Acute coronary syndrome and depression: A review of shared pathophysiological pathways

Smith, Isabelle Granville; Parker, Gordon; Rourke, Poppy; Cvejic, Erin; Vollmer‐Conna, Ute

doi:10.1177/0004867415597304

Cited by 13 publications

(11 citation statements)

References 148 publications

(281 reference statements)

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“…There was an association between perceived social support and lower cardiovascular reactivity in depression and ACS sufferers, 26 with a decrease in cardiac mortality. 20,27 In this study, we found that patients without social support tended to become depressed more often that those with it, though the difference was not statistically significant. When the analysis was controlled for gender, we found that this tendency held true for men without social support, who were two and a half times more likely to become depressed than those with social support.…”

Section: Discussioncontrasting

confidence: 60%

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Major Depression and Acute Coronary Syndrome-Related Factors

Figueiredo¹,

Silva²,

Pereira³

et al. 2017

Arquivos Brasileiros De Cardiologia

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BackgroundMajor Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS).ObjectiveTo assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables.MethodsObservational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period. All participants answered a standardized questionnaire requesting sociodemographic, lifestyle and clinical data, as well as a structured diagnostic interview for the DSM-IV regarding ongoing major depressive episodes. A general log-linear model of multivariate analysis was employed to assess association and interdependence with a significance level of 5%.ResultsAnalysis of 356 patients (229 men), with an average and median age of 60 years (SD ± 11.42, 27-89). We found an MDD point prevalence of 23%, and a significant association between MDD and gender, marital status, sedentary lifestyle, Killip classification, and MDD history. Controlling for gender, we found a statistically significant association between MDD and gender, age ≤ 60 years, sedentary lifestyle and MDD history. The log-linear model identified the variables MDD history, gender, sedentary lifestyle, and age ≤ 60 years as having the greatest association with MDD.ConclusionDistinct approaches are required to diagnose and treat MDD in young women with ACS, history of MDD, sedentary lifestyle, and who are not in stable relationships.

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Section: Discussioncontrasting

confidence: 60%

“…On the other hand, MDD and ACS seem to share such inflammatory biomarkers as cytokines, alterations in oxidative stress, platelet alterations, and vascular reactivity, with an array of complex biological interactions that are so far not fully understood. 18-20 …”

Section: Discussionmentioning

confidence: 99%

Major Depression and Acute Coronary Syndrome-Related Factors

Figueiredo¹,

Silva²,

Pereira³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“… 11 , 12 , 13 In reality, it is likely that all three mechanisms play a role in co-occurrence of some disorders, but confirming the presence of at least one mechanism would represent a key first step in understanding these relationships. 14 …”

Section: Introductionmentioning

confidence: 99%

Polygenic loading for major depression is associated with specific medical comorbidity

et al. 2017

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Major depressive disorder frequently co-occurs with medical disorders, raising the possibility of shared genetic liability. Recent identification of 15 novel genetic loci associated with depression allows direct investigation of this question. In cohorts of individuals participating in biobanks at two academic medical centers, we calculated polygenic loading for risk loci reported to be associated with depression. We then examined the association between such loading and 50 groups of clinical diagnoses, or topics, drawn from these patients' electronic health records, determined using a novel application of latent Dirichilet allocation. Three topics showed experiment-wide association with the depression liability score; these included diagnostic groups representing greater prevalence of mood and anxiety disorders, greater prevalence of cardiac ischemia, and a decreased prevalence of heart failure. The latter two associations persisted even among individuals with no mood disorder diagnosis. This application of a novel method for grouping related diagnoses in biobanks indicate shared genetic risk for depression and cardiac disease, with a pattern suggesting greater ischemic risk and diminished heart failure risk.

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“…In pursuing causal factors, then the focus should be on those that are relevant to depression commencing or already present at the time of the cardiac event. Biological explanations that have been put forward invoke pathophysiological mechanisms that are shared in those experiencing an ACS event and in those who are depressed and notably inflammation and cardiac autonomic regulation (Granville Smith et al, 2015b). Psychosocial factors may include the impact of demoralization or a lack of application to cardiac rehabilitation programs and even adherence with cardiac medications.…”

Section: Discussionmentioning

confidence: 99%

“…We collected and tested a set of biological markers measured at the time of the ACS event (Granville Smith et al, 2015b) and did not find sufficient support for the possible explanation of inflammatory processes being invoked. Only poor sleep quality was identified as differentiating specific sample sub-groups, being least likely in those who were never depressed and highest in those with ongoing depression.…”

Section: Discussionmentioning

confidence: 99%

Depression and poor outcome after an acute coronary event: Clarification of risk periods and mechanisms

Parker

Cvejic

Vollmer‐Conna

et al. 2018

Aust N Z J Psychiatry

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Acute coronary syndrome and depression: A review of shared pathophysiological pathways

Abstract: A broader conceptual framework of mind-body or neuro-visceral integration that can incorporate the existence of several causative scenarios may be more useful in directing future research and treatment approaches for acute coronary syndrome-associated depression.

Cited by 13 publications

References 148 publications

Major Depression and Acute Coronary Syndrome-Related Factors

Major Depression and Acute Coronary Syndrome-Related Factors

Polygenic loading for major depression is associated with specific medical comorbidity

Depression and poor outcome after an acute coronary event: Clarification of risk periods and mechanisms

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