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Association of Depression with Subclinical Coronary Atherosclerosis: a Systematic Review

Sher Ali Khan1, Usman Shahzad2, Muhammad Samsoor Zarak3

  • 1College of Public Health, The University of Arizona, Tucson, AZ, USA. Sheralikhan61@email.arizona.edu.

Journal of Cardiovascular Translational Research
|March 22, 2020
PubMed

Insights

Depression is significantly linked to early-stage coronary atherosclerosis. This association strengthens when depression is severe, prolonged, or presents with somatic symptoms, fulfilling key criteria for causality.

Area of Science:

  • Cardiology
  • Psychiatry
  • Epidemiology

Background:

  • Depression is a prevalent mental health condition.
  • Subclinical coronary atherosclerosis is a precursor to cardiovascular disease.
  • The relationship between depression and cardiovascular health requires further elucidation.

Purpose of the Study:

  • To evaluate the causal association between depression and subclinical coronary atherosclerosis.
  • To synthesize evidence using the Bradford Hill criteria for causality.

Main Methods:

  • Conducted a comprehensive literature search for studies assessing depression and coronary atherosclerosis.
  • Included studies diagnosing depression with validated tools in patients without diagnosed coronary artery disease.
  • Applied Bradford Hill criteria to assess the strength and causality of the association.

Main Results:

  • A significant association was found between depression and subclinical coronary atherosclerosis.
  • Studies fulfilling criteria like temporality (prospective design), dose-response (severity/duration), and scientific plausibility (somatic symptoms) showed stronger evidence.
  • Larger, multiethnic, and multicenter studies further supported the association.

Conclusions:

  • Depression is causally associated with the development of subclinical coronary atherosclerosis.
  • The findings highlight the importance of addressing depression in cardiovascular risk management.
  • Further research should focus on the mechanisms linking depression to atherosclerosis.

Keywords:
Center for epidemiological studies depression scale (CES-D)Coronary artery calcium scoreDepressionMajor depression inventory (MDI)Primary care evaluation of mental disorders (PRIME-MD)Structured clinical interview for the diagnostic and statistical manual of mental disorders fourth edition (SCID-IV)Study of women’s health across the nation (SWAN)

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