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Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome

Jacob Sama1, Dhananjay Vaidya2, Monica Mukherjee2

  • 1Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA. samajacob2000@gmail.com.

Journal of Thrombosis and Thrombolysis
|September 3, 2020
PubMed

Insights

Depression in acute coronary syndrome patients did not increase the risk of left ventricular dysfunction. However, platelet serotonin response was augmented in depressed patients with low left ventricular ejection fraction.

Area of Science:

  • Cardiology
  • Psychiatry
  • Biochemistry

Background:

  • Depression is linked to heart failure, potentially via enhanced platelet activation and negative inotropic effects impacting left ventricular ejection fraction (LVEF).
  • Understanding the interplay between depression, platelet function, and cardiac outcomes in acute coronary syndrome (ACS) is crucial.

Purpose of the Study:

  • To investigate if depression elevates the risk of left ventricular (LV) dysfunction in ACS patients.
  • To determine the role of platelet serotonin signaling in the relationship between depression and LV dysfunction post-ACS.

Main Methods:

  • Assessed major depression using the Structured Clinical Interview and depressive symptoms with the Beck Depression Inventory (BDI).
  • Defined LV dysfunction as LVEF ≤ 45%.
  • Measured platelet serotonin response via serotonin-augmented platelet aggregation and receptor density in 131 ACS patients.

Main Results:

  • 34.4% of patients presented with reduced LVEF; 47.0% had abnormal BDI scores, and 18.0% had major depressive disorder.
  • Platelet serotonin response was augmented in depressed patients with low LVEF compared to those with normal LVEF (p < 0.020).
  • LV dysfunction prevalence was similar in depressed (32.3%) and non-depressed (36.2%) patients (p = 0.714).

Conclusions:

  • Depression did not increase the risk for developing LV dysfunction in this ACS cohort.
  • Augmented platelet serotonin response in depressed patients with low LVEF suggests a specific pathway.
  • Alternative factors, independent of LV function, likely contribute to adverse cardiovascular outcomes in depressed post-ACS patients.

Keywords:
Acute coronary syndromeDepressionEjection fractionLeft ventricular dysfunctionPlateletsSerotonin

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