Determinants and escitalopram treatment effects on suicidal ideation in patients with acute coronary syndrome: Findings from the K-DEPACS and EsDEPACS studies

Kim, Jae-Min; Kang, Hee‐Ju; Bae, Kyung‐Yeol; Kim, Sung‐Wan; Shin, Il‐Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Kang, Hyeonggon; Yoon, Jin‐Sang

doi:10.1016/j.ijcard.2016.06.048

Cited by 13 publications

(27 citation statements)

References 33 publications

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“…The presence of SI was determined by a score of 2 (fleeting suicidal thoughts) or more, as described in previous studies [ 12 ]. Depression, sociodemographic, and cardiovascular characteristics potentially associated with SI in ACS patients [ 13 ] were investigated as covariates within 2 weeks of the index event, as described in Supplementary Table 1 (in the online-only Data Supplement).…”

Section: Methodsmentioning

confidence: 99%

BDNF Methylation and Suicidal Ideation in Patients with Acute Coronary Syndrome

Kang

Bae

Kim

et al. 2018

Psychiatry Investig

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ObjectivePatients with acute coronary syndrome (ACS) are at an increased risk of suicide. It is well known that epigenetic mechanisms may explain the pathophysiology of suicidal behavior including suicidal ideation (SI), but no study has explored these mechanisms in ACS populations. MethodsIn total, 969 patients were initially recruited within 2 weeks of the acute coronary event and, 711 patients were successfully followed up 1 year after ACS. SI was evaluated using the relevant items on the Montgomery-Åsberg Depression Rating Scale and covariates potentially affecting SI were estimated. ResultsBrain-derived neurotrophic factor (BDNF) hypermethylation was associated with SI in both the acute and chronic phases of ACS, although the association was not statistically significant in the acute phase after applying Bonferroni’s correction. ConclusionThese results suggested that BDNF hypermethylation may have played a role in an epigenetic predisposition for SI in ACS patients, particularly during the chronic phase.

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Section: Methodsmentioning

confidence: 99%

BDNF Methylation and Suicidal Ideation in Patients with Acute Coronary Syndrome

Kang

Bae

Kim

et al. 2018

Psychiatry Investig

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“…This was performed as a subanalysis using data from a large prospective study of ACS patients, the Korean DEPression in ACS (K-DEPACS) study, which also included a nested randomized controlled trial, the Escitalopram for DEPression in ACS (EsDEPACS) study. A description of the whole K-DEPACS study has been previously published [ 5 ], and the organization of these analyses is shown in Supplementary Figure 1 . Participants were consecutively recruited from patients recently hospitalized with ACS at the Department of Cardiology of Chonnam National University Hospital, Gwangju, South Korea, which serves as the principal coordinating center for the Korea Acute Myocardial Infarction Registry [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…Data on the covariates strongly associated with suicide in ACS patients in previous reports [ 5 ] were evaluated within 2 weeks after ACS. An assessment was performed to collect information on age, sex, years of education, living status (living alone or not), type of residence (owned or rented), and current occupation (employed or not).…”

Section: Methodsmentioning

confidence: 99%

“…Odds ratios (ORs) for SI related to various genotypes were calculated by applying logistic regression models after adjustment for covariates. Treatment status was considered as a covariate in the follow-up analysis considering previous result of antidepressants on SI [ 5 ]. An empirical p- value of 0.05 was applied to determine statistical significance.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, previous population-based case–control studies found that ACS was strongly associated with an increased risk of suicide per se, and this risk was highest shortly after discharge [ 4 ]. Despite the importance of identifying the predictors of suicide in patients with ACS, previous studies on this topic have focused on the psychiatric and clinical predictors of suicidal ideation (SI), including depression, marital status, and higher troponin I levels, as a phenotype [ 5 , 6 ]. However, few studies have explored the genetic predisposition for suicide in ACS populations.…”

Section: Introductionmentioning

confidence: 99%

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Genetic predisposition toward suicidal ideation in patients with acute coronary syndrome

et al. 2017

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The genetic predisposition toward suicidal ideation has been explored to identify subgroups at high risk and to prevent suicide. Acute coronary syndrome (ACS) is associated with an increased risk of suicide, but few studies have explored the genetic predisposition toward suicide in ACS populations. Therefore, this longitudinal study explored the genetic predisposition toward suicidal ideation in ACS patients. In total, of 969 patients within 2 weeks after ACS, 711 were followed at 1 year after ACS. Suicidal ideation was evaluated with the relevant items on the Montgomery–Åsberg Depression Rating Scale. Ten genetic polymorphisms associated with serotonergic systems, neurotrophic factors, carbon metabolism, and inflammatory cytokines were examined. Associations between genetic polymorphisms and suicidal ideation within 2 weeks and 1 year of ACS were investigated using logistic regression models. The 5-HTTLPR s allele was significantly associated with suicidal ideation within 2 weeks of ACS after adjusting for covariates and after the Bonferroni correction. TNF-α –308G/A, IL-1β –511C/T, and IL-1β + 3953C/T were significantly associated with suicidal ideation within 2 weeks after ACS, but these associations did not reach significance after the Bonferroni correction in unadjusted analyses and after adjusting for covariance. However, no significant association between genetic polymorphisms and suicidal ideation was found at 1 year. Genetic predisposition, 5-HTTLPR s allele in particular, may confer susceptibility to suicidal ideation in ACS patients during the acute phase of ACS.

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