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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

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Depressive symptom clusters and 5-year incidence of coronary artery calcification: the coronary artery risk

Jesse C Stewart¹, Desiree J Zielke, Misty A W Hawkins

¹Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N Blackford St, LD 100E, Indianapolis, IN 46202, USA. jstew@iupui.edu

|June 20, 2012

Summary

Depressed affect, a facet of depression, predicts coronary artery calcification (CAC) over five years. This finding highlights depressed affect as a key cardiovascular risk factor, challenging previous research on somatic symptoms.

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Area of Science:

Cardiology
Psychiatry
Public Health

Background:

Depression is a multidimensional construct with varying impacts on cardiovascular health.
Few studies have compared the predictive importance of different depressive symptom clusters for cardiovascular risk.

Purpose of the Study:

To evaluate the utility of depressive symptom clusters in predicting the 5-year incidence of coronary artery calcification (CAC).

Main Methods:

Utilized data from 2171 middle-aged adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Measured depressive symptom clusters via questionnaires and CAC using electron beam computed tomography over a 5-year period.
Defined incident CAC as the absence of CAC at baseline and its presence at follow-up.

Main Results:

Identified 243 cases (11%) of incident CAC.
Total depressive symptoms (OR, 1.16; P=0.03) and the depressed affect cluster (OR, 1.17; P=0.02) significantly predicted incident CAC.
Somatic, interpersonal distress, low positive affect, and pessimism clusters did not predict incident CAC.

Conclusions:

The depressed affect cluster, not the somatic cluster, was the primary driver of the association between depressive symptoms and incident CAC.
This suggests that the most cardiotoxic facet of depression may vary across different contexts.
The depressed affect-CAC relationship was independent of several demographic factors and antidepressant use, but partially mediated by tobacco use and mean arterial pressure.