MINOCA.