Psychophysiological biomarkers explaining the association between depression and prognosis in coronary artery patients: A critical review of the literature

Abstract

This paper aims to provide an overview of the current state of affairs on psychophysiological factors that may explain the link between depression and adverse outcome in coronary artery disease (CAD) patients. Factors discussed include heart rate variability, inflammation, platelet function, hypothalamus-pituitary-adrenal axis activity, serotonin metabolism and polyunsaturated fatty acids. Evidence suggests the involvement of each of these factors in both depression and CAD, together contributing to the prospective association between depression and cardiac outcome. Unfortunately, the involvement of above factors has been evaluated mostly in isolation, despite their functional interrelations and associations with behavioral factors. Moreover, there may be specific relations between individual symptoms of depression and certain psychophysiological mechanisms, rather than with general depression, further complicating the notion of depression as a cardiotoxic factor. The relatively understudied complexity of the relation between depression and CAD may serve as an explanation for the finding that depression treatment does not or barely affect cardiac outcome. Future studies should focus on the network of psychophysiological (and behavioral) factors to elucidate their precise role and timing in depressed cardiac patients.

Emotional triggering and low socio-economic status as determinants of depression following acute coronary syndrome

“…These associations are largely independent of markers of disease severity and cardiovascular risk profiles (Kronish et al 2009). Investigation of the mechanisms relating depression with future cardiovascular morbidity is an active field of research, with candidates including biological processes such as autonomic, inflammatory, neuroendocrine and endothelial dysfunction, together with deficits in adherence to medication and life-style advice (Grippo & Johnson, 2009 ;de Jonge et al 2010).…”

Depressive symptoms and white blood cell count in coronary heart disease patients: Prospective findings from the Heart and Soul Study

“…Depression has been found to have a negative influence on cardiac prognosis (van Melle et al, 2004), but the mechanisms of this association remain unclear (de Jonge et al, 2010). Several studies have evaluated the association between depression and inflammatory markers, including interleukin (IL)6, high sensitive C-reactive protein (hsCRP), tumor necrosis factor (TNF)-a and its soluble receptors (Penninx et al, 2003;Whooley et al, 2007;Kupper et al, 2012;Vogelzangs et al, 2012).…”

The Relation between RAGE Polymorphism and Cardiovascular Diseases: A Review

“…More recently, it has been suggested that RAGE may form dimers and multimers for ligand binding to occur. 7 A range of splice variants of murine and human RAGE has been identified; most of these lead to removal of the transmembrane domain to produce soluble variants. RAGE has a C-truncated secretory isoform that circulates in plasma and which at least two variants: one secreted from cells, endogenously secreted RAGE (esRAGE), and another one, which formed by proteolytic cleavage, by matrix metalloproteinases from the cell-surface, cleaved-RAGE (cRAGE).…”