High genetic risk for depression as an independent risk factor for mortality in patients referred for coronary
Robert M Krämer1, Angela P Moissl2,3,4, Stefan Lorkowski3,4
1Department for Children and Adolescent Psychiatry, Central Institute for Mental Health Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
Insights
A genetic depression risk score (GDRS) is linked to increased mortality in cardiovascular patients. This genetic predisposition did not correlate with depression history or antidepressant use in the study.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Psychiatry
Background:
- Depression is associated with increased comorbidities and mortality.
- The underlying mechanisms linking depression to adverse health outcomes remain unclear.
Purpose of the Study:
- To investigate the association between a genetic depression risk score (GDRS) and mortality (all-cause and cardiovascular).
- To explore the relationship between GDRS and depression markers, including antidepressant use and history of depression, in cardiovascular patients.
Main Methods:
- Utilized data from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, including 3,316 patients undergoing coronary angiography.
- Calculated GDRS in 3,061 participants and performed Cox regression analyses adjusted for multiple risk factors.
- Assessed associations with all-cause mortality, cardiovascular mortality, antidepressant intake, and depression history.
Main Results:
- GDRS was significantly associated with both all-cause (p=0.013) and cardiovascular mortality (p=0.001) after adjusting for covariates.
- The GDRS did not show association with antidepressant intake or a history of depression.
- No specific biomarkers correlating with GDRS were identified in the LURIC cohort.
Conclusions:
- Genetic predisposition to depression, as indicated by GDRS, is an independent predictor of all-cause and cardiovascular mortality in patients with coronary artery disease.
- The study did not find a correlation between GDRS and clinical depression markers in this cohort, possibly due to underreporting.
- Further research is needed to elucidate the biological pathways linking genetic depression risk to cardiovascular outcomes and mortality.
Background:
Different observations have suggested that patients with depression have a higher risk for a number of comorbidities and mortality. The underlying causes have not been fully understood yet.
Aims:
The aim of our study was to investigate the association of a genetic depression risk score (GDRS) with mortality [all-cause and cardiovascular (CV)] and markers of depression (including intake of antidepressants and a history of depression) in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study involving 3,316 patients who had been referred for coronary angiography.
Methods And Results:
The GDRS was calculated in 3,061 LURIC participants according to a previously published method and was found to be associated with all-cause (p = 0.016) and CV mortality (p = 0.0023). In Cox regression models adjusted for age, sex, body mass index, LDL-cholesterol, HDL-cholesterol, triglycerides, hypertension, smoking, and diabetes mellitus, the GDRS remained significantly associated with all-cause [1.18 (1.04-1.34, p = 0.013)] and CV [1.31 (1.11-1.55, p = 0.001)] mortality. The GDRS was not associated with the intake of antidepressants or a history of depression. However, this cohort of CV patients had not specifically been assessed for depression, leading to marked underreporting. We were unable to identify any specific biomarkers correlated with the GDRS in LURIC participants.
Conclusion:
A genetic predisposition for depression estimated by a GDRS was independently associated with all-cause and CV mortality in our cohort of patients who had been referred for coronary angiography. No biomarker correlating with the GDRS could be identified.
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