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Journal of the American Heart Association

Clinical Articles, Lead Article

Depression can lead to reduced coronary perfusion

Depressed patients with coronary heart disease (CHD) are particularly susceptible to the impairment in myocardial perfusion which occurs during psychological stress (PS), according to a study published recently in the Journal of the American Heart Association.1

Depression is prevalent in CHD patients, and increases risk for ACS recurrence and mortality despite optimal medical care. Authors investigated the confluence of acute PS with depression, hoping it would reveal coronary vascular mechanisms of risk.

146 patients completed the Beck Depression Inventory‐I (BDI‐I), a measure of depression linked to recurrent ACS and post‐ACS mortality, and underwent single‐photon emission computed tomography myocardial perfusion imaging at rest and during acute PS.

The likelihood of new/worsening impairment in myocardial perfusion from baseline to PS as a function of depression severity was tested. On the BDI‐I, 41 patients scored in the normal range, 48 in the high normal range, and 57 in the depressed range previously linked to CHD prognosis.

Effects on Myocardial Perfusion 2A BDI‐I score in the depressed range was associated with a significantly greater likelihood of new/worsening impairment in myocardial perfusion from baseline to PS (odds ratio =2.89, 95% CI: 1.26 to 6.63, P=0.012). This remained significant in models controlling ACS recurrence/mortality risk factors and medications. There was no effect for selective serotonin reuptake inhibitor medications.

References

1. Burg MM, Meadows J, Shimbo D, Davidson KW, Schwartz JE, Soufer R. Confluence of depression and acute psychological stress among patients with stable coronary heart disease: effects on myocardial perfusion. J Am Heart Assoc 2014;3:e000898. http://dx.doi.org/10.1161/JAHA.114.000898

Published on: December 19, 2014

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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