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首页> 外文期刊>The American heart journal >Initiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: Insights from the Prospective Registry Evaluating Outcomes after Myocardial Infarctions: Events and Recovery (PREMIER) and Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) registries
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Initiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: Insights from the Prospective Registry Evaluating Outcomes after Myocardial Infarctions: Events and Recovery (PREMIER) and Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) registries

机译：急性心肌梗死后开始他汀类药物治疗与抑郁症状恶化无关：前瞻性注册表评估心肌梗死后结果的见解：事件和恢复（PREMIER）以及研究急性心肌梗死患者健康状况（TRIUMPH）的根本差异的转化研究登记处

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Background Whereas statins are considered the cornerstone of prevention after acute myocardial infarction (AMI), concerns about worsening depression in association with their use have been raised. Methods Using data from 2 prospective AMI registries (PREMIER and TRIUMPH), we examined the change in depressive symptoms from baseline and at 1, 6 and 12 months among statin-na?ve patients who were and were not discharged on a statin. Depressive symptoms were assessed with the 8-item Patient Health Questionnaire (PHQ-8). Within-group change in PHQ-8 scores from baseline to each follow-up period was assessed using paired t tests. A repeated-measures propensity-matched analysis examined whether changes in PHQ-8 scores from baseline were different between statin-treated and statin-untreated patients. Results Of 3,675 patients not previously treated with statins, 3,050 (83%) were discharged on a statin and 625 (17%) were not. Scores of PHQ-8 in the statin group decreased from baseline by a mean (±SD) of 0.9 (±5.1), 1.2 (±5), and 1.1 (±5.1) at 1, 6, and 12 months, respectively. Corresponding changes in the nonstatin group were 0.9 (±5.2), 1.3 (±5.1), and 1.5 (±5.8), respectively (P <.0001 for all comparisons). After propensity matching, 451 patients not discharged on statins with 1,240 patients discharged on statins, the mean change in PHQ-8 scores between baseline and the 3 follow-up time points was not significantly different between groups (mean between-group difference at 1 month: -0.13, 95% CI [-0.69 to 0.43], P =.65; at 6 months: -0.07, 95% CI [-0.66 to 0.52], P =.82; and at 12 months: -0.05, 95% CI [-0.67 to 0.58], P =.88). Conclusions Initiation of statins after AMI was not associated with worsening depression.
机译：背景技术尽管他汀类药物被认为是预防急性心肌梗塞（AMI）后的基石，但人们对使用他汀类药物会导致抑郁加剧感到担忧。方法使用来自两个前瞻性AMI登记处（PREMIER和TRIUMPH）的数据，我们检查了在未使用他汀类药物或未使用他汀类药物的未接受他汀类药物治疗的初治患者中，其抑郁症状自基线以及1、6、12个月时的变化。抑郁症状通过8项患者健康问卷（PHQ-8）进行评估。使用配对t检验评估从基线到每个随访期的PHQ-8评分的组内变化。重复测量的倾向匹配分析检查了在他汀类药物治疗和未他汀类药物治疗的患者中，PHQ-8得分相对于基线的变化是否存在差异。结果3675例先前未接受他汀类药物治疗的患者中，有3,050名（83％）接受他汀类药物出院，而625名（17％）未接受他汀类药物出院。他汀类药物组的PHQ-8得分在第1、6和12个月时分别比基线降低了0.9（±5.1），1.2（±5）和1.1（±5.1）的平均值（±SD）。非他汀类药物组的相应变化分别为0.9（±5.2），1.3（±5.1）和1.5（±5.8）（对于所有比较，P <.0001）。倾向匹配后，451名未使用他汀类药物出院的患者和1,240名使用他汀类药物出院的患者，基线与3个随访时间点之间的PHQ-8评分的平均变化在各组之间无显着差异（平均组间差异为1个月） ：-0.13，95％CI [-0.69至0.43]，P = .65; 6个月时：-0.07，95％CI [-0.66至0.52]，P = .82;以及12个月时：-0.05，95 ％CI [-0.67至0.58]，P = .88）。结论AMI后开始他汀类药物与抑郁恶化无关。

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