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Predictive value of homocysteine for depression after acute coronary syndrome

Hee Ju Kang1, Robert Stewart2, Kyung Yeol Bae1

  • 1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.

Oncotarget
|September 15, 2016
PubMed

Insights

High homocysteine levels are linked to depression in acute coronary syndrome (ACS) patients, especially those with the MTHFR TT genotype. This suggests targeted interventions may reduce depression risk post-ACS.

Area of Science:

  • Cardiovascular Medicine
  • Psychiatry
  • Genetics

Background:

  • Depression is a common complication following acute coronary syndrome (ACS).
  • Plasma homocysteine and methylenetetrahydrofolate reductase (MTHFR) gene variants are potential risk factors for depression.
  • Understanding these factors' roles is crucial for managing depression in ACS patients.

Purpose of the Study:

  • To investigate the association between plasma homocysteine, MTHFR genotype, and the risk and persistence of depressive disorder in patients with recent ACS.
  • To examine the influence of these factors on antidepressant treatment response.

Main Methods:

  • A cohort of 969 patients with recent ACS was recruited, with 711 followed up after 1 year.
  • A subset of 378 patients with baseline depressive disorder participated in a 24-week randomized controlled trial of escitalopram versus placebo.
  • Plasma homocysteine levels and MTHFR gene polymorphisms (including TT genotype) were assessed.

Main Results:

  • Higher plasma homocysteine was independently associated with prevalent depressive disorder at baseline, regardless of MTHFR genotype.
  • Elevated homocysteine was linked to incident and persistent depressive disorder at follow-up, but only in patients with the MTHFR TT genotype.
  • MTHFR genotype alone was not associated with depressive disorder after ACS.
  • No significant associations were found between homocysteine, MTHFR genotype, and antidepressant treatment response over 24 weeks.

Conclusions:

  • Plasma homocysteine may serve as a valuable biomarker for depressive disorder, particularly during the acute phase of ACS.
  • Interventions targeting individuals with high homocysteine levels and the MTHFR TT genotype could potentially mitigate the risk of developing depression post-ACS.
  • Further research is warranted to explore the therapeutic implications of these findings.

Keywords:
MTHFR C677T polymorphismacute coronary syndromebiomarkersdepressionhomocysteine

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