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首页> 外文期刊>The journal of clinical psychiatry >Positive affect and survival in patients with stable coronary heart disease: Findings from the heart and soul study
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Positive affect and survival in patients with stable coronary heart disease: Findings from the heart and soul study

机译：稳定型冠心病患者的积极影响和生存：心脏和灵魂研究的发现

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Objective: Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might explain this association. Method:The Heart and Soul Study is a prospective cohort study of 1,018 outpatients with stable coronary heart disease. Participants were recruited between September 11,2000, and December 20, 2002, and were followed up to June 2011. Baseline positive affect was assessed by using the 10-item positive affect subscale of the Positive and Negative Affect Schedule. Cox proportional hazards regression was used to estimate the risk of mortality (primary outcome measure) and cardiovascular events (heart failure, myocardial infarction, suoke, uansier ischemic anack) associated with posiive affect, adjusting for baseline cardiac disease severity and depression. We also evaluated the extent to which these associations were explained by potential biological and behavioral mediators. Results:Atotal of 369 patients (36%) died during a mean ± SD follow-up period of 7.1 ± 2.5 years. Positive affect was not significantly associated with cardiovascular events (hazard ratio [H RI: 0.89; 95% Cl, 0.79 1.00; P=.06). However, each standard deviation (8.8-point) increase in positive affect score was associated with a 1 6% decreased risk of all-cause mortality (HR: 0.84; 95% Cl, 0.76 0.92; P=.001). After adjustment for cardiac disease severity and depressive symptoms, positive affect remained significantly associated with improved survival (HR: 0.87; 95% Cl, 0.78 0.97; P=.01). The association was no longer significant after adjustment for behavioral factors, and particularly physical activity (HR: 0.92; 95% Cl, 0.82 1.03; P=.16). Further adjustment for C-reactive protein and omega-3 fatty acids did not result in any meaningful changes (HR: 0.94; 95% Cl, 0.84 1.06; P=.31). Conclusions: In this sample of outpatients with coronary heart disease, positive affect was associated with improved survival.This association was largely explained by physical activity.
机译：目的：积极影响可以提高生存率，但造成这种关联的机制尚不清楚。我们试图评估稳定的冠心病患者的积极影响与死亡率之间的关联，并确定可能解释这种关联的生物学和行为因素。方法：《心脏与灵魂研究》是一项针对1,018名患有稳定型冠心病的门诊患者的前瞻性队列研究。在2000年9月11日至2002年12月20日之间招募参与者，并随访至2011年6月。使用“正面和负面影响时间表”的10项正面影响子量表评估基线正面影响。使用Cox比例风险回归来估计与积极影响相关的死亡风险（主要结局指标）和心血管事件（心力衰竭，心肌梗塞，抽烟，缺血性心脏病发作），并根据基线心脏病的严重程度和抑郁进行调整。我们还评估了潜在的生物学和行为介体解释这些关联的程度。结果：总共369例患者（36％）在平均±SD随访期7.1±2.5年内死亡。积极影响与心血管事件无显着相关（危险比[H RI：0.89; 95％Cl，0.79 1.00; P = .06）。然而，积极影响得分每增加一个标准差（8.8点），全因死亡率降低了6％（HR：0.84; 95％Cl，0.76 0.92; P = .001）。在调整了心脏病的严重程度和抑郁症状后，积极的影响仍然与存活率显着相关（HR：0.87; 95％Cl，0.78 0.97; P = .01）。调整行为因素，尤其是身体活动后，这种关联不再显着（HR：0.92; 95％Cl，0.82 1.03; P = .16）。 C反应蛋白和omega-3脂肪酸的进一步调整未导致任何有意义的变化（HR：0.94; 95％Cl，0.84 1.06; P = .31）。结论：在该样本的冠心病门诊患者中，积极的影响与存活率的提高有关，这种关联在很大程度上是通过体育锻炼来解释的。

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