scholarly journals Emotional triggering and low socio-economic status as determinants of depression following acute coronary syndrome

2011 ◽  
Vol 41 (9) ◽  
pp. 1857-1866 ◽  
Author(s):  
A. Steptoe ◽  
G. J. Molloy ◽  
N. Messerly-Bürgy ◽  
A. Wikman ◽  
G. Randall ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Emotional Stress ◽  
Low Income ◽  
Rating Scale ◽  
Economic Status ◽  
Depression And Anxiety ◽  
Coronary Syndrome ◽  
Socio Economic Status ◽  
Acute Emotional Stress ◽  
Increased Risk

BackgroundThe determinants of depression following acute coronary syndrome (ACS) are poorly understood. Triggering of ACS by emotional stress and low socio-economic status (SES) are predictors of adverse outcomes. We therefore investigated whether emotional triggering and low SES predict depression and anxiety following ACS.MethodThis prospective observational clinical cohort study involved 298 patients with clinically verified ACS. Emotional stress was assessed for the 2 h before symptom onset and compared with the equivalent period 24 h earlier using case-crossover methods. SES was defined by household income and education. Depression was measured with the Beck Depression Inventory and the Hamilton Rating Scale for Depression and anxiety with the Hospital Anxiety and Depression Scale 3 weeks after ACS and again at 6 and 12 months. Age, gender, ethnicity, marital status, the Global Registry of Acute Coronary Events risk score, duration of hospital stay and history of depression were included as covariates.ResultsEmotional stress during the 2-h hazard period was associated with increased risk of ACS (odds ratio 1.88, 95% confidence interval 1.01–3.61). Both low income and emotional triggering predicted depression and anxiety at 3 weeks and 6/12 months independently of covariates. The two factors interacted, with the greatest depression and anxiety in lower income patients who experienced acute emotional stress. Education was not related to depression.ConclusionsPatients who experience acute emotional stress during their ACS and are lower SES as defined by current affluence and access to resources are particularly vulnerable to subsequent depression and anxiety.

scholarly journals A study on depression in people living with HIV/AIDS in South-West part of Uttar Pradesh, India

2015 ◽  
Vol 5 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Preeti Rai ◽  
Babu L Verma
Keyword(s):  
Risky Sexual Behavior ◽  
Rating Scale ◽  
Economic Status ◽  
Uttar Pradesh ◽  
Control Group ◽  
People Living With Hiv ◽  
Depression And Anxiety ◽  
Hiv Patients ◽  
Socio Economic Status ◽  
Hiv Aids

HIV/AIDS and depression are often thought to be interlinked. HIV positive cases may trigger symptoms of depression which, in turn, may result in risky sexual behavior and spread of HIV. Interviews were conducted in 104 patients of HIV/AIDS at the Anti-Retroviral Therapy (ART) Clinic of a teaching hospital in Uttar Pradesh (India) to study depression and examine its prevalence and association, if any, with some socio-demographic and clinical variables. The tools used to assess anxiety and depression and their severities were General Health Questionnaire (GHQ) 28 and Montgomery-Asberg Depression Rating Scale (MADRS) . The majority of patients were of age 35 years & above (62%), males (67%), married (85%), Hindus (88%), literate (73.1%), unemployed (35%) and of upper-lower socio-economic status (52%). Significant association of depression was found with religion, occupation and socio-economic status. Depression and anxiety were also found to be significantly associated with each other. There was, however, no association of depression with respondents’ age, gender, marital status, education, habitat, income, duration of illness from HIV/AIDS and the CD4 count. The high prevalence rate (67.3%) of depression amongst HIV patients in our study may be taken as marker to alert Counsellors of country’s ART Clinics for possible risk of depression in HIV patients. The above findings however, should be interpreted in the light of the fact that a parallel control group in the study was not included, studied sample was not large enough and the tools used to study the subjects for depression and anxiety were not adequately standardized.South East Asia Journal of Public Health Vol.5(1) 2015: 12-17

Socio-economic Status of the Patients with Acute Coronary Syndrome: Data from a District-level General Hospital of Bangladesh

2017 ◽  
Vol 10 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Borhanuddin Ahmed ◽  
Karimul Huda Shiraji ◽  
Mohiuddin Humayun Kabir Chowdhury ◽  
Mohammed Gias Uddin ◽  
Sharafat Nurul Islam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
General Hospital ◽  
Economic Status ◽  
Study Data ◽  
District Level ◽  
Economic Class ◽  
Medical College ◽  
Coronary Syndrome ◽  
Socio Economic Status

Background: Several studies have reported the correlation between socio-economic status (SES) and incidence of acute coronary syndrome (ACS). However, none of these studies have included data on Bangladesh. Hence, we aimed to find out the SES among the patients with ACS admitted in a district-level general hospital of Bangladesh.Methods: All the patients with a diagnosis of ACS admitted from March 2016 to February 2017 in the Cardiology department of 250-bedded General Hospital (Abdul Malek Ukil Medical College & Hospital), Noakhali were enrolled in this study. Data on demography, risk factors and SES parameters of the patients was screened and recorded with the help of a pre-defined questionnaire. Socioeconomic profile of the patients was defined according to modified Kuppuswamy SES scale.Results: A total of 366 patients were included (mean age 56.6 ± 11.5 years, 261 male and 105 female). Most of the patients had multiple risk factors like smoking, hypertension, diabetes, dyslipidemia and family history of cardiovascular disease. 80.1% (n=293) of the studied patients were from lower socio-economic class followed by 18.3% (n=67) from middle class and only 1.6% (n=6) were from upper class.Conclusion: This study found that most of the patients admitted due to ACS in a district-level general hospital of Bangladesh are from lower socio-economic class. These findings could be useful to draw the attention of health authorities towards people of lower socio-economic class and to adopt preventive strategies for them against ACS.Cardiovasc. j. 2017; 10(1): 17-20

scholarly journals Interaction effects of diabetes and brain-derived neurotrophic factor on suicidal ideation in patients with acute coronary syndrome

2021 ◽  
Author(s):  
Wonsuk Choi ◽  
Ju-Wan Kim ◽  
Hee-Ju Kang ◽  
Hee Kyung Kim ◽  
Ho-Cheol Kang ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Suicidal Ideation ◽  
Neurotrophic Factor ◽  
Rating Scale ◽  
Brain Derived Neurotrophic Factor ◽  
Interaction Effects ◽  
Diabetic Patients ◽  
Val66met Polymorphism ◽  
Coronary Syndrome ◽  
Increased Risk

Abstract Background Acute coronary syndrome (ACS) is associated with an increased risk of suicide. Although both diabetes and the brain-derived neurotrophic factor (BDNF) pathway are closely related to ACS and suicide, the effects of these factors on suicidal behavior in ACS patients have not been assessed. The aim of this study was to investigate the individual and interaction effects of diabetes and BDNF-related markers, namely the serum BDNF (sBDNF) level and the BDNF Val66Met polymorphism, on suicidal ideation (SI) in ACS patients. Methods The presence of diabetes was ascertained, and sBDNF levels and the presence of the BDNF Val66Met polymorphism were measured in 969 patients within 2 weeks after an ACS episode. Among these patients, 711 were followed up at 1 year after the ACS episode. SI was evaluated using the relevant items of the Montgomery–Åsberg Depression Rating Scale at baseline (acute SI) and the 1-year follow-up (chronic SI). Results Significant individual effects of low sBDNF levels were found on acute SI. The presence of both diabetes and a low sBDNF level or the BDNF Met/Met genotype was associated with acute SI, with multivariate logistic regression analyses revealing significant interaction effects. The highest frequency of chronic SI was seen in diabetic patients with an sBDNF level in the lowest tertile or with the BDNF Met/Met genotype, although the interaction terms were not statistically significant. Conclusions Combining diabetes and BDNF-related markers, such as the sBDNF level and the BDNF Val66Met polymorphism, might provide a useful predictor of acute SI in patients with ACS.

scholarly journals Risk factors for hospitalizations associated with depression among women during the years around a birth: a retrospective cohort study

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Jennifer Christine Fairthorne ◽  
Tim F Oberlander ◽  
Rollin Brant ◽  
Gillian E Hanley
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Post Partum ◽  
Economic Status ◽  
Low Ses ◽  
Post Partum Depression ◽  
Socio Economic Status ◽  
Increased Risk

IntroductionSocio-economic status (SES) is an important determinant of health and low SES is associated with higher rates of prenatal and post-partum depression while prenatal and post-partum depression are associated with sub-optimal maternal and infant health. Furthermore, increased negative effects of post-partum depression have been reported in children from low SES backgrounds. ObjectivesTo assess whether socio-economic status (SES) was related to the risk of a medical or psychiatric hospitalization associated with depression (HAWD) and the risk of a HAWD by anti-depressant (AD) use during the years around a birth MethodsThis retrospective cohort study used linked birth, hospitalization, prescription and tax-file records of the study cohort. We linked registry data of 243,933 women delivering 348,273 live infants in British Columbia (1999-2009). The outcomes of interest were a HAWD and a HAWD and the associated patient anti-depressant (AD) use. Ranked area-based measures of equivalised, family disposable income were used to create income deciles (Decile-1 low), our proxy for SES. Mothers from Decile-6 were the comparator group. Anti-depressant use was defined as having a prenatal prescription for a serotonin reuptake inhibitor or other AD and the years around a birth were the period beginning 12 months before conception and ending 12 months after the birth. We analysed by pregnancy using mixed effects logistic regression whilst adjusting for maternal age and parity. ResultsCompared to middle-income mothers from Decile-6, (Decile-1, Decile-2) mothers from low income neighbourhoods had increased odds of HAWDs [aOR=1.77(CI: 1.43, 2.19); aOR=1.56(CI: 1.26, 1.94)]. Mothers from low income areas with depression and no AD use had even higher odds of HAWDs [aOR=1.83(CI: 1.33, 2.20); aOR=1.71(CI: 1.33, 2.20)]. ConclusionsResults provide preliminary evidence that barriers to treating depression with ADs in mothers from low income areas during the years around a birth might contribute to their increased risk of a hospitalization associated with non-pharmacologically treated depression. Further research is implicated to further elucidate the origins of this increased risk. KeywordsMothers; Socio-economic status; Antidepressive agents; Pregnancy; Post-partum period; Parturition; Prescriptions; Hospitalization. Disclaimer All inferences, opinions, and conclusions drawn in this manuscript are those of the authors and do not reflect the opinions or policies of the Data Stewards of Population Data BC.

scholarly journals Longitudinal study assessing the joint effects of socio-economic status and birth risks on adult emotional and nervous conditions

2001 ◽  
Vol 178 (S40) ◽  
pp. s78-s83 ◽  
Author(s):  
Angela P. Fan ◽  
William W. Eaton
Keyword(s):  
Low Income ◽  
Economic Status ◽  
Adult Life ◽  
Income Group ◽  
Lower Income ◽  
Birth Complications ◽  
Lower Income Group ◽  
Socio Economic Status ◽  
Increased Risk ◽  
The Impact

BackgroundPrevious investigations into the impact of birth complications and social environment have generally followed their subjects only at young ages.AimsTo assess the long-range impact of socio-economic status (SES) and birth risks on the development of emotional and nervous conditions through adulthood.MethodThe Johns Hopkins Pathways Study interviewed 1824 subjects born between 1960 and 1965. The median household income of the children at age 7–8 years was used to divide the cohort into high and low income categories. Differences in lifetime prevalence of emotional and nervous conditions through adulthood between the two income groups were identified.ResultsChildren in the lower income group were 1.86 times more likely to report an emotional or nervous condition in adult life. Boys in the lower income group at age 7–8 years were 3.2 times more likely to do so. The risks of difficult birth for adult mental disturbance were accentuated in the low-income group.ConclusionsChildren who experience birth complications are at increased risk of developing adult mental disturbances; this increase is mitigated by higher SES.

scholarly journals Profile of copper-associated DNA methylation and its association with incident acute coronary syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Pinpin Long ◽  
Qiuhong Wang ◽  
Yizhi Zhang ◽  
Xiaoyan Zhu ◽  
Kuai Yu ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Acute Coronary Syndrome ◽  
Methylation Level ◽  
Meta Analysis ◽  
Regulation Of Gene Expression ◽  
Density Lipoprotein ◽  
Blood Leukocytes ◽  
Coronary Syndrome ◽  
A Genome ◽  
Increased Risk

Abstract Background Acute coronary syndrome (ACS) is a cardiac emergency with high mortality. Exposure to high copper (Cu) concentration has been linked to ACS. However, whether DNA methylation contributes to the association between Cu and ACS is unclear. Methods We measured methylation level at > 485,000 cytosine-phosphoguanine sites (CpGs) of blood leukocytes using Human Methylation 450 Bead Chip and conducted a genome-wide meta-analysis of plasma Cu in a total of 1243 Chinese individuals. For plasma Cu-related CpGs, we evaluated their associations with the expression of nearby genes as well as major cardiovascular risk factors. Furthermore, we examined their longitudinal associations with incident ACS in the nested case-control study. Results We identified four novel Cu-associated CpGs (cg20995564, cg18608055, cg26470501 and cg05825244) within a 5% false discovery rate (FDR). DNA methylation level of cg18608055, cg26470501, and cg05825244 also showed significant correlations with expressions of SBNO2, BCL3, and EBF4 gene, respectively. Higher DNA methylation level at cg05825244 locus was associated with lower high-density lipoprotein cholesterol level and higher C-reactive protein level. Furthermore, we demonstrated that higher cg05825244 methylation level was associated with increased risk of ACS (odds ratio [OR], 1.23; 95% CI 1.02–1.48; P = 0.03). Conclusions We identified novel DNA methylation alterations associated with plasma Cu in Chinese populations and linked these loci to risk of ACS, providing new insights into the regulation of gene expression by Cu-related DNA methylation and suggesting a role for DNA methylation in the association between copper and ACS.

scholarly journals Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 1108
Author(s):  
Admira Bilalic ◽  
Tina Ticinovic Kurir ◽  
Marko Kumric ◽  
Josip A. Borovac ◽  
Andrija Matetic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Hospital Mortality ◽  
Vascular Calcification ◽  
Matrix Gla Protein ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
St Elevation

Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.

Candidate Genes of the 5-Lipoxygenase Pathway in Acute Coronary Syndrome: A Pilot Study

2008 ◽  
Vol 9 (4) ◽  
pp. 280-292 ◽  
Author(s):  
Shu-Fen Wung ◽  
Bradley E. Aouizerat
Keyword(s):  
Acute Coronary Syndrome ◽  
Pilot Study ◽  
Nucleotide Polymorphisms ◽  
Common Allele ◽  
Lipoxygenase Pathway ◽  
Single Nucleotide ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Caucasian Patients ◽  
Alox5ap Gene

Purpose. The purpose of this pilot study was to examine arachidonate 5-lipoxygenase (ALOX5) and ALOX5-activating protein (ALOX5AP) gene variations in patients with and without acute coronary syndrome (ACS). Methodology. Four and six single nucleotide polymorphisms spanning the ALOX5 and ALOX5AP genes, respectively, were genotyped in 19 non-Hispanic Caucasian patients with ACS and 27 controls. Results. Presence of the common allele of rs9508835 (ALOX5AP) and the minor allele of rs2029253 (ALOX5) were associated with ACS. After adjustment for age, being a carrier of the rs9508835 common allele was associated with an increased risk of ACS (odds ratio = 2.86). Relevance for nursing practice. Through the inhibition of the ALOX5AP gene by downregulation of the leukotriene pathway, the risk of ACS may be decreased in individuals that carry susceptibility allele(s). Knowledge of the genetic basis of treatments that downregulate the leukotriene pathway may prove essential to the care of individuals with ACS.

Abstract 12644: Growth Differentiation Factor-15 (GDF-15) for Risk Stratification in Patients After an Acute Coronary Syndrome: Insights From the SOLID-TIMI 52 trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eri Toda Kato ◽  
David A Morrow ◽  
Christopher P Cannon ◽  
Mary Ann Lukas ◽  
Andrzej Budaj ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Biomarkers ◽  
Individual Element ◽  
Clinical Predictors ◽  
Coronary Syndrome ◽  
Differentiation Factor ◽  
Increased Risk ◽  
Prognostic Utility ◽  
Traditional Risk Factors ◽  
Risk Predictors

Background: Growth differentiation factor (GDF)-15, a stress responsive cytokine, is associated with the risk of CV events after an acute coronary syndrome (ACS). Unlike other established cardiac biomarkers, the level of GDF-15 remains elevated in sub-acute phase after ACS and gradually decreases over time. We evaluated the prognostic utility of GDF-15 in patients after ACS accounting for established markers and risk predictors. Methods: GDF-15 (R&D Systems) and other established cardiac biomarkers (BNP, hsCRP and hsTnI) were measured at baseline in a randomly selected cohort of 4,968 patients enrolled within 30 days of hospitalization with ACS (median=14d) in SOLID-TIMI 52. Previously defined cutpoints were applied for GDF-15 concentration: <1200 (n=3451), 1200-1800 (n=919), and > 1800 ng/L (n=598). Analyses were adjusted for established risk predictors, days from the ACS event and other markers. MACE was defined as CV death, MI or stroke. Median follow-up was 2.5 years. Results: Patients with higher GDF-15 tended to be older, more likely to have diabetes, hypertension, history of revascularization, and CKD at baseline. Higher baseline levels of GDF-15 identified patients with higher rates of MACE as well as each individual element (p-trend <0.001 for all endpoints, Fig). The rate of MI was ∼2-fold higher in those with GDF-15 concentration >1800ng/L compared to patients with GDF-15 concentration <1200 ng/L. After adjustment for clinical predictors and other markers, GDF-15 was independently associated with the risk of MACE (HR 1.4, 95% CI 1.1-1.7; HR 1.8, 95% CI 1.4-2.3 for GDF-15 1200-1800, >1800, respectively). Individuals with GDF-15 >1800 ng/L had an increased risk of MI (adj HR 1.4, 95% CI 1.1-2.0) and stroke (adj HR 2.3, 95% CI 1.3-3.9). Conclusion: In patients after ACS, GDF-15 concentration is associated with the risk of MACE including MI and stroke independent of traditional risk factors and risk markers.

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