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Xu C, Wang D, Sun M, Huang B, Wang Y, Lin P. Joint effects of depressive symptoms and triglyceride-glucose index on cardiovascular events in acute coronary syndrome patients: The mediating role of TyGi. J Psychosom Res 2025; 189:112034. [PMID: 39787969 DOI: 10.1016/j.jpsychores.2024.112034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 12/17/2024] [Accepted: 12/30/2024] [Indexed: 01/12/2025]
Abstract
OBJECTIVE Our aim was to explore the joint impacts of depressive symptoms along with triglyceride-glucose index (TyGi) on major adverse cardiovascular events (MACE) in patients who have acute coronary syndrome (ACS) and investigate whether the impact of depressive symptoms on MACE is mediated through the TyGi. METHODS This extensive cohort study included 3681 ACS patients. Depressive symptoms and TyGi were assessed at baseline, and the patients were subsequently followed for two years to monitor the occurrence of MACE. RESULTS Throughout the two-year monitoring period, 387 (10.5 %) patients with ACS experienced MACE. The TyGi was positively correlated with MACE risk (hazard ratio [HR]: 1.301, 95 % confidence interval [CI]: 1.112-1.522, p = .001). A nonlinear relation was observed between the TyGi and MACE (p for nonlinearity = 0.04). Joint analyses revealed that, unlike the non-depression & TyG low group, the depression & TyG low group had a two-fold elevation in MACE risk (HR: 2.108, 95 % CI: 1.499-2.966), while the depression & TyG high group represented an even higher risk (HR: 2.442, 95 % CI: 1.786-3.339). The mediation analysis results showcased that the TyGi was a significant mediator of the interplay between depressive symptoms and MACE. CONCLUSION Depressive symptoms and the TyGi jointly influence MACE risk in ACS patients, with the TyGi mediating this relation. Close monitoring and management of depressive symptoms and the TyGi are crucial during ACS rehabilitation.
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Affiliation(s)
- Chengqian Xu
- College of Nursing of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Di Wang
- College of Nursing of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mengru Sun
- College of Nursing of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bingji Huang
- College of Nursing of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yini Wang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Ping Lin
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Veríssimo LF, Alves FHF, Estrada VB, da Costa Marques LA, Andrade KC, Bonancea AM, Okano NT, Corrêa FMDA, Pelosi GG. Cardiovascular effects of early maternal separation and escitalopram treatment in rats with depressive-like behaviour. Auton Neurosci 2024; 256:103223. [PMID: 39616948 DOI: 10.1016/j.autneu.2024.103223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 11/18/2024] [Accepted: 11/22/2024] [Indexed: 12/12/2024]
Abstract
Depression and cardiovascular diseases are two of the world's major health problems. Escitalopram (ESC) is widely used because of its safety in relation to other drugs in that class; however, it can affect the cardiovascular system. The present study evaluated the cardiovascular parameters of depressive-like male rats and the cardiovascular effects of ESC treatment on that condition. The EMS protocol consisted of separating the litter from the dam for 3 h over 13 days. Animals were anesthetized with tribromoethanol (250 mg/kg, intraperitoneally) and the catheters were inserted into the femoral and into the femoral vein. Depressive-like rats showed an increase in the pressor response to phenylephrine (Emax:depressive = 50.36 ± 2.997 mmHg; non-depressive = 39.51 ± 3.328 mmHg; p < 0.05) and a reduction in the EC50 (depressive = 0.6203 ± 0.03005 μg/kg; non-depressive = 0.7320 ± 0.03519 μg/kg; p < 0.05) with no change in the other cardiovascular parameters. After treatment with ESC, a reduction of intrinsic heart rate was observed in the depressive-like rats (control: 342 ± 6 bpm; ESC: 316 ± 5 bpm; p < 0.05). In addition, ESC treatment increased the bradycardic (control: -97.81 ± 8.3 bpm; ESC: -137.1 ± 12.31 bpm; p = 0.0236; t = 2.502) during the baroreflex response, caused by an increase in cardiac parasympathetic modulation in the heart, in depressive-like rats (p < 0.001). The findings suggest that depressive-like rats showed cardiovascular changes, and that ESC treatment was able to reverse these changes, suggesting that ESC has a good safety profile for depressive patients with cardiovascular disease due to increased parasympathetic modulation.
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Affiliation(s)
- Luiz Fernando Veríssimo
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Paraná, Brazil
| | | | - Viviane Batista Estrada
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Paraná, Brazil
| | | | - Karoliny Coelho Andrade
- Department of Health Sciences Faculty of Medicine Federal University of Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Amanda Monteiro Bonancea
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Paraná, Brazil
| | - Natália Tavares Okano
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Paraná, Brazil
| | | | - Gislaine Garcia Pelosi
- Department of Physiological Sciences, Center of Biological Sciences, State University of Londrina, Paraná, Brazil
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Yang W, Wang Y, Li X, Jing R, Mu L, Hu Y. Antidepressive and cardioprotective effects of Kai-xin-san via the regulation of HPA axis dysfunction and lipid metabolism in a rat model of depressive-cardiac disease. Brain Res Bull 2024; 219:111126. [PMID: 39542048 DOI: 10.1016/j.brainresbull.2024.111126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 11/01/2024] [Accepted: 11/11/2024] [Indexed: 11/17/2024]
Abstract
Depressive-cardiac disease is a comorbid state in which both cardiovascular diseases and mental disorders are present. Patients with depression are more likely to develop cardiovascular disease, which increases the risk of cardiovascular events, such as acute coronary syndrome. Cardiovascular diseases also exacerbate the poor mood of patients with psychiatric disorders. Kai-xin-san (KXS), a classic antidepressant formula, has potential antidepressive and cardioprotective effects. In the present study, we first evaluated the antidepressive and cardioprotective effects of KXS in two post-myocardial ischemic depressed rat models: a) isoproterenol (ISO) via intraperitoneal injection combined with chronic unpredictable mild stress (CUMS)-induced myocardial ischemia and depression and b) left anterior descending coronary artery ligation (LAD) combined with chronic restraint stress (CRS)-induced myocardial ischemia and depression. We then induced exogenous corticosterone in a rat model of depressive-cardiac disease. Our study revealed that chronic administration of corticosterone could induce depression-like syndromes accompanied by cardiac insufficiency. The potential mechanism involves parallel onset of HPA axis dysfunction and an imbalance in lipid metabolism. KXS treatment successfully reversed corticosterone-induced depression-like behaviors and cardiac insufficiency. The present study highlights the pivotal role of the HPA axis and lipid metabolism in the development of comorbid depression and cardiovascular disease. Thus, KXS could be a promising therapeutic option for depressive-cardiac disease.
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Affiliation(s)
- Wenshan Yang
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China; Department of Intensive Care Unit, Group 82 Military Hospital, Baoding 071000, China
| | - Yuanbo Wang
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China
| | - Xia Li
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China
| | - Rui Jing
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China
| | - Lihua Mu
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China
| | - Yuan Hu
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, China.
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4
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Thakur B, Strenth C, Arnold EM, Schneider FD. Sex Differences in the Association of Depression Symptoms and Cardiovascular Disease in Adults in the United States. Am J Health Promot 2024; 38:1199-1209. [PMID: 38864762 PMCID: PMC11528955 DOI: 10.1177/08901171241262249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
PURPOSE This study explores the relationship between depression and cardiovascular disease (CVD) in the US adult population, focusing on sex differences. DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey data (2013-2018). PARTICIPANTS A total of 14 699 community-dwelling adults (≥20 years). MEASURE The Patient Health Questionnaire (PHQ-9) depression screening tool assessed depressive symptoms. CVD events included heart failure, coronary heart disease, angina, heart attack, or stroke. ANALYSIS Adjusted prevalence ratios were estimated using a Poisson regression model. RESULTS The study finds a positive association between CVD incidents and both mild to moderate depressive symptoms (aPR:1.42, P = .002) and moderately severe to severe depression (aPR:1.72, P = .024). Overall, females exhibit a 47% lower likelihood of CVD incidents compared to males. However, in a subgroup analysis, increased depressive symptoms correlate with higher CVD incidents in females (aPRs range: 2.09 to 3.43, P < .001) compared to males (aPRs range: 1.45 to 1.77, P < .001). CONCLUSION Depression is associated with increased cardiovascular disease (CVD) risk. Females generally have a lower CVD risk than males, but more severe depressive symptoms elevate CVD risk in females. These findings emphasize the significance of considering sex differences. Further research is needed to understand the underlying mechanisms.
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Affiliation(s)
- Bhaskar Thakur
- Department of Family & Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Chance Strenth
- Department of Family & Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Frank David Schneider
- Department of Family & Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
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Wells A, Reeves D, Belcher A, Wilson P, Doherty P, Capobianco L. Protocol for an implementation study of group metacognitive therapy for anxiety and depression in NHS cardiac rehabilitation services in England (PATHWAY-Beacons). FRONTIERS IN HEALTH SERVICES 2024; 4:1296596. [PMID: 39483442 PMCID: PMC11524926 DOI: 10.3389/frhs.2024.1296596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/25/2024] [Indexed: 11/03/2024]
Abstract
Background Cardiac rehabilitation (CR) services aim to improve heart disease patients' health and quality of life and reduce the risk of further cardiac events. Depression and anxiety are common among CR patients but psychological treatments have usually had small effects. In contrast, the recent NIHR-funded PATHWAY trial found that group Metacognitive Therapy (MCT) was associated with improvements in anxiety and depression when added to CR and was more effective than usual CR alone. The next stage is to test implementation of MCT within the National Health Service through the creation of a network of CR beacon sites. The study will test the quality of data capture following addition of a new MCT data-field to the national audit of cardiac rehabilitation (NACR), examine level of adoption at sites, examine mental health outcomes benchmarked against usual CR and the PATHWAY data, examine the enablers and barriers to implementation and the expected resource requirements. The study has been registered: NCT05956912 (13th July, 2023). Methods Beacon sites will be recruited as preliminary adopters of group MCT from NHS CR services in England. A national invitation for expressions of interest from CR services will be issued and those meeting eligibility criteria will be considered for inclusion. Two staff at each site will receive training in MCT, and mixed-methods will be used to address questions concerning the quality of patient data recorded, level of adoption at sites, the characteristics of patients attending MCT, the impact of adding MCT to CR on mental health outcomes, and patient, healthcare staff and commissioner views of barriers/enablers to implementation. Exploration of implementation will be informed by Normalisation Process Theory. Discussion The study will support development of an NHS roll-out strategy, assess the mental health outcomes associated with MCT, examine treatment fidelity in real-world settings, and evaluate revised data collection structures that can be used to assess the impact of national-level implementation. Trial Registration NCT05956912; 13th July 2023.
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Affiliation(s)
- Adrian Wells
- Division of Psychology and Mental Health, School of Psychological Sciences, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom
| | - David Reeves
- NIHR School for Primary Care Research, Williamson Building, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Jean McFarlane Building, Faculty of Biology Medicine and Health, Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Andrew Belcher
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom
| | - Paul Wilson
- NIHR School for Primary Care Research, Williamson Building, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Patrick Doherty
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Department of Health Sciences, University of York, York, United Kingdom
| | - Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, National Health Service Foundation, Manchester, United Kingdom
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Banerjee P, Chau K, Kotla S, Davis EL, Turcios EB, Li S, Pengzhi Z, Wang G, Kolluru GK, Jain A, Cooke JP, Abe J, Le NT. A Potential Role for MAGI-1 in the Bi-Directional Relationship Between Major Depressive Disorder and Cardiovascular Disease. Curr Atheroscler Rep 2024; 26:463-483. [PMID: 38958925 DOI: 10.1007/s11883-024-01223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW Major Depressive Disorder (MDD) is characterized by persistent symptoms such as fatigue, loss of interest in activities, feelings of sadness and worthlessness. MDD often coexist with cardiovascular disease (CVD), yet the precise link between these conditions remains unclear. This review explores factors underlying the development of MDD and CVD, including genetic, epigenetic, platelet activation, inflammation, hypothalamic-pituitary-adrenal (HPA) axis activation, endothelial cell (EC) dysfunction, and blood-brain barrier (BBB) disruption. RECENT FINDINGS Single nucleotide polymorphisms (SNPs) in the membrane-associated guanylate kinase WW and PDZ domain-containing protein 1 (MAGI-1) are associated with neuroticism and psychiatric disorders including MDD. SNPs in MAGI-1 are also linked to chronic inflammatory disorders such as spontaneous glomerulosclerosis, celiac disease, ulcerative colitis, and Crohn's disease. Increased MAGI-1 expression has been observed in colonic epithelial samples from Crohn's disease and ulcerative colitis patients. MAGI-1 also plays a role in regulating EC activation and atherogenesis in mice and is essential for Influenza A virus (IAV) infection, endoplasmic reticulum stress-induced EC apoptosis, and thrombin-induced EC permeability. Despite being understudied in human disease; evidence suggests that MAGI-1 may play a role in linking CVD and MDD. Therefore, further investigation of MAG-1 could be warranted to elucidate its potential involvement in these conditions.
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Affiliation(s)
- Priyanka Banerjee
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
- Medical Physiology, College of Medicine, Texas A&M Health Science Center, Bryan, TX, USA
| | - Khanh Chau
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Sivareddy Kotla
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eleanor L Davis
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Estefani Berrios Turcios
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Shengyu Li
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Zhang Pengzhi
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Guangyu Wang
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | | | - Abhishek Jain
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX, USA
- Department of Medical Physiology, School of Medicine, Texas A&M Health Science Center, Bryan, USA
| | - John P Cooke
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Junichi Abe
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nhat-Tu Le
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA.
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Mortensen M, Nilsen RM, Kvalheim VL, Bjørnstad JL, Svendsen ØS, Haaverstad R, Moi AL. The influence of socio-demographic and clinical factors on sick leave and return to work after open-heart surgery: a nationwide registry-based cohort study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:431-445. [PMID: 37858302 PMCID: PMC11307200 DOI: 10.1093/ehjqcco/qcad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/27/2023] [Accepted: 10/18/2023] [Indexed: 10/21/2023]
Abstract
AIMS To estimate sick leave (SL) duration after first-time elective open-heart surgery and identify factors contributing to increased SL. METHODS AND RESULTS A retrospective nationwide cohort study combined data from the Norwegian Register for Cardiac Surgery and SL data from the Norwegian Labour and Welfare Administrations. All able-bodied adults who underwent first-time elective open-heart surgery in Norway between 2012 and 2021 were followed until 1 year after surgery. The impact of socio-demographic and clinical factors on SL after surgery was analysed using logistic regression and odds ratios. Of 5456 patients, 1643 (30.1%), 1798 (33.0%), 971 (17.8%), 1035 (18.9%), and 9 (0.2%) had SL of <3, 3-6, 6-9, and 9-12 months, and 1 year, respectively. SL >6 months was associated with female gender, primary education only, and average annual income. Post-operative stroke, post-operative renal failure, New York Heart Association Functional Classification system (NYHA) score >3, earlier myocardial infarction, and diabetes mellitus increased the odds of SL >6 months. CONCLUSION This study demonstrates that socio-demographic and clinical factors impact SL after first-time elective open-heart surgery. Patients who experience a stroke or develop renal failure after surgery have the highest odds of SL >6 months. Females and patients with low education levels, earlier myocardial infarction, or NYHA scores III-IV have a two-fold chance of SL >6 months. The findings allow for future investigations of pre- and post-surgery interventions that can most effectively reduce SL and aid return to work.
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Affiliation(s)
- Michael Mortensen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O box 7030, 5020 Bergen, Norway
| | - Roy M Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Venny L Kvalheim
- Department of Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Johannes L Bjørnstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Norwegian Register for Cardiac Surgery, Oslo, Norway
| | - Øyvind S Svendsen
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
| | - Rune Haaverstad
- Department of Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Asgjerd L Moi
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O box 7030, 5020 Bergen, Norway
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
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Neppala S, Chigurupati HD, Chauhan S, Chinthapalli MT, Desai R. Impact of depression on in-hospital outcomes for adults with type 2 myocardial infarction: A United States population-based analysis. World J Cardiol 2024; 16:412-421. [PMID: 39086894 PMCID: PMC11287453 DOI: 10.4330/wjc.v16.i7.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/25/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Type 2 myocardial infarction (T2MI) is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary event. However, though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction (T1MI), data remains non-existent to evaluate the association with T2MI. AIM To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital outcomes. METHODS We queried the National Inpatient Sample (2019) to identify T2MI hospitalizations using Internal Classification of Diseases-10 codes in hospitalized adults (≥ 18 years). In addition, we compared sociodemographic and comorbidities in the T2MI cohort with vs without comorbid depression. Finally, we used multivariate regression analysis to study the odds of T2MI hospitalizations with vs without depression and in-hospital outcomes (all-cause mortality, cardiogenic shock, cardiac arrest, and stroke), adjusting for confounders. Statistical significance was achieved with a P value of < 0.05. RESULTS There were 331145 adult T2MI hospitalizations after excluding T1MI (median age: 73 years, 52.8% male, 69.9% white); 41405 (12.5%) had depression, the remainder; 289740 did not have depression. Multivariate analysis revealed lower odds of T2MI in patients with depression vs without [adjusted odds ratio (aOR) = 0.88, 95% confidence interval (CI): 0.86-0.90, P = 0.001]. There was the equal prevalence of prior MI with any revascularization and a similar prevalence of peripheral vascular disease in the cohorts with depression vs without depression. There is a greater prevalence of stroke in patients with depression (10.1%) vs those without (8.6%). There was a slightly higher prevalence of hyperlipidemia in patients with depression vs without depression (56.5% vs 48.9%), as well as obesity (21.3% vs 17.9%). There was generally equal prevalence of hypertension and type 2 diabetes mellitus in both cohorts. There was no significant difference in elective and non-elective admissions frequency between cohorts. Patients with depression vs without depression also showed a lower risk of all-cause mortality (aOR = 0.75, 95%CI: 0.67-0.83, P = 0.001), cardiogenic shock (aOR = 0.65, 95%CI: 0.56-0.76, P = 0.001), cardiac arrest (aOR = 0.77, 95%CI: 0.67-0.89, P = 0.001) as well as stroke (aOR = 0.79, 95%CI: 0.70-0.89, P = 0.001). CONCLUSION This study revealed a significantly lower risk of T2MI in patients with depression compared to patients without depression by decreasing adverse in-hospital outcomes such as all-cause mortality, cardiogenic shock, cardiac arrest, and stroke in patients with depression.
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Affiliation(s)
- Sivaram Neppala
- Department of Internal Medicine, University of Texas at San Antonio, San Antonio, TX 78249, United States
| | - Himaja Dutt Chigurupati
- Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ 07102, United States
| | - Shaylika Chauhan
- Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States.
| | | | - Rupak Desai
- Independent Researcher, Atlanta, GA 30079, United States
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9
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Bahr F, Ricke-Hoch M, Ponimaskin E, Müller F. Serotonin Receptors in Myocardial Infarction: Friend or Foe? ACS Chem Neurosci 2024; 15:1619-1634. [PMID: 38573542 PMCID: PMC11027101 DOI: 10.1021/acschemneuro.4c00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Acute myocardial infarction (AMI) is one of the leading causes of death worldwide and treatment costs pose a major burden on the global health care system. Despite the variety of treatment options, individual recovery can be still poor and the mortality rate, especially in the first few years after the event, remains high. Therefore, intense research is currently focused on identifying novel target molecules to improve the outcome following AMI. One of the potentially interesting targets is the serotonergic system (5-HT system), not at least because of its connection to mental disorders. It is known that patients suffering from AMI have an increased risk of developing depression and vice versa. This implicates that the 5-HT system can be affected in response to AMI and might thus represent a target structure for patients' treatment. This review aims to highlight the importance of the 5-HT system after AMI by describing the role of individual serotonin receptors (5-HTR) in the regulation of physiological and pathophysiological responses. It particularly focuses on the signaling pathways of the serotonin receptors 1, 2, 4, and 7, which are expressed in the cardiovascular system, during disease onset, and the following remodeling process. This overview also emphasizes the importance of the 5-HT system in AMI etiology and highlights 5-HTRs as potential treatment targets.
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Affiliation(s)
- F.S. Bahr
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
| | - M. Ricke-Hoch
- Cardiology
and Angiology, Hannover Medical School, 30625 Hannover, Germany
| | - E. Ponimaskin
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
| | - F.E. Müller
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
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10
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Alsuwaidan SD, Bakhaider MA, Alsenaidy AA, Alshehri MA, Alzaid FN, Aldakhil LO, Albrahim FZ. Prevalence of depression in postmyocardial infarction patients in a tertiary care center in Riyadh. J Family Community Med 2024; 31:57-62. [PMID: 38406215 PMCID: PMC10883433 DOI: 10.4103/jfcm.jfcm_166_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The coexistence of coronary artery disease (CAD) and depression is a growing concern, as both conditions lead to disability. Although depression is more prevalent in CAD patients than in the general population and has been associated with adverse cardiac outcomes, the underlying mechanisms linking depression and CAD are not yet fully understood. This study aims to assess the prevalence of depression in postmyocardial infarction (MI) patients as baseline data in Saudi Arabia. MATERIALS AND METHODS A cross-sectional study was conducted at King Saud Medical City, Riyadh. The study population included male and female patients who had survived MI from January 2022 to June 2022. A sample size of 323 patients was initially planned, but only 249 patients could be included on account of exclusions. The patients underwent screening for depression using Patient Health Questionnaire-2 (PHQ-2), and those who were positive on screening were further assessed using the PHQ-9 according to DSM-5 criteria. Sociodemographic data, comorbidities, and previous cardiac interventions were collected from medical records. RESULTS The mean age of the study participants was 57.15 years, and majority (76.6%) were males. The prevalence of previously diagnosed depression was 9.2%, and 5.2% of patients reported using antidepressant medication. According to the PHQ-9 scores, 33.33% had depression, 9% had moderate depression, and 2.4% had severe depression. There were significant associations between the severity of depression and previous CAD (P < 0.05), previous coronary artery bypass graft surgery (P < 0.05), and heart failure (P < 0.05). CONCLUSION This study reveals a high prevalence of depression in post-MI patients at King Saud Medical City. The findings highlight the need for comprehensive management of depression in this population to improve outcomes. Further research into the underlying mechanisms linking depression and CAD to develop effective interventions is required.
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Affiliation(s)
- Salem D. Alsuwaidan
- Department of Family Medicine, King Saud Medical City, Research Centre, Riyadh, Saudi Arabia
| | - Moaz A. Bakhaider
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | | | | | - Fahad N. Alzaid
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Lina O. Aldakhil
- Department of Family Medicine, King Saud Medical City, Research Centre, Riyadh, Saudi Arabia
| | - Fatima Z. Albrahim
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
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11
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Park J, Lee H, Jeon Y, Park EJ, Park S, Ann SH, Kim Y, Lee Y, Park G, Choi SH. Depression and Subclinical Coronary Atherosclerosis in Adults Without Clinical Coronary Artery Disease. J Am Heart Assoc 2023; 12:e030315. [PMID: 38063186 PMCID: PMC10863772 DOI: 10.1161/jaha.123.030315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The relationship between depression and subclinical coronary atherosclerosis in asymptomatic individuals is not clear. We evaluated this relationship in a Korean population. METHODS AND RESULTS We analyzed 3920 individuals (mean age 54.7±7.9 years and 2603 men [66.4%]) with no history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography and screening for depression using the Beck Depression Inventory as part of a general health examination. The degree and extent of subclinical coronary atherosclerosis were evaluated by coronary computed tomographic angiography, and ≥50% diameter stenosis was defined as significant. Participants were categorized into groups of those with or without depression using the Beck Depression Inventory scores ≥16 as a cutoff value. Of the study participants, 272 (6.9%) had a Beck Depression Inventory score of 16 or higher. After adjustment for cardiovascular risk factors, depression was not significantly associated with any coronary plaque (adjusted odds ratio [OR], 1.05 [95% CI, 0.78-1.41]; P=0.746), calcified plaque (OR, 0.95 [95% CI, 0.71-1.29]; P=0.758), noncalcified plaque (OR, 1.31 [95% CI, 0.79-2.17]; P=0.305), mixed plaque (OR, 1.16 [95% CI, 0.60-2.23]; P=0.659), or significant coronary artery stenosis (OR, 1.22 [95% CI, 0.73-2.03]; P=0.450). In the propensity score-matched population (n=1318) as well, none of the coronary artery disease measures of subclinical coronary atherosclerosis were statistically significantly associated with depression (all P>0.05). CONCLUSIONS In this large cross-sectional study with asymptomatic individuals undergoing coronary computed tomographic angiography and Beck Depression Inventory evaluation, depression was not associated with an increased risk of subclinical coronary atherosclerosis.
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Affiliation(s)
- Jangho Park
- Department of PsychiatryUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Hyeji Lee
- Department of Emergency MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Young‐Jee Jeon
- Department of Family MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Eun Ji Park
- Big Data CenterUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Sangwoo Park
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Soe Hee Ann
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Yong‐Giun Kim
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Yongjik Lee
- Department of Thoracic and Cardiovascular SurgeryUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Gyung‐Min Park
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Seong Hoon Choi
- Department of RadiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
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12
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Borgi M, Biondi-Zoccai G, Frati G, Peruzzi M. Cardiovascular disease and mental health: a dangerous duo? Eur J Prev Cardiol 2023; 30:1686-1688. [PMID: 37294922 DOI: 10.1093/eurjpc/zwad199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/11/2023]
Affiliation(s)
- Marco Borgi
- Department of Clinical and Experimental Medicine, Policlinic 'G. Martino,' University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy
- Mediterranea Cardiocentro, Via Orazio 2, 80122 Napoli, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy
- IRCCS NEUROMED, Via Atinense 18, 86077 Pozzilli, Italy
| | - Mariangela Peruzzi
- Mediterranea Cardiocentro, Via Orazio 2, 80122 Napoli, Italy
- Department of Clinical Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
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13
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Suarez L, Melikian R, Alnahhal KI, Allison GM, Jimenez D, Urhiafe V, Salehi P, Iafrati M. Preoperative Depression is Associated with Worse Outcomes after The Lower Extremity Revascularization. Vascular 2023; 31:968-976. [PMID: 35588170 DOI: 10.1177/17085381221103061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This retrospective study sought to describe the association between preoperative diagnosis of depression and major adverse events after infrainguinal bypass surgery or peripheral vascular intervention (PVI). METHODS We retrospectively analyzed a consecutive series of all patients undergoing PVI and/or infrainguinal bypass surgery at a single tertiary institution between 2010 and 2019. Propensity matching and Cox regression analysis were conducted to examine the impact of comorbid depression on the incidence of major adverse events (MAEs), defined as re-intervention, major amputation, or death, within 2 years of surgery. RESULTS Of all patients (n = 512) undergoing intervention at our institution, 166 (32.4%) suffered an MAE and 169 (33.0%) patients had a preoperative diagnosis of depression. After propensity score matching, univariate (HR, 1.7; 95% CI, 1.1-2.7) and multivariable hazard analyses (aHR, 1.50; [1.1-2.2]) demonstrate that there is a statistically significant relationship between the diagnosis of depression and increased MAE. CONCLUSION Over one-third of our lower extremity revascularization patients were noted to have a preoperative diagnosis of depression. After intervention, these patients had worse outcomes compared to patients without depression; this finding was more evident in patients who underwent PVI mainly due to high overall mortality rate. Prospective studies are necessary to better understand this association and to ascertain if early intervention can improve post-procedure vascular outcomes.
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Affiliation(s)
- Luis Suarez
- Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA, USA
| | | | - Khaled I Alnahhal
- Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA, USA
| | - Genève M Allison
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | | | - Vanessa Urhiafe
- Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA, USA
| | - Payam Salehi
- Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA, USA
| | - Mark Iafrati
- Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA, USA
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14
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Buto PT, Shah A, Pearce BD, Lima BB, Almuwaqqat Z, Martini A, Al-Abboud O, Tarlapally N, Sullivan S, Sun YV, Murrah NV, Driggers E, Shallenberger L, Lewis TT, Elon L, Bremner JD, Raggi P, Quyyumi A, Vaccarino V. Association of systemic inflammation with posttraumatic stress disorder after a myocardial infarction. Brain Behav Immun Health 2023; 30:100629. [PMID: 37396337 PMCID: PMC10308211 DOI: 10.1016/j.bbih.2023.100629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 07/04/2023] Open
Abstract
Background Adverse mental health conditions including depression, posttraumatic stress disorder (PTSD), and anxiety are prevalent among patients who survive myocardial infarctions (MI) and are associated with adverse outcomes. The mechanisms underlying these associations, however, are not well understood. Inflammatory pathways may mediate the cardiovascular outcomes of patients with mental health disorders. We examined the bidirectional association between PTSD symptoms and inflammatory biomarkers in a young/middle-aged post MI population. We further examined how this association may differ between women and men as well as between Black and non-Black individuals. Methods Participants included individuals with early onset MI between the ages 25 and 60. Mental health scores for depression, PTSD, perceived stress, and anxiety as well as inflammatory biomarkers, interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP), were collected at baseline and at six-month follow up. We examined the bidirectional changes in mental health symptoms and inflammatory biomarkers between baseline and follow-up. Results Among 244 patients in the study (mean age: 50.8, 48.4% female, 64.3% Black), the geometric means for IL-6 level and hsCRP at rest were 1.7 pg/mL and 2.76 mg/L, respectively. Mental health scores at baseline did not consistently predict changes in inflammatory biomarkers at follow-up. However, baseline levels of both IL-6 and hsCRP were robustly associated with an increase in re-experiencing PTSD symptoms at 6 months: in adjusted linear mixed models, there was a 1.58-point increase in re-experiencing PTSD symptoms per unit of baseline hsCRP (p = 0.01) and 2.59-point increase per unit of baseline IL-6 (p = 0.02). Once the analysis was stratified by race, the association was only noted in Black individuals. Baseline inflammation was not associated with change in any of the other mental health symptom scores. Conclusion Markers of inflammation are associated with an increase in post-event PTSD symptoms in younger or middle-aged patients who experienced an MI, especially Black patients. These results suggest a mechanistic link between inflammation and the development of PTSD among individuals with cardiovascular disease.
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Affiliation(s)
- Peter T. Buto
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Health Care System, Decatur, GA, USA
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zakaria Almuwaqqat
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Afif Martini
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Omar Al-Abboud
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nitya Tarlapally
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Yan V. Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Atlanta VA Health Care System, Decatur, GA, USA
| | - Nancy V. Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Emily Driggers
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - J. Douglas Bremner
- Atlanta VA Health Care System, Decatur, GA, USA
- Departments of Psychiatry and Behavioral Sciences and Radiology, Emory University School of Medicine, USA
| | - Paolo Raggi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Arshed Quyyumi
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
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15
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Vyas A, Desai R, Patel V, Bansal P, Jain A, Gupta T, Priyadarshini S, Shalaby M, Khalife W. Rising Burden of Cardiovascular Disease Risk Factors and Acute Cardiac Events in Young Adults with Comorbid Depression: A Comparison Nationwide US Cohorts Hospitalized 10-years Apart. Curr Probl Cardiol 2023; 48:101755. [PMID: 37088176 DOI: 10.1016/j.cpcardiol.2023.101755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
Depression and coronary artery disease are leading causes of mortality in adults in high-income countries. Due to the paucity of data on the young, we aimed to investigate the prevalence of cardiovascular disease (CVD) risk factors and associated major adverse cardiac and cerebrovascular events (MACCE) in young adults hospitalized with comorbid depression a decade apart. We conducted a retrospective analysis of the National Inpatient Sample Database for the years 2007 and 2017. Young adults (18-44 years) hospitalized with comorbid depression were identified using ICD-9 CM/ICD-10 codes. Frequency and trends in demographics, comorbidities including cardiovascular disease risk factors, and MACCE have been compared between the 2017 vs. 2007 cohorts. A total of 1,274,118 admissions with a median age of 34 years and 68.7% of females were recorded with comorbid depression. When the 2007 cohort was compared with the 2017 cohort, a rising trend in depression was observed (5.5% vs. 8.2%, p<0.001). The 2017 cohort of young adults with depression more often consisted of male, non-white patients. The burden of CVD risk factors such as hypertension, diabetes with chronic complications, smoking, and obesity was also greater in the 2017 cohort. Although the all-cause mortality remained comparable (0.3%) in both cohorts, there was a significantly higher rate and risk of MACCE including acute myocardial infarction (aOR 1.18, 95%CI:1.10-1.26), atrial fibrillation or flutter (aOR 1.47, 95%CI:1.40-1.54) and stroke (aOR 1.33, 95%CI: 1.26-1.40) (p <0.001) in the 2017 cohort. In conclusion, this nationwide study reveals an alarmingly increased prevalence of CVD risk factors and an increase in the rate and risk of MACCE in two cohorts of young adults with comorbid depression studied a decade apart. The burden of mental disorders in young adults has been rising in the last decade and warrants extra vigilance by clinicians to recognize and manage depression to curtail CVD risk and improve MACE-associated outcomes.
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Affiliation(s)
- Ankit Vyas
- Baptist Hospitals of Southeast Texas, TX
| | | | | | | | - Akhil Jain
- Mercy Catholic Medical Center, Darby, PA
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16
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Wang Z, Luo Y, Zhang Y, Chen L, Zou Y, Xiao J, Min W, Yuan C, Ye Y, Li M, Tu M, Hu J, Zou Z. Heart rate variability in generalized anxiety disorder, major depressive disorder and panic disorder: A network meta-analysis and systematic review. J Affect Disord 2023; 330:259-266. [PMID: 36914118 DOI: 10.1016/j.jad.2023.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Heart rate variability (HRV) in patients with emotional disorders and healthy controls (HCs) has been investigated in many studies but the difference between these emotional disorders was unclear. METHODS The PubMed, Embase, Medline and Web of Science databases were systematically searched for studies published in English that compared HCs with generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD) patients in HRV. We conducted a network meta-analysis to compare HRV in patients with GAD, MDD, PD and HCs. HRV outcomes, including time domain indices (the standard deviation of NN intervals (SDNN) and the root mean square of the successive differences between normal heartbeats (RMSSD)), and frequency domain indices (High-frequency (HF), Low-frequency (LF) and the ratio of LF to HF (LF/HF)) were obtained. A total of 4008 participants from 42 studies were included. RESULTS The results of pairwise meta-analysis showed that compared with controls, GAD, PD and MDD patients exhibited significantly reduced HRV. Similar findings were also confirmed in network meta-analysis. The most important finding from network meta-analysis was that GAD patients had significantly lower SDNN than PD patients (SMD = -0.60, 95 % CI [-1.09, -0.11]). CONCLUSION Our findings provided a potential objective biological marker to distinguish between GAD and PD. In the future, a large sample of research is needed to directly compare HRV of various mental disorders, which is crucial for finding biomarkers to distinguish them.
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Affiliation(s)
- Zuxing Wang
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yuanyuan Luo
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yuan Zhang
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, PR China
| | - Lili Chen
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yazhu Zou
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Jun Xiao
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Wenjiao Min
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Cui Yuan
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yu Ye
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Mingmei Li
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Mengtian Tu
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Jiangli Hu
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Zhili Zou
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, PR China.
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17
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Importance of Depressive Symptoms in Patients With Coronary Heart Disease - Review Article. Curr Probl Cardiol 2023; 48:101646. [PMID: 36773947 DOI: 10.1016/j.cpcardiol.2023.101646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
Patients with myocardial infarction (MI) have both major depression as well as depressive symptoms. Therefore, due to the high prevalence of depression in post-MI patients, an assessment of its prognostic importance was put on the agenda. Patients after ACS frequently report fatigue, sleep problems, and sadness. Evaluation of these symptoms is very important because it should be clarified whether these symptoms are related only to the main disease or they indicate the presence of concomitant depression. Given a high predictive value of somatic-affective symptoms, it is recommended to assess them in post-MI patients. Further treatment of somatic and cognitive-affective symptoms of depression will improve the quality of life of patients with acute coronary events.
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18
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Chen TY, Geng JH, Chen SC, Lee JI. Living alone is associated with a higher prevalence of psychiatric morbidity in a population-based cross-sectional study. Front Public Health 2022; 10:1054615. [PMID: 36466461 PMCID: PMC9714444 DOI: 10.3389/fpubh.2022.1054615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Living alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort. Methods In this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity. Results The participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone. Conclusions Our findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.
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Affiliation(s)
- Te-Yu Chen
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,*Correspondence: Jia-In Lee
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19
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Abstract
Depression is a well-known risk factor for adverse cardiovascular outcomes in patients with cardiovascular diseases. The prevalence of depression in patients with cardiovascular diseases has been reported to be approximately 20 %. A two-step depression screening protocol using the 2-item Patient Health Questionnaire (PHQ-2) and the 9-item Patient Health Questionnaire (PHQ-9) is recommended for patients with cardiovascular diseases. Cardiovascular diseases and depression share a common pathology, including increased activity of the sympathetic nervous system, hyperactivity of hypothalamic-pituitary-adrenal axis, and inflammation. Psychosocial and environmental factors are also associated with depression and cardiovascular outcomes. Randomized controlled trials of antidepressant treatment for patients with depression and cardiovascular diseases have shown no advantage regarding cardiovascular outcomes. However, improvement in depressive symptoms, regardless of the method, may lead to a reduction in subsequent cardiovascular events. A collaborative approach between cardiologists and psychiatrists is recommended to manage depression in patients with cardiovascular diseases. Future research should identify more specific targets for treating patients with cardiovascular diseases, involve collaboration with professionals across fields, and establish community support systems.
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20
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Segan L, Prabhu S, Kalman JM, Kistler PM. Atrial Fibrillation and Stress: A 2-Way Street? JACC Clin Electrophysiol 2022; 8:1051-1059. [PMID: 35981797 DOI: 10.1016/j.jacep.2021.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 02/05/2023]
Abstract
The accumulating literature linking stress with negative health outcomes, including cardiovascular disease (CVD), is extensively reported yet poorly defined. Stress is associated with a higher risk of hypertension, acute myocardial infarction, arrhythmogenesis, and heart failure. Stress mediates its effect through direct neuronal, endocrine, autonomic, and immune processes and indirectly by modifying lifestyle behaviors that promote CVD progression. Stress occurs when an individual perceives that internal or external demands exceed the capacity for an adaptive response. Psychologic stress is increasingly recognized in the atrial fibrillation (AF) population, although the pathophysiology remains unclear. There appears to be a bidirectional relationship between AF and stress with a complex interplay between the 2 entities. Stress modulates the immune and autonomic nervous systems, key drivers in AF initiation and potentiation. AF leads to increasing anxiety, psychologic distress, and suicidal ideation. Recently, lifestyle modification has emerged as the fourth pillar of AF management, with stress reduction a potential reversible risk factor and future target for intervention. This review examines proposed mechanisms linking AF and stress and explores stress reduction as an adjunct to the AF management armamentarium.
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Affiliation(s)
- Louise Segan
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Sandeep Prabhu
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Jonathan M Kalman
- University of Melbourne, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Australia
| | - Peter M Kistler
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia.
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21
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David F, Philipp J, Henrike AB, Nikolaos PP, Christine PH, Martin C, Oliver PR, Benjamin S. Impact of the Educational Level on Non-Fatal Health Outcomes following Myocardial Infarction. Curr Probl Cardiol 2022; 47:101340. [DOI: 10.1016/j.cpcardiol.2022.101340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
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22
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Shin J, Cho E. Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006-2016). BMC Psychiatry 2022; 22:246. [PMID: 35395760 PMCID: PMC8991942 DOI: 10.1186/s12888-022-03905-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults. METHODS Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006-2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms. RESULTS Five depressive symptom trajectory groups were identified: Group 1, "None" (28.9%); Group 2, "Slowly worsening" (24.3%); Group 3, "Rapidly worsening" (17.5%); Group 4 "Improving" (12.4%); and Group 5, "Persistently severe" (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms. CONCLUSIONS This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults.
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Affiliation(s)
- Jinhee Shin
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, Republic of Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, Republic of Korea.
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Lorem GF, Opdal IM, Wilsgaard T, Schirmer H, Løchen ML, Olsen IP, Steigen T, Rognmo K. Assessment of mental health trajectories before and after myocardial infarction, atrial fibrillation or stroke: analysis of a cohort study in Tromsø, Norway (Tromsø Study, 1994-2016). BMJ Open 2022; 12:e052948. [PMID: 35365517 PMCID: PMC8977765 DOI: 10.1136/bmjopen-2021-052948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The increased survival rate of cardiovascular disease (CVD) implies a higher proportion of individuals who live with CVD. Using data from the Tromsø Study, we aimed to investigate mental health symptom trajectories before and after myocardial infarction, atrial fibrillation or stroke in a general population and to explore factors that contribute to the association. DESIGN Cohort study. SETTING Sample drawn from inhabitants of the municipality of Tromsø, Norway, who participated in the Tromsø Study (1994-2016). PARTICIPANTS A total of 18 719 participants (52.3% women) were included, and of these 2098 (32.9% women) were diagnosed with myocardial infarction, 1896 (41.9% women) with atrial fibrillation and 1263 (42.9% women) with stroke. PRIMARY OUTCOME MEASURES Mental health symptoms were assessed using the Hopkins Symptom Checklist-10 and the Conor Mental Health Index. RESULTS The participants who were diagnosed with either myocardial infarction or stroke had a significant monotonous increase in mental health symptoms before myocardial infarction (p=0.029) and stroke (p=0.029) that intensified at the time of diagnosis. After the event, the study found a higher prevalence of mental health symptoms with a decline in symptom levels over time for myocardial infarction (p<0.001) and stroke (p=0.004), but not for atrial fibrillation (before: p=0.180, after: p=0.410). The risk of elevated mental health symptoms with myocardial infarction, atrial fibrillation and stroke was associated with sex (p<0.001), age (p<0.01), physical activity (p<0.001), diabetes (p<0.05) and other comorbidities (p<0.001). CONCLUSION The study indicates that mental health problems among individuals with myocardial infarction, atrial fibrillation and stroke may have started to develop several years before the cardiovascular event and suggests that successful CVD rehabilitation may need to consider previous life factors. Future research is recommended to examine whether health promotion measures in a general population also create mental health resilience after a CVD event.
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Affiliation(s)
| | - Ida Marie Opdal
- Department of Psychology, UiT The Arctic University of Norway, Tromso, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, University of Oslo Faculty of Medicine, Lørenskog, Norway
- Department of Cardiology, Akershus University Hospital, Lorenskog, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Cardiology, University Hospital of North Norway, UNN, Tromso, Norway
| | - Ingrid Petrikke Olsen
- Department of Gynaecology and Obstetrics, Finnmark Hospital Trust, Hammerfest, Norway
- Institute of Clinical Medicine, University of Tromso, Tromso, Norway
| | - Terje Steigen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
- Department of Cardiology, University Hospital of North Norway, UNN, Tromso, Norway
| | - Kamilla Rognmo
- Department of Psychology, UiT The Arctic University of Norway, Tromso, Norway
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Bruns B, Daub R, Schmitz T, Hamze-Sinno M, Spaich S, Dewenter M, Schwale C, Gass P, Vogt M, Katus H, Herzog W, Friederich HC, Frey N, Schultz JH, Backs J. Forebrain corticosteroid receptors promote post-myocardial infarction depression and mortality. Basic Res Cardiol 2022; 117:44. [PMID: 36068417 PMCID: PMC9448693 DOI: 10.1007/s00395-022-00951-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/19/2022] [Accepted: 08/07/2022] [Indexed: 01/31/2023]
Abstract
Myocardial infarction (MI) with subsequent depression is associated with increased cardiac mortality. Impaired central mineralocorticoid (MR) and glucocorticoid receptor (GR) equilibrium has been suggested as a key mechanism in the pathogenesis of human depression. Here, we investigate if deficient central MR/GR signaling is causative for a poor outcome after MI in mice. Mice with an inducible forebrain-specific MR/GR knockout (MR/GR-KO) underwent baseline and follow-up echocardiography every 2 weeks after MI or sham operation. Behavioral testing at 4 weeks confirmed significant depressive-like behavior and, strikingly, a higher mortality after MI, while cardiac function and myocardial damage remained unaffected. Telemetry revealed cardiac autonomic imbalance with marked bradycardia and ventricular tachycardia (VT) upon MI in MR/GR-KO. Mechanistically, we found a higher responsiveness to atropine, pointing to impaired parasympathetic tone of 'depressive' mice after MI. Serum corticosterone levels were increased but-in line with the higher vagal tone-plasma and cardiac catecholamines were decreased. MR/GR deficiency in the forebrain led to significant depressive-like behavior and a higher mortality after MI. This was accompanied by increased vagal tone, depleted catecholaminergic compensatory capacity and VTs. Thus, limbic MR/GR disequilibrium may contribute to the impaired outcome of depressive patients after MI and possibly explain the lack of anti-depressive treatment benefit.
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Affiliation(s)
- Bastian Bruns
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany ,Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany ,Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Ricarda Daub
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany ,Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Thomas Schmitz
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany ,Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Maria Hamze-Sinno
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Sebastian Spaich
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany ,Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany ,Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Matthias Dewenter
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
| | - Chrysovalandis Schwale
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany ,Institute for Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany
| | - Peter Gass
- Central Institute of Mental Health, RG Animal Models in Psychiatry, Medical Faculty of Mannheim/University of Heidelberg, Mannheim, Germany
| | - Miriam Vogt
- Central Institute of Mental Health, RG Animal Models in Psychiatry, Medical Faculty of Mannheim/University of Heidelberg, Mannheim, Germany
| | - Hugo Katus
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany ,DZHK (German Centre for Cardiovascular Research), Partner Site, Heidelberg/Mannheim, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany ,DZHK (German Centre for Cardiovascular Research), Partner Site, Heidelberg/Mannheim, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Johannes Backs
- Institute of Experimental Cardiology, Heidelberg University, Heidelberg and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Im Neuenheimer Feld 669, 69120 Heidelberg, Germany
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25
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Saini RK, Chaudhury S, Singh N, Chadha DS, Kapoor R. Depression, anxiety, and quality of life after percuataneous coronary interventions. Ind Psychiatry J 2022; 31:6-18. [PMID: 35800859 PMCID: PMC9255611 DOI: 10.4103/ipj.ipj_126_21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/25/2021] [Accepted: 08/29/2021] [Indexed: 11/04/2022] Open
Abstract
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the world. However, some fascinating advances in the field of cardiology have not only added years to people's life but life to years as well. Percutaneous coronary intervention (PCI), commonly known as coronary angioplasty is a nonsurgical procedure used to treat stenotic coronary arteries. In recent years, PCI has become the preferred modality of treatment for occluded coronary arteries. However, there has been growing interest in the quality of life (QOL) issues for those who undergo such procedures. Depression, anxiety, vital exhaustion, hostility, anger, and acute mental stress have been evaluated as risk factors for the development and progression of CAD. Further, they also have strong bearing toward recovery from an acute coronary event. The current article discusses the role of depression, anxiety, and QOL of patients undergoing PCI.
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Affiliation(s)
- Rajiv Kumar Saini
- Department of Psychiatry, Command Hospital (Eastern Command), Kolkata, West Bengal, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
| | - Navreet Singh
- Department of Cardiology, CH (WC) Chandimandir, Panchkula, India
| | - D S Chadha
- Department of Cardiology, CH (IAF), Bengaluru, Karnataka, India
| | - Rajneesh Kapoor
- Department of Interventional Cardiology, Medanta Medicity, Gurgaon, Haryana, India
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26
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Jiang T, Nagy D, Rosellini AJ, Horváth-Puhó E, Keyes KM, Lash TL, Galea S, Sørensen HT, Gradus JL. Suicide prediction among men and women with depression: A population-based study. J Psychiatr Res 2021; 142:275-282. [PMID: 34403969 PMCID: PMC8456450 DOI: 10.1016/j.jpsychires.2021.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Accurate identification of persons at risk of suicide is challenging because suicide is a rare outcome with a multifactorial origin. The purpose of this study was to predict suicide among persons with depression using machine learning methods. METHODS A case-cohort study was conducted in Denmark between January 1, 1995 and December 31, 2015. Cases were all persons who died by suicide and had an incident depression diagnosis in Denmark (n = 2,774). The comparison subcohort was a 5% random sample of all individuals in Denmark at baseline, restricted to persons with an incident depression diagnosis during the study period (n = 11,963). Classification trees and random forests were used to predict suicide. RESULTS In men with depression, there was a high risk of suicide among those who were prescribed other analgesics and antipyretics (i.e., non-opioid analgesics such as acetaminophen), prescribed hypnotics and sedatives, and diagnosed with a poisoning (n = 96; risk = 81%). In women with depression, there was an elevated risk of suicide among those who were prescribed other analgesics and antipyretics, anxiolytics, and hypnotics and sedatives, but were not diagnosed with poisoning nor cerebrovascular diseases (n = 338; risk = 58%). DISCUSSION Psychiatric disorders and their associated medications were strongly indicative of suicide risk. Notably, anti-inflammatory medications (e.g., acetaminophen) prescriptions, which are used to treat chronic pain and illnesses, were associated with suicide risk in persons with depression. Machine learning may advance our ability to predict suicide deaths.
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Affiliation(s)
- Tammy Jiang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - David Nagy
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Anthony J. Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | | | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Timothy L. Lash
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA,Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Henrik T. Sørensen
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jaimie L. Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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27
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Exploring Depressive Symptoms and Anxiety Among Patients With Atrial Fibrillation and/or Flutter at the Time of Cardioversion or Ablation. J Cardiovasc Nurs 2021; 36:470-481. [PMID: 32675627 PMCID: PMC9126094 DOI: 10.1097/jcn.0000000000000723] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression and anxiety in patients with atrial fibrillation (AF) and/or atrial flutter may influence the effectiveness of cardioversion and ablation. There is a lack of knowledge related to depressive symptoms and anxiety at the time of these procedures. OBJECTIVE We aimed to describe the prevalence and explore potential covariates of depressive symptoms and anxiety in patients with AF at the time of cardioversion or ablation. We further explored the influence of depressive symptoms and anxiety on quality of life at the time of procedure and 6-month AF recurrence. METHODS Depressive symptoms, anxiety, and quality of life were collected at the time of cardioversion or ablation using the Patient Health Questionnaire-9, State-Trait Anxiety Inventory, and Atrial Fibrillation Effect on Quality of Life questionnaire. Presence of AF recurrence within 6 months post procedure was evaluated. RESULTS Participants (N = 171) had a mean (SD) age of 61.20 (11.23) years and were primarily male (80.1%) and white, non-Hispanic (81.4%). Moderate to severe depressive symptoms (17.2%) and clinically significant state (30.2%) and trait (23.6%) anxiety were reported. Mood/anxiety disorder diagnosis was associated with all 3 symptoms. Atrial fibrillation symptom severity was associated with both depressive symptoms and trait anxiety. Heart failure diagnosis and digoxin use were also associated with depressive symptoms. Trends toward significance between state and trait anxiety and participant race/ethnicity as well as depressive symptoms and body mass index were observed. Study findings support associations between symptoms and quality of life, but not 6-month AF recurrence. CONCLUSION Depressive symptoms and anxiety are common in patients with AF. Healthcare providers should monitor patients with AF for depressive symptoms and anxiety at the time of procedures and intervene when indicated. Additional investigations on assessment, prediction, treatment, and outcome of depressive symptoms and anxiety in patients with AF are warranted.
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28
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Ivanov SV, Voronova EI. [Depression therapy for somatic diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:106-112. [PMID: 34405665 DOI: 10.17116/jnevro2021121052106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A review of works devoted to the problem of psychopharmacotherapy of depression in general medical practice is presented. The issues of its comorbidity with somatic and neurological diseases, as well as multimorbidity are discussed. Both direct and side-effects of antidepressants, which are important for effective therapy of not only affective disorders proper, but also the symptoms of the leading pathology, are considered in detail for individual organs and systems. The analysis of the preferred pharmacological classes of antidepressants, which are drugs of first choice, taking into account the somatic condition of the patient, is carried out, and drugs are indicated, the appointment of which is undesirable for the treatment of a patient with a certain disease. The presented results are aimed both at increasing the efficiency of therapy for patients with general medical level of health care, and at increasing the safety of treatment of psychiatric patients with concomitant somatic disorders.
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Affiliation(s)
- S V Ivanov
- Mental Health Research Centre, Moscow, Russia.,Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E I Voronova
- Mental Health Research Centre, Moscow, Russia.,Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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29
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Liblik K, Mulvagh SL, Hindmarch CCT, Alavi N, Johri AM. Depression and anxiety following acute myocardial infarction in women. Trends Cardiovasc Med 2021; 32:341-347. [PMID: 34363978 DOI: 10.1016/j.tcm.2021.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease is the leading global cause of mortality, with ischemic heart disease causing the majority of cardiovascular deaths. Despite this, diagnostic delay commonly occurs in women experiencing acute myocardial infarction (AMI) who have a higher associated in-hospital mortality. Several studies have demonstrated that women are significantly more likely than men to experience depression and anxiety following AMI which is linked with increased morbidity, rehospitalization, and mortality, as well as decreased quality of life. Thus, it is imperative that future work aims to understand the factors that put women at higher risk for depression and anxiety following AMI, informing prevention and intervention. This narrative review will summarize the current literature on the association between AMI and mental health in women, including the impact on morbidity, mortality, and quality of life.
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Affiliation(s)
- Kiera Liblik
- School of Medicine, Queen's University, Kingston, ON, Canada
| | - Sharon L Mulvagh
- Department of Medicine, Division of Cardiology, Dalhousie University, Halifax, NS, Canada
| | - Charles C T Hindmarch
- Queen's Cardiopulmonary Unit, Translational Institute of Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Amer M Johri
- Department of Medicine, Cardiovascular Imaging Network at Queen's University, Kingston, ON, Canada.
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30
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Sylvia LG, Faulkner M, Rakhilin M, Amado S, Gold AK, Albury EA, Dinerman JG, Dohse H, Tovey R, Turner JA, Schopfer DW, Pletcher MJ, Nierenberg AA. An online intervention for increasing physical activity in individuals with mood disorders at risk for cardiovascular disease: Design considerations. J Affect Disord 2021; 291:102-109. [PMID: 34029880 DOI: 10.1016/j.jad.2021.04.094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/09/2021] [Accepted: 04/25/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Physical activity can mitigate the risk of cardiovascular diseases, but the presence of mood disorders makes it challenging to follow or develop a regular exercise habit. We conducted an online comparative effectiveness study (Healthy Hearts Healthy Minds) to evaluate whether an online psychosocial intervention adjunctive to an activity monitor (Fitbit) can improve adherence to physical activity among individuals with mood disorders who have or are at-risk for cardiovascular disease (CVD). METHODS In this paper, we explore design considerations (including both procedural challenges and achievements) of relevance to our study. RESULTS Challenges of this study included navigating a complex IRB review process, integrating two study platforms, automating study procedures, and optimizing participant engagement. Achievements of this study included building trust with collaborators, leveraging existing online communities, generating daily data reports, and conducting patient-centered research. LIMITATIONS These design considerations are based on a single online comparative effectiveness study, and other online intervention studies may be presented with other unique challenges that are specific to their study format or aims. Consistent with some of the generalizability challenges facing other online studies, participants in this study were overall highly educated (most had at least a college degree). CONCLUSIONS We successfully conducted a large-scale virtual online intervention to increase physical activity of participants with comorbid mood and cardiovascular disorders by overcoming substantial operational and technical challenges. We hope that this exploration of design considerations in the context of our online study can inform upcoming online intervention studies.
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Affiliation(s)
- Louisa G Sylvia
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | | | - Marina Rakhilin
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Selen Amado
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Alexandra K Gold
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Evan A Albury
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Jacob G Dinerman
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Heidi Dohse
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Roberta Tovey
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Jon A Turner
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | | | - Mark J Pletcher
- University of California San Francisco, San Francisco, CA, USA
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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31
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Kim H, Turiano NA, Forbes MK, Kotov R, Krueger RF, Eaton NR. Internalizing psychopathology and all-cause mortality: a comparison of transdiagnostic vs. diagnosis-based risk prediction. World Psychiatry 2021; 20:276-282. [PMID: 34002512 PMCID: PMC8129836 DOI: 10.1002/wps.20859] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Previous studies have documented the utility of a transdiagnostic internalizing factor in predicting important future outcomes (e.g., subsequent mental disorder diagnoses). To date, however, no study has investigated whether an internalizing factor predicts mortality risk. Also, while pre-vious studies of mortality risk have emphasized its associations with particular internalizing disorders, no study has assessed how the transdiagnostic internalizing factor vs. disorder-specific variance differently predict that risk. The primary aims of this study were to explore: a) whether the internalizing factor predicts mortality risk, b) whether particular internalizing psychopathologies uniquely predict mortality risk over and beyond the transdiagnostic internalizing factor, and c) whether there is a significant interaction of internalizing with self-reported health in the prediction of mortality risk. We utilized a large national sample of American adults from the Midlife in the United States (MIDUS), a longitudinal study that examined midlife development of individuals across multiple waves between 1995 and 2015. Data were analyzed for the 6,329 participants who completed the phone interview and self-administered questionnaire in MIDUS 1 (1995-1996) and were then followed up until October 31, 2015 or until death. To investigate the association between internalizing and mortality risk, we used the semi-parametric proportional hazards Cox model, where survival time was regressed on a latent internalizing factor. Overall findings indicate that a transdiagnostic internalizing factor significantly predicts mortality risk over a 20-year period (hazard ratio, HR=1.12, 95% CI: 1.05-1.16, p<0.01) and that internalizing outperforms disorder-specific variance (e.g., depression-specific variance) in the prediction of that risk. Further, there was a significant interaction between transdiagnostic internalizing and self-reported health, whereby internalizing psychopathology had a specific association with early death for individuals with excellent self-reported health condition (HR=1.50, 95% CI: 1.17-1.84, p<0.05). This highlights the clinical utility of using the transdiagnostic internalizing factor for prediction of an important future outcome, and supports the argument that internalizing psychopathology can be a meaningful liability to explore in public health practice.
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Affiliation(s)
- Hyunsik Kim
- Department of PsychologySogang UniversitySeoulSouth Korea
| | | | | | - Roman Kotov
- Department of PsychiatryStony Brook UniversityStony Brook, New YorkNYUSA
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Abstract
PURPOSE OF REVIEW The purpose of this review is to outline the relationship between cardiovascular disease (CVD) and depression, both as a cause of and a result of CVD. RECENT FINDINGS The prevalence of depression seems to be increasing in the general population.It is likely that depression will be even more of a problem for CVD patients in the post-COVID-19 pandemic era.New studies confirm the independent association of depression with later incident CVD, although perhaps not as strong as suggested by some previous studies.Depression seems to be becoming even more prevalent in CVD patients, with new data for stroke and peripheral arterial disease patients.Cardiologists rarely screen for depression and most do not believe that they have a responsibility for detecting or treating depression.There are new data suggesting that patients who are more in control of their lives have better outcomes and that change is possible. SUMMARY Depression is preventable and treatable. It is imperative to detect and manage depression in CVD patients. Additional research is required to see whether or not comprehensive patient screening for depression translates into both better quality of life and improved clinical outcomes.
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Affiliation(s)
- David L Hare
- Department of Cardiology, Austin Health, Heidelberg
- Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Sama J, Vaidya D, Mukherjee M, Williams M. Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome. J Thromb Thrombolysis 2021; 51:693-700. [PMID: 32876809 PMCID: PMC11140724 DOI: 10.1007/s11239-020-02268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Depression is associated with heart failure independent of traditional cardiovascular disease risk factors. Enhanced platelet activation has been suggested as a potential mechanism and has been associated with negative inotropic effects that can affect left ventricular ejection fraction (LVEF). We examined 131 consecutive acute coronary syndrome (ACS) patients to assess whether depression increased the risk for developing LV dysfunction, and to determine the effects of platelet serotonin signaling in this relationship. Major depression was assessed using the Structured Clinical Interview and depressive symptoms were measured using the Beck Depression Inventory (BDI), with BDI ≥ 10 defined as abnormal. LV dysfunction was defined as LVEF ≤ 45%. Platelet serotonin response was measured by serotonin augmented platelet aggregation and platelet serotonin receptor density. Mean age of ACS participants was 59 years, 78.6% male and 74.0% Caucasian. 34.4% of patients had a reduced LVEF ≤ 45% on presentation. Almost half (47.0%) of patients had BDI ≥ 10 and 18.0% had major depressive disorder. Platelet serotonin response was found to be augmented in depressed patients with low LVEF compared to depressed patients with normal LVEF (p < 0.020). However, the presence of LV dysfunction was found to be similar in both depressed (32.3%) and non-depressed (36.2%) patients (p = 0.714). This suggests alternative factors contribute to poor cardiovascular outcomes in depressed patients that are independent of LV function in post ACS patients.
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Affiliation(s)
- Jacob Sama
- Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA.
| | - Dhananjay Vaidya
- Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA
| | - Monica Mukherjee
- Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA
| | - Marlene Williams
- Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA
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Abstract
ABSTRACT Postoperative depression is a multifaceted condition that can limit quality of life and potentially decrease the survival benefits of open heart surgery (OHS). We postulated that sex, pre-event character strengths, medical, and certain surgery indicators would predict post-event/myocardial infarction depression. To identify predictors, we collected three-wave survey data from 481 OHS patients at a large academic referral institution (age, 62+; female, 42%) and included key medical and surgical information. The final model (F[7, N = 293] = 28.15, p < 0.001, R2 = 0.408) accounted for over two fifths of the variance in post-OHS depression. Pre-event/OHS optimism mitigated post-OHS depression. Being female, older, living alone, longer surgical perfusion time, absence of left main disease greater than 50%, and pre-OHS depression were associated with the increased likelihood of post-OHS depression. Our findings suggest that teaching optimism to OHS patients might be beneficial in reducing the risk of postoperative depression and that female patients should be monitored more closely for the development of depression through an interdisciplinary approach.
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Affiliation(s)
- Amy L. Ai
- Institute of Longevity; Departments of Behavioral Science and Social Medicine; Colleges of Social Work and Nursing, 2570 University Center Building C, Florida State University, Tallahassee, FL, 32306
| | - Susan S. Smyth
- Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, 320 CTW Building, University of Kentucky, Lexington, KY, 40536
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Effectiveness of e-Health cardiac rehabilitation program on quality of life associated with symptoms of anxiety and depression in moderate-risk patients. Sci Rep 2021; 11:3760. [PMID: 33580174 PMCID: PMC7881008 DOI: 10.1038/s41598-021-83231-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 01/25/2021] [Indexed: 01/30/2023] Open
Abstract
Exploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.
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Guo Y, Zhang C, Chen X, Liu X, Ye T, Fo Y, Shi S, Qu C, Liang J, Shen B, Yang B. Sigma-1 receptor ligands improves ventricular repolarization-related ion remodeling in rats with major depression disorder. Psychopharmacology (Berl) 2021; 238:487-499. [PMID: 33140216 DOI: 10.1007/s00213-020-05697-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/23/2020] [Indexed: 02/07/2023]
Abstract
RATIONALE It has been reported that patients with major depressive disorder (MDD) are prone to developing ventricular arrhythmias. Moreover, the Sigma-1 receptor not only plays a crucial role in MDD but has also been shown to have antiarrhythmic properties. The Sigma-1 receptor is a common receptor related to depression and ventricular arrhythmias. OBJECTIVE We analyzed the effects of the Sigma-1 receptor on depression and ventricular repolarization-related ion remodeling in MDD rats. METHODS MDD was induced in rats by chronic unpredictable mild stress (CUMS), and 28 days later, the rats were subjected to behavior tests. Protein expression was measured by western blotting, and cardiac morphological changes were observed by Masson staining. Electrophysiological measurement of the myocardium was performed with the whole-cell patch-clamp technique. RESULTS Compared with the control rats, the MDD rats exhibited lower transient outward potassium current (Ito) and L-type calcium current (ICa-L) amplitudes. On the other hand, a trend of depolarization of Ito and hyperpolarization of ICa-L was observed in the MDD rats. Thus, we investigated the effect of fluvoxamine, a Sigma-1 receptor agonist, on Ito and ICa-L. Fluvoxamine enhanced Ito and altered its current kinetics, as shown by acceleration of activation and recovery from inactivation. In contrast, fluvoxamine inhibited the Ca2+ by hyperpolarizing the steady-state activation of ICa-L. All these effects were blocked by BD1047. CONCLUSION Taken together, our results indicate that Sigma-1 receptor modulates the functions of Ito and ICa-L to possibly exert antiarrhythmic effects.
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Affiliation(s)
- Yan Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Cui Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Xiuhuan Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Xin Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Tianxin Ye
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Yuhong Fo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Shaobo Shi
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Chuan Qu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Jinjun Liang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Bo Shen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China.
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.
| | - Bo Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China.
- Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.
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Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease: A Real-Life Investigation From Italy. J Clin Psychopharmacol 2020; 40:112-121. [PMID: 32134848 DOI: 10.1097/jcp.0000000000001189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to assess the possible relation between use of antidepressant (AD) drugs, that is, tricyclic ADs, selective serotonin reuptake inhibitors (SSRIs), and atypical ADs (AAs), and the risk of hospitalization for cardiovascular (CV) events among older patients with previous CV diseases. METHODS A nested case-control study was carried out among patients aged 65 years and older from 5 Italian health care territorial units who were discharged for CV disease during 2008 to 2010. The cohort was composed by 344,747 individuals, and of these, 97,739 (28%) experienced hospital admission for CV events (myocardial infarction, arrhythmia, stroke, heart failure) during follow-up (until 2014) and were included as cases. Up to 5 controls were randomly selected and matched to each. A conditional logistic regression was fitted to estimate the risk of CV events associated with ADs past or current use. A within-patient comparison was performed by the case-crossover design to account the effect of depression. FINDINGS Current users of SSRIs and AAs were at increased risk of CV events with odds ratios of 1.25 (95% confidence interval, 1.21-1.29) and 1.31 (1.25-1.37), respectively. An increased risk of arrhythmia and stroke was associated with current use of SSRIs and AAs, whereas an increased risk of heart failure was detected with current use of any ADs. The results were confirmed by the case-crossover approach. IMPLICATIONS Evidence that AD use is associated with an increased risk of CV events in accordance with specific mechanisms of action among older people with CV disease was added by this study.
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Beyond Haemostasis and Thrombosis: Platelets in Depression and Its Co-Morbidities. Int J Mol Sci 2020; 21:ijms21228817. [PMID: 33233416 PMCID: PMC7700239 DOI: 10.3390/ijms21228817] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Alongside their function in primary haemostasis and thrombo-inflammation, platelets are increasingly considered a bridge between mental, immunological and coagulation-related disorders. This review focuses on the link between platelets and the pathophysiology of major depressive disorder (MDD) and its most frequent comorbidities. Platelet- and neuron-shared proteins involved in MDD are functionally described. Platelet-related studies performed in the context of MDD, cardiovascular disease, and major neurodegenerative, neuropsychiatric and neurodevelopmental disorders are transversally presented from an epidemiological, genetic and functional point of view. To provide a complete scenario, we report the analysis of original data on the epidemiological link between platelets and depression symptoms suggesting moderating and interactive effects of sex on this association. Epidemiological and genetic studies discussed suggest that blood platelets might also be relevant biomarkers of MDD prediction and occurrence in the context of MDD comorbidities. Finally, this review has the ambition to formulate some directives and perspectives for future research on this topic.
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Lookens J, Tymejczyk O, Rouzier V, Smith C, Preval F, Joseph I, Baptiste RJ, Victor J, Severe P, Apollon S, Dumont E, Forestal G, St Preux S, Rivera V, Seo G, Charles B, Ariste W, Kingery J, Devieux J, Koenig S, Nash D, Fitzgerald D, Safford M, Deschamps MM, Pape J, McNairy M. The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort. BMC Public Health 2020; 20:1633. [PMID: 33131500 PMCID: PMC7603639 DOI: 10.1186/s12889-020-09734-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions. Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants. Aim 2: Determine the incidence of CVD risk factors and CVD during 2-3.5 years of follow-up and their association with social and environmental determinants. METHODS The Haiti CVD Cohort is a longitudinal observational study of 3000 adults > 18 years in Port-au-Prince (PAP), Haiti. The study population is recruited using multistage random sampling from census blocks. Adults receive blood pressure (BP) measurements in the community and those with elevated BP are referred to the Groupe Haitien d'Etude Sarcome de Kaposi et des Infections Opportunistes Clinic for care. After informed consent, participants undergo a clinical exam with medical history. BP, electrocardiogram, echocardiogram, a study questionnaire on health behaviors, and laboratory specimens. Every 6 months, BP is remeasured. At 12 and 24 months, clinical exams and questionnaires are repeated. Labs are repeated at 24 months. Adjudicated study outcomes include the prevalence and incidence of CVD risk factors (hypertension, diabetes, obesity, dyslipidemia, kidney disease, inflammation, poor diet, smoking, and physical inactivity) and events (myocardial infarction, heart failure, stroke, and CVD mortality). We also measure social determinants including poverty. Depression, stress, social isolation, food insecurity, and lead exposure. Blood, urine, and stool samples are biobanked at study enrollment. DISCUSSION The Haiti CVD Cohort is the largest population-based cohort study evaluating CVD risk factors and CVD among adults in urban Haiti with the goal of understanding the drivers of the CVD epidemic in Haiti. Study outcomes are comparable with existing international cohorts, and the biobank will provide important data for future research. Our goal is to translate findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti.
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Affiliation(s)
- Jean Lookens
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Olga Tymejczyk
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | - Vanessa Rouzier
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Caleigh Smith
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Fabyola Preval
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Inddy Joseph
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Raynold Jean Baptiste
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Joscar Victor
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Patrice Severe
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Sandra Apollon
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Emelyne Dumont
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Guyrlaine Forestal
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Stephano St Preux
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Vanessa Rivera
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Grace Seo
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | - Benedict Charles
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Wilson Ariste
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Justin Kingery
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jessy Devieux
- Department of Health Promotion and Disease Prevention, Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Serena Koenig
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - Denis Nash
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | | | - Monika Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Marie Marcelle Deschamps
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Jean Pape
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | - Margaret McNairy
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA.
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Deischinger C, Dervic E, Leutner M, Kosi-Trebotic L, Klimek P, Kautzky A, Kautzky-Willer A. Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men. BMJ Open Diabetes Res Care 2020; 8:8/1/e001430. [PMID: 32973072 PMCID: PMC7517557 DOI: 10.1136/bmjdrc-2020-001430] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Both diabetes mellitus and being female significantly increase the risk of being diagnosed with major depressive disorder (MDD). The diagnosis of MDD, combined with diabetes mellitus, can be detrimental in terms of mortality and morbidity. We aimed at investigating the impact of diabetes mellitus on the gender gap in MDD over the course of a human lifetime. RESEARCH DESIGN AND METHODS In a cross-sectional study over the course of 17 years, medical claims data of the general Austrian population (n=8 996 916) between 1997 and 2014 was analyzed. Of these, 123 232 patients with diabetes mellitus were extracted and compared with non-diabetic controls. RESULTS In a cohort of 123 232 patients with diabetes mellitus and 1 933 218 controls (52% females, 48% males), women with diabetes had 2.55 times increased ORs to be diagnosed with MDD compared with women without diabetes (95% CI 2.48 to 2.62, p<0.001) between the age of 30 and 69 years. The effect of diabetes mellitus on the prevalence of MDD was significantly smaller in men (OR=1.85, 95% CI 1.80 to 1.91, p<0.001). Between 0 and 30 years and after age 70 years, the gender gap of MDD was not different between patients with and without diabetes mellitus. The peak of the gender gap in MDD in patients with diabetes mellitus was around the age of 40-49 years. A sensitivity analysis identified overweight, obesity and alcohol dependence as the most potent influencing factors of the widening of the gender gap among patients with diabetes mellitus. CONCLUSIONS Diabetes mellitus is a stronger risk factor for MDD in women than in men, with the greatest width of the gender gap between 40 and 49 years. High-risk patients for MDD, such as overweight female patients with diabetes, should be more carefully assessed and monitored.
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Affiliation(s)
- Carola Deischinger
- Department of Medicine III, Endocrinology and Metabolism, Medical University of Vienna, Wien, Austria
| | - Elma Dervic
- Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | - Michael Leutner
- Department of Medicine III, Endocrinology and Metabolism, Medical University of Vienna, Wien, Austria
| | - Lana Kosi-Trebotic
- Department of Medicine III, Endocrinology and Metabolism, Medical University of Vienna, Wien, Austria
| | - Peter Klimek
- Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Medicine III, Endocrinology and Metabolism, Medical University of Vienna, Wien, Austria
- Gender Institute, Gars am Kamp, Austria
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Nicholson B, Morse S, Lundgren T, Vadiei N, Bhattacharjee S. Effect of depression on health behavior among myocardial infarction survivors in the United States. Ment Health Clin 2020; 10:222-231. [PMID: 32685333 PMCID: PMC7337999 DOI: 10.9740/mhc.2020.07.222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Introduction The purpose of this study was to evaluate the effect of depression on health behavior among myocardial infarction (MI) survivors. Methods This retrospective, cross-sectional study used publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS) data. Our study sample includes adults aged 50 years or older who completed the 2015 BRFSS survey and reported having MI. The BRFSS participants with a yes response to the question, Has a doctor, nurse, or other health care professional ever told you that you had a heart attack, also called a myocardial infarction? were identified as MI survivors. The presence or absence of depression among MI survivors was identified using a similar question. Health behaviors, the dependent variable of this study, included physical activity, smoking status, alcohol use, body mass index, last flu immunization, last physical checkup, last blood cholesterol check, heavy drinking, and vegetable and fruit consumption. Univariate (χ2 tests) and multivariable (binomial logistic regression) analyses were used to assess the differences in health behaviors between MI survivors with or without depression. Results Our final study sample consists of 20 483 older adults with MI among whom 5343 (26.19%) reported having depression. Multivariable analyses reveal MI survivors with depression are more overweight, have less physical activity, and have higher likelihood of smoking but less odds of consuming alcohol compared to MI survivors without depression. Discussion In this nationally representative sample of adults aged over 50 years in the United States, MI survivors with depression exhibited poorer health behaviors compared to those without depression.
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Affiliation(s)
- Brooke Nicholson
- Pharmacist, Banner University Medical Center South, Tucson, Arizona
| | | | | | - Nina Vadiei
- Assistant Professor, Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona
| | - Sandipan Bhattacharjee
- Pharmacist, Banner University Medical Center South, Tucson, Arizona.,Pharmacist, Walmart, Sierra Vista, Arizona.,Pharmacist, Genoa Healthcare, Tucson, Arizona.,Assistant Professor, Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona
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42
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Khandaker GM, Zuber V, Rees JMB, Carvalho L, Mason AM, Foley CN, Gkatzionis A, Jones PB, Burgess S. Shared mechanisms between coronary heart disease and depression: findings from a large UK general population-based cohort. Mol Psychiatry 2020; 25:1477-1486. [PMID: 30886334 PMCID: PMC7303009 DOI: 10.1038/s41380-019-0395-3] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/29/2019] [Accepted: 02/14/2019] [Indexed: 12/15/2022]
Abstract
While comorbidity between coronary heart disease (CHD) and depression is evident, it is unclear whether the two diseases have shared underlying mechanisms. We performed a range of analyses in 367,703 unrelated middle-aged participants of European ancestry from UK Biobank, a population-based cohort study, to assess whether comorbidity is primarily due to genetic or environmental factors, and to test whether cardiovascular risk factors and CHD are likely to be causally related to depression using Mendelian randomization. We showed family history of heart disease was associated with a 20% increase in depression risk (95% confidence interval [CI] 16-24%, p < 0.0001), but a genetic risk score that is strongly associated with CHD risk was not associated with depression. An increase of 1 standard deviation in the CHD genetic risk score was associated with 71% higher CHD risk, but 1% higher depression risk (95% CI 0-3%; p = 0.11). Mendelian randomization analyses suggested that triglycerides, interleukin-6 (IL-6), and C-reactive protein (CRP) are likely causal risk factors for depression. The odds ratio for depression per standard deviation increase in genetically-predicted triglycerides was 1.18 (95% CI 1.09-1.27; p = 2 × 10-5); per unit increase in genetically-predicted log-transformed IL-6 was 0.74 (95% CI 0.62-0.89; p = 0.0012); and per unit increase in genetically-predicted log-transformed CRP was 1.18 (95% CI 1.07-1.29; p = 0.0009). Our analyses suggest that comorbidity between depression and CHD arises largely from shared environmental factors. IL-6, CRP and triglycerides are likely to be causally linked with depression, so could be targets for treatment and prevention of depression.
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Affiliation(s)
- Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Verena Zuber
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Jessica M B Rees
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Livia Carvalho
- Department of Clinical Pharmacology, Queen Mary University of London, London, UK
| | - Amy M Mason
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
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Yamaguchi D, Izawa A, Matsunaga Y. The Association of Depression with Type D Personality and Coping Strategies in Patients with Coronary Artery Disease. Intern Med 2020; 59:1589-1595. [PMID: 32612062 PMCID: PMC7402968 DOI: 10.2169/internalmedicine.3803-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/09/2020] [Indexed: 01/13/2023] Open
Abstract
Objective Depression in patients with coronary artery disease (CAD) has been a risk factor for adverse cardiovascular events. However, personality types, strategies for coping with stressors, and their associations with depression have not been fully elucidated in patients with CAD. This study explored depression in patients with CAD and examined its association with personality types and coping strategies. Methods A prospective observational study of 89 patients with CAD was conducted between August 2016 and July 2018. The presence of depression and type D personality and types of coping strategies were measured one month after percutaneous coronary intervention. A logistic regression analysis was performed to identify characteristics associated with depression. Results Generally, the incidence of depression and type D personality was 55.1% and 44.9%, respectively. The incidence of depression in patients with type D and non-type D personality was 72.5% and 40.8%, respectively. Patients with type D personality coped less frequently using a planning strategy but frequently using a responsibility-shifting strategy. A logistic regression analysis showed that the presence of depression was significantly associated with type D personality and inversely associated with a planning strategy. Conclusion The high prevalence of depression in patients with CAD was associated with type D personality and a low rate of adoption of a planning strategy. Specific coping interventions in patients with CAD with type D personality may be potential targets for improving coping skills and preventing the development of depression.
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Affiliation(s)
| | - Atsushi Izawa
- School of Health Sciences, Shinshu University, Japan
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Sun ZQ, Yu TT, Ma Y, Ma QM, Jiao YD, He DX, Jia-KeWu, Wen ZY, Wang XN, Hou Y, Sun ZJ. Depression and myocardial injury in ST-segment elevation myocardial infarction: A cardiac magnetic resonance imaging study. World J Clin Cases 2020; 8:1232-1240. [PMID: 32337197 PMCID: PMC7176617 DOI: 10.12998/wjcc.v8.i7.1232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes. However, the association between depression and myocardial injury on cardiac magnetic resonance (CMR) in patients with ST-segment elevation myocardial infarction (STEMI) has still not been assessed.
AIM To assess the association between depression and myocardial injury on CMR in patients with STEMI.
METHODS A total of 107 STEMI patients undergoing primary percutaneous coronary intervention (P-PCI) were analyzed in this prospectivecohort study. Each subject completed the Patient Health Questionnaire-9 (PHQ-9) to assess the presence and severity of depressive symptoms. CMR was performed at a median of 3 d after P-PCI for quantifying post-MI myocardial injury. Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.
RESULTS In this study, 19 patients (17.8%) were diagnosed with major depression identified by the PHQ-9 ≥ 10. PHQ-9 was analyzed both as a continuous variable and dichotomous variable. After multivariable adjustment, the proportion of patients with large infarction size was significantly higher in the major depression group (PHQ-9 ≥ 10) (OR: 4.840, 95%CI: 1.122–20.868, P =0.034). When the PHQ-9 was evaluated as a continuous variable, after multivariable adjustment, an increased PHQ-9 score was associated with an increased risk of large infarction size (OR: 1.226, 95%CI: 1.073–1.401, P =0.003).
CONCLUSION In patients with STEMI undergoing PCI, depression was independently associated with a large infarction size.
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Affiliation(s)
- Zhao-Qing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Tong-Tong Yu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Yue Ma
- Department of Radiology, Shenyang 110004, Liaoning Province, China
| | - Quan-Mei Ma
- Department of Radiology, Shenyang 110004, Liaoning Province, China
| | - Yun-Di Jiao
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Dong-Xu He
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Jia-KeWu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zong-Yu Wen
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xiao-Nan Wang
- Department of Radiology, Shenyang 110004, Liaoning Province, China
| | - Yang Hou
- Department of Radiology, Shenyang 110004, Liaoning Province, China
| | - Zhi-Jun Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Association of Depression with Subclinical Coronary Atherosclerosis: a Systematic Review. J Cardiovasc Transl Res 2020; 14:685-705. [PMID: 32198701 DOI: 10.1007/s12265-020-09985-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/02/2020] [Indexed: 01/26/2023]
Abstract
To assess causal association of depression with subclinical coronary atherosclerosis, we performed computer-based and manual search of literature for studies which had assessed relationship of depression disorder with coronary atherosclerosis. All studies had diagnosed depression with validated tools in patients without diagnosed coronary artery disease. The Bradford Hill criteria of cause-effect association was consistently fulfilled by those studies which achieved statistical significance and further showed incremental strength of association with one or more of the following attributes: (1) prospective cohort study, met cause-effect criteria of "temporality"; (2) relatively severe and/or longer period of depression, met cause-effect criteria of "dose-response"; (3) depression with predominantly somatic symptoms cluster, met cause-effect criteria of "scientific plausibility"; (4) multiethnic larger sample, met cause-effect criteria of "population equivalence"; and (5) multicenter study, met criteria of "environmental equivalence." Our results show that there is a significant association of depression with coronary atherosclerosis at its subclinical stages.
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Bangalore S, Shah R, Gao X, Pappadopulos E, Deshpande CG, Shelbaya A, Prieto R, Stephens J, Chambers R, Schepman P, McIntyre RS. Economic burden associated with inadequate antidepressant medication management among patients with depression and known cardiovascular diseases: insights from a United States-based retrospective claims database analysis. J Med Econ 2020; 23:262-270. [PMID: 31665949 DOI: 10.1080/13696998.2019.1686311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Aims: The current study examined the association between insufficient major depressive disorder (MDD) care and healthcare resource use (HCRU) and costs among patients with prior myocardial infarction (MI) or stroke.Methods: This was a retrospective study conducted using the MarketScan Claims Database (2010-2015). The date of the first MI/stroke diagnosis was defined as the cardiovascular disease (CVD) index date and the first date of a subsequent MDD diagnosis was the index MDD date. Adequacy of MDD care was assessed during the 90 days following the index MDD date (profiling period) using 2 measures: dosage adequacy (average fluoxetine equivalent dose of ≥20 mg/day for nonelderly and ≥10 mg/day for elderly patients) and duration adequacy (measured as the proportion of days covered of 80% or higher for all MDD drugs). Study outcomes included all-cause and CVD-related HCRU and costs which were determined from the end of the profiling period until the end of study follow-up. Propensity-score adjusted generalized linear models (GLMs) were used to compare patients receiving adequate versus inadequate MDD care in terms of study outcomes.Results: Of 1,568 CVD patients who were treated for MDD, 937 (59.8%) were categorized as receiving inadequate MDD care. Results from the GLMs suggested that patients receiving inadequate MDD care had 14% more all-cause hospitalizations, 4% more all-cause outpatient visits, 17% more CVD-related outpatient visits, 13% more CVD-related emergency room (ER) visits, higher per patient per year CVD-related hospitalization costs ($21,485 vs. $17,756), higher all-cause outpatient costs ($2,820 vs. $2,055), and higher CVD-related outpatient costs ($520 vs. $434) compared to patients receiving adequate MDD care.Limitations: Clinical information such as depression severity and frailty, which are potential predictors of adverse CVD outcomes, could not be ascertained using administrative claims data.Conclusions: Among post-MI and post-stroke patients, inadequate MDD care was associated with a significantly higher economic burden.
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Affiliation(s)
- Sripal Bangalore
- Cardiovascular Outcomes Group, Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA
| | | | - Xin Gao
- Pharmerit International, LP, Bethesda, MD, USA
| | | | | | - Ahmed Shelbaya
- Pfizer Inc., New York, NY, USA
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | | | | | - Roger S McIntyre
- Mood Disorders PsychoPharmacology Unit University Health Network, University of Toronto, Toronto, Canada
- Brain and Cognition Discovery Foundation, Toronto, Canada
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Choi KW, Jeon HJ. Heart Rate Variability for the Prediction of Treatment Response in Major Depressive Disorder. Front Psychiatry 2020; 11:607. [PMID: 32695031 PMCID: PMC7339656 DOI: 10.3389/fpsyt.2020.00607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/11/2020] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) is one of the disabling diseases in the world-wide, and known to increase cardiac morbidity and mortality. Therefore, previous studies related heart rate variability (HRV) have been conducted to evaluate and diagnose MDD, and to predict treatment outcomes in patient with MDD. We reviewed extensively on the previous peer-reviewed publications associated with this issue, using Pub-Med. In this review article, we introduce the basic concept of HRV and HRV measures, and present several important findings associated with diagnosis and treatment prediction in MDD with using HRV parameters. Furthermore, we discuss the possible underlying mechanism of this phenomenon, and suggest several considerations for the future research.
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Affiliation(s)
- Kwan Woo Choi
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Worcester MU, Goble AJ, Elliott PC, Froelicher ES, Murphy BM, Beauchamp AJ, Jelinek MV, Hare DL. Mild Depression Predicts Long-Term Mortality After Acute Myocardial Infarction: A 25-Year Follow-Up. Heart Lung Circ 2019; 28:1812-1818. [DOI: 10.1016/j.hlc.2018.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/25/2018] [Accepted: 11/26/2018] [Indexed: 12/11/2022]
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Depression, Anxiety, Perceived Stress, and Their Changes Predict Greater Decline in Physical Health Functioning over 12 Months Among Patients with Coronary Heart Disease. Int J Behav Med 2019; 26:352-364. [PMID: 31218559 DOI: 10.1007/s12529-019-09794-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although the deleterious impact of psychological distress on patients with coronary heart disease (CHD) is recognized, few studies have examined the influence of change in psychological distress on health outcomes over time. This study investigated whether three common manifestations of distress (depression, anxiety, and perceived stress) and their changes predicted the decline in physical functioning in CHD patients over 12 months. In addition, perceived social support was examined as a buffer of psychological distress or a direct predictor of physical functioning. METHODS Participants were 255 CHD patients with a mean age of 63 (SD = 8.65) years, including 208 men and 47 women. Psychological distress and physical functioning were assessed at baseline, 6 months and 12 months. Hierarchical regression analyses were conducted to examine the influences of psychological factors on physical functioning over 12 months. All models were adjusted for baseline physical functioning, age, gender, marital status, education, BMI, and length of participation at a wellness center. RESULTS For each psychological distress variable (depression, anxiety, or perceived stress), both the baseline (βs = - 0.19 to - 0.32, ps = 0.008 to < 0.001) and its respective change over time (βs = - 0.17 to - 0.38, ps = 0.020 to < 0.001) independently and significantly predicted greater decline in physical functioning at 6 and 12 months, after adjusting for covariates. Perceived social support predicted greater improvement in physical functioning at 12 months (β = 0.13, p = 0.050), but it did not buffer impact of psychological distress. CONCLUSIONS Findings underscore the importance of monitoring various forms of psychological distress continuously over time for CHD patients.
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Whitehead AM, Maher NH, Goldstein K, Bean-Mayberry B, Duvernoy C, Davis M, Safdar B, Saechao F, Lee J, Frayne SM, Haskell SG. Sex Differences in Veterans' Cardiovascular Health. J Womens Health (Larchmt) 2019; 28:1418-1427. [DOI: 10.1089/jwh.2018.7228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Alison M. Whitehead
- Department of Veterans Affairs, Central Office, Washington, District of Columbia
| | - Nancy H. Maher
- Department of Veterans Affairs, Central Office, Washington, District of Columbia
| | - Karen Goldstein
- Durham VA and Duke University School of Medicine, Durham, North Carolina
| | - Bevanne Bean-Mayberry
- VA Greater Los Angeles and Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Claire Duvernoy
- VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, Michigan
| | - Melinda Davis
- Department of Medicine, Cardiology Clinic, University of Michigan, Ann Arbor, Michigan
| | - Basmah Safdar
- Department of Emergency Medicine, Yale University, New Haven, Connecticut
| | - Fay Saechao
- VA Health Services Research and Development (HSR&D) Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California
| | - Jimmy Lee
- VA HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California
| | - Susan M. Frayne
- VA HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California
- Division of Primary Care and Population Health, Stanford University, Stanford, California
| | - Sally G. Haskell
- Department of Veterans Affairs, Central Office, Washington, District of Columbia
- VA Connecticut Healthcare System and Yale University, West Haven, Connecticut
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