Association of FKBP5 genotype with depressive symptoms in patients with coronary heart disease: a prospective study

AbstractDepression and coronary heart disease (CHD) are prevalent and often co-occurring disorders. Both have been associated with a dysregulated stress system. As a central element of the stress system, the FKBP5 gene has been shown to be associated with depression. In a prospective design, this study aims to investigate the association of FKBP5 with depressive symptoms in CHD patients. N = 268 hospitalized CHD patients were included. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS-D) at four time points (baseline, and after 1 month, 6 months, and 12 months). The functional FKBP5 single-nucleotide polymorphism (SNP) rs1360780 was selected for genotyping. Linear regression models showed that a higher number of FKBP5 C alleles was associated with more depressive symptoms in CHD patients both at baseline (p = 0.015) and at 12-months follow-up (p = 0.025) after adjustment for confounders. Further analyses revealed that this effect was driven by an interaction of FKBP5 genotype with patients’ prior CHD course. Specifically, only in patients with a prior myocardial infarction or coronary revascularization, more depressive symptoms were associated with a higher number of C alleles (baseline: p = 0.046; 1-month: p = 0.026; 6-months: p = 0.028). Moreover, a higher number of C alleles was significantly related to a greater risk for dyslipidemia (p = .016). Our results point to a relevance of FKBP5 in the association of the two stress-related diseases depression and CHD.

Download Full-text

Assessment and follow-up of suicidal ideation when screening for depression in hospitalized coronary heart disease patients – development of a protocol

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v3i4.1030 ◽

2015 ◽

Vol 3 (4) ◽

pp. 523 ◽

Cited By ~ 1

Author(s):

Katja Beer ◽

Nina Rieckmann ◽

Mira Ertl ◽

Laura Grosse ◽

Thorsten Zeidler ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Suicidal Ideation ◽

Information Transfer ◽

Depression Scale ◽

Depression Screening ◽

Care Hospital ◽

Screening Instruments ◽

Post Traumatic Stress

Rationale, aims and objectives: Depression is common in coronary heart disease (CHD) patients and routine depression screening is often performed in research settings and recommended for clinical practice. Many depression screening instruments contain an item assessing suicidal ideation. A positive answer for suicidal ideation requires timely follow-up evaluation by trained clinicians; however, the process of transferal of this information is not without its problems. We aimed to develop and implement a step-by-step action protocol for the timely follow-up evaluation of positive screenings for suicidal ideation in hospitalized CHD patients who complete a depression screening in a research study.Method: The protocol was developed by a team of psychiatrists and psychologists as part of a two-site prospective cohort study which includes 1265 hospitalized CHD patients with and without co-morbid depression. Patients were presented with two depression screening instruments as part of the baseline assessment, the Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS). All participants underwent a standardized computer based evaluation for clinical depression, anxiety and post-traumatic stress disorder using the Composite International Diagnostic Interview (CIDI). The protocol was adapted continuously with the aims to optimize information transfer between study team and clinic staff and to initiate potentially required care.Results: The protocol was adapted to site-specific exigencies, resulting in a stepped approach of handling suicidal ideation, starting with suicidality assessment in a depression screening questionnaire. In case of positive screening, a detailed procedure for following-up on suicidal ideation was developed, including guidelines for various eventualities. In case of insufficient or doubtful distance from suicidal intent as assessed by clinical psychologists in training, psychiatric consultation was initiated. Conclusions:Implementation of a protocol to follow-up on a positive suicidality screening in a research setting at two coronary care hospital sites was a logistical challenge, but proved feasible and acceptable to patients and staff.

Download Full-text

Serum brain-derived neurotrophic factor and stability of depressive symptoms in coronary heart disease patients: A prospective study

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2016.12.015 ◽

2017 ◽

Vol 77 ◽

pp. 196-202 ◽

Cited By ~ 10

Author(s):

Stella L. Kuhlmann ◽

Mira Tschorn ◽

Volker Arolt ◽

Katja Beer ◽

Julia Brandt ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Prospective Study ◽

Neurotrophic Factor ◽

Brain Derived Neurotrophic Factor ◽

A Prospective Study

Download Full-text

Symptoms of anxiety and depression in patients with stable coronary heart disease: prognostic value and consideration of pathogenetic links

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1097/hjr.0b013e3280142a02 ◽

2007 ◽

Vol 14 (4) ◽

pp. 547-554 ◽

Cited By ~ 67

Author(s):

Dietrich Rothenbacher ◽

Harry Hahmann ◽

Bernd Wüsten ◽

Wolfgang Koenig ◽

Hermann Brenner

Keyword(s):

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Hazard Ratio ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Manifest Anxiety ◽

Cardiovascular Disease Event

Background We evaluated the association of symptoms of anxiety and depression with fatal and non-fatal cardiovascular disease events among patients with coronary heart disease and considered several potential underlying pathogenetic links. Design This was a prospective cohort study. Methods In this study, including coronary heart disease patients undergoing an in-patient rehabilitation program, symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (HADS). Fatal and non-fatal cardiovascular disease events were determined during a 3-year follow-up. Results Of the 1052 patients with CHD 16.1% showed a borderline and 8.3% a manifest anxiety symptoms score, whereas 11.8 and 5.9% showed a borderline and manifest depressive symptoms score, respectively. During the 3-year follow-up fatal and non-fatal cardiovascular disease events were observed in 73 (6.9%) patients. After adjustment for covariates, patients having manifest anxiety symptoms had a statistically significant hazard ratio (HR) of 2.32 [95% confidence interval (CI) 1.14-4.74] for a cardiovascular disease event, and patients with depressive symptoms had an HR of 1.47 (95% CI 0.62-3.51) compared to other patients. In a model considering anxiety and depressive symptom scores simultaneously, the hazard ratio for a cardiovascular disease event associated with anxiety symptoms increased to 3.31 (95% CI 1.32-8.27), whereas the hazard ratio associated with depressive symptoms decreased (HR 0.62; 95% CI 0.20-1.87). We found a positive association of increased anxiety scores with body mass index and systolic blood pressure. Conclusions The study suggests an important role especially for symptoms of anxiety for long-term prognosis of patients with known coronary heart disease. It furthermore suggests that several pathogenetic links may partly explain the increased risk.

Download Full-text

Sarcopenia and Coronary Heart Disease Synergistically Increase the Risk of New Onset Depressive Symptoms in Older Adults

10.21203/rs.3.rs-112175/v1 ◽

2020 ◽

Author(s):

Xiaoyu Chen ◽

Peipei Han ◽

Xing Yu ◽

Yuanyuan Zhang ◽

Peiyu Song ◽

...

Keyword(s):

Older Adults ◽

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

The Elderly ◽

Community Dwelling ◽

Geriatric Depression ◽

New Onset

Abstract Background: It is well known that psychological and physical are very common among the elderly. This study aimed to investigate the additive effects of coronary heart disease (CHD) and sarcopenia on the risk of new onset depressive symptoms in older adults. Methods: The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9±5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline.Results: We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.81, 95% confidence interval (CI) = 1.07-3.07]], sarcopenia alone (OR = 2.77, 95% CI = 1.24-6.16), and co-occurring (OR = 7.12, 95% CI = 2.73-18.61) had higher risk of depressive symptoms than the normal group after adjusting for the covariates.Conclusions: CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.

Download Full-text

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study (Preprint)

10.2196/preprints.16420 ◽

2019 ◽

Author(s):

Avijit Sengupta ◽

Theresa Beckie ◽

Kaushik Dutta ◽

Arup Dey ◽

Sriram Chellappan

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Health Behaviors ◽

Mobile Health ◽

Controlled Trial ◽

Coronary Revascularization ◽

The United States ◽

Usability Study ◽

Mhealth Intervention

BACKGROUND Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care. OBJECTIVE The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants. METHODS Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment. RESULTS All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04). CONCLUSIONS The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

Download Full-text

Depression is associated with self-rated frailty in older adults from an outpatient clinic: a prospective study

International Psychogeriatrics ◽

10.1017/s104161021800100x ◽

2018 ◽

Vol 31 (3) ◽

pp. 425-434 ◽

Cited By ~ 4

Author(s):

Ivan Aprahamian ◽

Claudia Kimie Suemoto ◽

Sumika Mori Lin ◽

Alaise Silva Santos de Siqueira ◽

Marina Maria Biella ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Health Status ◽

Outpatient Clinic ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Estimating Equation ◽

Antidepressant Use ◽

A Prospective Study

ABSTRACTObjectives:The aim of the present study was to evaluate the association between depression and SSRI monotherapy and frailty both baseline and prospectively in older adults.Design:Prospective cohort study, 12-month follow-up.Setting:Geriatric outpatient clinic in São Paulo, Brazil.Participants:A total of 811 elderly adults aged 60 or older.Measurements:Depression was diagnosed as follows: (1) a diagnosis of major depression disorder (MDD) according to DSM-5; or (2) an incomplete diagnosis of MDD, referred to as minor or subsyndromic depression, plus Geriatric Depression Scale 15-itens ≥ 6 points, and social or functional impairment secondary to depressive symptoms and observed by relatives. Frailty evaluation was performed through the FRAIL questionnaire, which is a self-rated scale. Trained investigators blinded to the baseline assessment conducted telephone calls to evaluate frailty after 12-month follow-up. The association between depression and the use of SSRI with frailty was estimated through a generalized estimating equation adjusted for age, gender, total drugs, and number of comorbidities.Results:Depression with SSRI use was associated with frailty at baseline (OR 2.82, 95% CI = 1.69–4.69) and after 12 months (OR 2.75, 95% CI = 1.84–4.11). Additionally, depression with SSRI monotherapy was also associated with FRAIL subdomains Physical Performance (OR 1.99, 95% CI = 1.29–3.07) and Health Status (OR 4.64, 95% CI = 2.11–10.21). SSRI use, without significant depressive symptoms, was associated with subdomain Health Status (OR 1.52, 95% CI = 1.04–2.23).Conclusion:It appears that depression with SSRI is associated to frailty, and this association cannot be explained only by antidepressant use.

Download Full-text

Sarcopenia and coronary heart disease synergistically increase the risk of new onset depressive symptoms in older adults

BMC Geriatrics ◽

10.1186/s12877-021-02710-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaoyu Chen ◽

Peipei Han ◽

Xing Yu ◽

Yuanyuan Zhang ◽

Peiyu Song ◽

...

Keyword(s):

Older Adults ◽

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Financial Burden ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

New Onset

Abstract Background Coronary heart disease (CHD), sarcopenia and depression are common disorders that markedly impair quality of life and impose a huge financial burden on society. They are also frequently comorbid, exacerbating condition and worsening prognosis. This study aimed to investigate the additive effects of CHD and sarcopenia on the risk of new onset depressive symptoms in older adults. Methods The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9 ± 5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline. Results We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.78, 95% confidence interval (CI) = 1.05–3.02], sarcopenia alone (OR = 2.79, 95% CI = 1.26–6.22), and co-occurring (OR = 7.19, 95% CI = 2.75–18.81) had higher risk of depressive symptoms than the normal group after adjusting for the covariates. Conclusions CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.

Download Full-text

Depressive Symptoms and Complications Early after Acute Myocardial Infarction: Gender Differences

The Open Nursing Journal ◽

10.2174/1874434601812010205 ◽

2018 ◽

Vol 12 (1) ◽

pp. 205-214 ◽

Cited By ~ 5

Author(s):

Mohannad Eid AbuRuz ◽

Ghadeer Al-Dweik

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Acute Myocardial Infarction ◽

Gender Differences ◽

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Depression Scale ◽

Assessment Tools ◽

Male Patients

Background:Cardiovascular disease is the first leading cause of death worldwide. Coronary heart disease is the most common manifestation of cardiovascular disease. Acute myocardial infarction is the primary manifestation of coronary heart disease. Depression is a common and predicted complication after acute myocardial infarction. Limited studies evaluated gender differences in depressive symptoms after acute myocardial infarction especially in developing countries.Objective:The study aimed to determine whether there was a difference in depression levels and rate of complications based on gender early after acute myocardial infarction.Method:This was a prospective comparative study on 230 patients (150 men and 80 women) with a confirmed diagnosis of acute myocardial infarction. All participants signed an informed consent, filled sociodemographic and clinical questionnaire and the Depression Subscale of the Hospital Anxiety and Depression Scale. Clinical data were abstracted from the participants’ medical record after discharge.Results:Eighty-six participants (37.4%), 54 men and 32 women, developed 1 or more complications during hospitalization. Female patients were more depressed (14.4±3.5vs.8.3 ± 2.6) and developed more complications (1.9 ± 0.9vs.0.8 ± 0.5) than male patients did. Depressive symptoms increased the occurrence of complication by 40% and 33% for female and male patients respectively after controlling for sociodemographic and clinical variables.Conclusion:Depressive symptoms independently predicted complications after acute myocardial infarction in both men and women. The inclusion of depression assessment tools in acute myocardial infarction treatment protocols is highly recommended.

Download Full-text

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study

JMIR Formative Research ◽

10.2196/16420 ◽

2020 ◽

Vol 4 (6) ◽

pp. e16420 ◽

Cited By ~ 1

Author(s):

Avijit Sengupta ◽

Theresa Beckie ◽

Kaushik Dutta ◽

Arup Dey ◽

Sriram Chellappan

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Depressive Symptoms ◽

Health Behaviors ◽

Mobile Health ◽

Controlled Trial ◽

Coronary Revascularization ◽

The United States ◽

Usability Study ◽

Mhealth Intervention

Background Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care. Objective The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants. Methods Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment. Results All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04). Conclusions The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

Download Full-text