老年冠心病患者PCI术后焦虑抑郁对预后的影响

Effect of Anxiety and Depression on Prognosis in Elderly Patients with Coronary Heart Disease after PCI

目的:探讨老年冠心病患者在经皮冠状动脉介入治疗(PCI)后抑郁、焦虑及其同时发生对6个月主要心血管不良事件的预测价值。方法:2021年1-9月在北京丰台医院接受PCI治疗的年龄≥60岁冠心病患者(n=169),在3~6个月复查时均完成了医院焦虑和抑郁量表(HADS)。PCI术后6个月内记录主要心血管不良事件(MACEs)。对抑郁和非抑郁、焦虑和非焦虑患者的组间差异进行比较,采用多变量Cox回归分析法检验抑郁和焦虑症状对MACEs的预测价值。结果:抑郁和焦虑的患病率分别为24.9%和34.3%。14例(8.3%)患者出现MACEs。在调整社会人口统计学和临床特征后,Cox比例风险回归模型显示抑郁症状是MACEs的独立预测因子(HR=4.801,95%CI:1.528,15.087,P=0.007)。结论:抑郁与老年患者PCI术后6个月发生MACEs的风险增加有关,焦虑与MACEs关系不显著,在合并抑郁的情况下,焦虑亦没有额外的价值。

Objective:To explore the predictive value of depression,anxiety and their simultaneous occurrence in elderly patients with coronary heart disease after percutaneous coronary intervention (PCI) for major adverse cardiovascular events in 6 months.Method:The study population included coronary heart disease patients ≥60 years old who received PCI in Beijing Fengtai Hospital from January to September 2021 (n=169).All patients completed the hospital anxiety and Depression Scale (HADS) at 3 to 6 months.Major adverse cardiovascular events (MACEs) were recorded within 6 months after PCI.The differences between depression and non depression,anxiety and non anxiety patients were compared.Multivariate Cox regression analysis were used to test the predictive value of depression and anxiety symptoms on MACEs.Result:The prevalence rates of depression and anxiety were 24.9% and 34.4%,respectively.MACEs occurred in 14 patients (8.3%).After adjusting for sociodemographic and clinical characteristics,Cox proportional hazards regression model showed that depression (HR=4.801,95%CI:1.528,15.087,P=0.007) symptoms was independent predictors of MACEs.Conclusion:Depression is associated with an increased risk of MACEs in elderly patients 6 months after PCI,there is no significant correlation between anxiety and MACEs,and there is no additional value of anxiety in patients with combined depression.