Circ-Heart Fail:伴有和不伴有严重精神疾病患者心力衰竭及其与长期结局的关系

2021-10-08 MedSci原创 MedSci原创

SMI与男性而非女性患者的不良HF结局相关。尽管伴有和不伴有SMI的患者接受HF手术的机会相同,但SMI患者的术后死亡率较高。

与普通人群相比,患有包括精神分裂症、双相情感障碍和严重抑郁症在内的严重精神疾病(SMI)患者血管危险因素发病较早,未来更容易发生心力衰竭(HF)。

近日,心血管领域权威杂志Circ-Heart Fail上发表了一篇研究文章,研究人员旨在调查伴有/不伴有SMI与长期HF结局之间的关联。

研究人员确定了2002年至2017年期间杜克大学医疗系统中伴有和不伴有SMI的HF患者,并使用多变量Cox回归,评估了全因死亡率的主要结局。次要结局包括植入式心脏复律除颤器的使用率、心脏再同步治疗、左心室辅助装置植入率和心脏移植率。

研究人员纳入了20906名HF患者(SMI,n=898;非SMI,n=20008)。SMI患者的临床表现比没有SMI的患者早7年。研究人员观察到SMI和性别对全因死亡率存在相互作用(P=0.002)。与没有SMI的男性相比,在患有SMI的男性中观察到更高的死亡率(风险比为1.36[95%CI为1.17-1.59])。在伴有和不伴有SMI的女性中没有观察到相关性(风险比为0.97[95%CI为0.84-1.12])。植入式心脏复律除颤器使用率、心脏再同步治疗、左心室辅助装置植入和心脏移植在伴有和不伴有SMI的患者之间相似(6.1% vs. 7.9%,P=0.095)。接受这些HF手术的SMI患者比不伴有SMI的患者预后更差(风险比为2.12[95%CI,1.08-4.15])。

由此可见,SMI与男性而非女性患者的不良HF结局相关。尽管伴有和不伴有SMI的患者接受HF手术的机会相同,但SMI患者的术后死亡率较高。

原始出处:

Christoffer Polcwiartek,et al.Clinical Heart Failure Among Patients With and Without Severe Mental Illness and the Association With Long-Term Outcomes.Circulation:heart failure.2021.https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.121.008364

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    2021-10-10 slcumt
  6. [GetPortalCommentsPageByObjectIdResponse(id=1799174, encodeId=0ab21e9917444, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Fri May 27 02:34:50 CST 2022, time=2022-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357804, encodeId=3c49135e80424, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Oct 10 07:34:50 CST 2021, time=2021-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385132, encodeId=5e9313851320e, content=<a href='/topic/show?id=99d99e03311' target=_blank style='color:#2F92EE;'>#长期结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97033, encryptionId=99d99e03311, topicName=长期结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Sun Oct 10 07:34:50 CST 2021, time=2021-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469031, encodeId=3f731469031c0, content=<a href='/topic/show?id=c42121206a5' target=_blank style='color:#2F92EE;'>#严重精神疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21206, encryptionId=c42121206a5, topicName=严重精神疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a426994829, createdName=sjq029, createdTime=Sun Oct 10 07:34:50 CST 2021, time=2021-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563531, encodeId=5bec156353145, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Oct 10 07:34:50 CST 2021, time=2021-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1058662, encodeId=a2fe10586625d, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/04/14/72ac0b80f0a63c1ffa90ede8635b36da.jpg, createdBy=7dc12461402, createdName=junebenf, createdTime=Fri Oct 08 17:00:18 CST 2021, time=2021-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1058661, encodeId=d0ee1058661ca, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Fri Oct 08 16:59:45 CST 2021, time=2021-10-08, status=1, ipAttribution=)]
    2021-10-08 junebenf

    学习了

    0

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    2021-10-08 医鸣惊人

    认真学习了

    0

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