Comparing the effects of depression,anxiety,and comorbidity on quality-of-life,adverse outcomes,and medical expenditure in Chinese patients with acute coronary syndrome  

作　　者：Kun Xia Le-Feng Wang Xin-Chun Yang Hong-Yan Jiang Li-Jing Zhang Dao-Kuo Yao Da-Yi Hu Rong-Jing Ding 

机构地区：[1]Heart Center,Chaoyang Hospital,Capital Medical University,Beijing 100020,China [2]Heart Center,Beijing First Hospital of Integrative Chinese & Western Medicine,Beijing 100021,China [3]Heart Center,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China [4]Heart Center,Friendship Hospital,Capital Medical University,Beijing 100050,China [5]Heart Center,Peking University People's Hospital,Beijing 100044,China

出　　处：《Chinese Medical Journal》2019年第9期1045-1052,共8页中华医学杂志（英文版）

基　　金：a grant from Beijing Natural Science Foundation (No.2108000050).

摘　　要：Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL),adverse outcomes,and medical expenditure in patients with acute coronary syndrome (ACS).However,the relevant data are lacking for Chinese ACS populations,especially regarding different effects of major depression,anxiety,and comorbidity.The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression,anxiety,and comorbidity on QOL,adverse outcomes,and medical expenditure in Chinese patients with ACS.Methods:For this prospective longitudinal study,a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015.Among them,531 patients (82.1%) completed 12-month follow-ups.Logistic regression model was utilized for analyzing the association of baseline major depression,anxiety,and comorbidity with 12-month all-cause mortality,cardiovascular events,QOL,and health expenditure.Results:During a follow-up period of 12 months,7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac rehospitalization.Baseline comorbidity,rather than major depression/anxiety,strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]:1.77,95% confidence interval [CI]:1.22–2.52,P = 0.003).Regarding 12-month non-fatal MI and cardiac re-hospitalization,baseline anxiety (OR:2.83,95% CI:1.33–5.89,P<0.01;OR:4.47,95% CI:1.50–13.00,P<0.01),major depression (OR:2.58,95% CI:1.02–6.15,P<0.05;OR:5.22,95% CI:1.42–17.57,P<0.03),and comorbidity (OR:6.33,95% CI:2.96–13.79,P<0.0001,OR:14.08,95% CI:4.99–41.66,P<0.0001) were all independent predictors,and comorbidity had the highest predictive value.Number of re-hospitalization stay,admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.Conclusions:Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization.However,comorb

关 键 词：Acute CORONARY syndrome Major DEPRESSION ANXIETY COMORBIDITY ADVERSE outcome 

分 类 号：R[医药卫生]