Associations between 5-HTR2A -1438A/G and 5-HTR2C Cys23Ser polymorphisms and depression and its severity were studied in CHD patients with consideration for the trigger factors, pathogenetic characteristics of CHD, and personal anxiety. The study was carried out in 169 men aged 31-84 (59.0 ± 8.8) years with verified CHD. Depression was more severe (Hamilton score) if it was caused by manifestation or exacerbation of CHD (nosogenic factor) and in the presence of the painful syndrome caused by the cardiac disease, high personal anxiety, and presence of allele G polymorphism - 1438A/G in the genotype. The risk of medium-severe and severe depression in allele G carriers was 2.4-fold higher than in AA genotype carriers. The nosogenic factor modulated the association between allele G and severity of depression symptoms. The risk of medium-severe and severe depression was almost 4-fold higher in carriers of this allele in the presence of this factor.

The comparative analysis of the core symptoms of depression demonstrated that group 1 had a peculiar psychometric profile with marked apathy, which was not accompanied by marked hypothymia, guilt feelings or anxiety, compared to group 2. The molecular-genetic correlate of this profile was found. It included a combination of an allele S (5-HTTLPR) of the serotonin transporter gene, an allele G (A-1438G) of the serotonin receptor type 2A gene and the genotype ValVal (Val66Met) of the brain-derived neurotrophic factor gene.

Objective: to analyze available scientific publications on the problem of clinical and genetic aspects of depressive disorders in patients with coronary heart disease (CHD). Material and methods: by keywords “coronary heart disease”, “mental disorders”, “depression”, “genetics”, “genetic markers”, “polymorphism”, “personality” articles in English and Russian were searched in the MEDLINE/PubMed, Scopus, Web of science, eLibrary databases in the period from 2020 to 2021. Conclusion: depression comorbid CHD is considered as a clinical problem due to its high prevalence, as well as its influence on the features of the course and prognosis of CHD, as well as on the compliance of patients. Heterogeneity of the clinical structure of depressive disorders in CHD (nosogenic, endogenomorphic, endogenous, somatogenic depression) causes difficulties in differential diagnosis and complex therapeutic measures. There are several factors contributing to the onset of depression in CHD patients: biological, clinical, personal characteristics. Genetic markers of depression in CHD, which have prognostic value, require further clarification.