Medicine-based evidence: the case of antidepressants in patients with coronary artery disease

AbstractIn individuals with coronary artery disease and concurrent depressive symptomatology, the evidence on the beneficial and harmful effects of antidepressants is very limited. Recently, a study was carried out to describe depressive symptoms and the treatments provided under real-world circumstances to cardiac patients who entered the Mayo Clinic cardiac rehabilitation program. Antidepressant use was associated with reductions in depressive symptoms, but also with poorer cardiovascular outcomes. In this commentary, the results of this study are discussed in view of their clinical implications for everyday clinical practice and for the production of knowledge.

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DEPRESSIVE SYMPTOMS AND ASSOCIATED RISK FACTORS IN CORONARY ARTERY DISEASE PATIENTS HEATHER L. ROGERS, MARIANTONIA LEMOS HOYOS, VERÓNICA CUARTAS MURILLO & JUAN CARLOS

REVISTA ARGENTINA DE CLINICA PSICOLOGICA ◽

10.24205/03276716.2018.1047 ◽

2018 ◽

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Depressive Symptoms ◽

Coronary Artery ◽

Artery Disease ◽

Associated Risk Factors

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1072-215 Depressive symptoms are associated with reduced heart rate variability in individuals without coronary artery disease

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(04)90504-9 ◽

2004 ◽

Vol 43 (5) ◽

pp. A120-A121

Author(s):

Viola Vaccarino ◽

Rachel Lampert ◽

Forrester Lee ◽

J.Douglas Bremner ◽

Jerome L Abramson ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Depressive Symptoms ◽

Coronary Artery ◽

Artery Disease

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Serum Levels of FGF21, β-Klotho, and BDNF in Stable Coronary Artery Disease Patients With Depressive Symptoms: A Cross-Sectional Single-Center Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.587492 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yeshun Wu ◽

Zijun Chen ◽

Jiahao Duan ◽

Kai Huang ◽

Bin Zhu ◽

...

Keyword(s):

Coronary Artery Disease ◽

Depressive Symptoms ◽

Coronary Artery ◽

Stable Coronary Artery Disease ◽

Depression Scale ◽

Serum Levels ◽

Fibroblast Growth Factor 21 ◽

Healthy Population ◽

Cross Sectional ◽

Artery Disease

Background: The incidence of depressive symptoms (DS) in patients with stable coronary artery disease (SCAD) is significantly higher than those in healthy population, and that DS are independent risk factors for cardiovascular events. Previous studies have reported that fibroblast growth factor 21 (FGF21), β-klotho, mature brain-derived neurotrophic factor (mBDNF), and BDNF precursor (proBDNF) play important roles in the pathogenesis and treatment of coronary heart disease and depression. With this in mind, the present study aimed to clarify the relationship between FGF21, β-klotho, mBDNF, and proBDNF and SCAD with comorbid depression, in addition to also exploring the underlying mechanisms of these disease processes.Methods: A total of 116 patients with SCAD and 45 healthy controls were recruited. Patients with SCAD were further divided into two subgroups based on the Zung Self-Rating Depression Scale (SDS), which were characterized as those with no DS (NDS) and those with DS. Baseline data were collected, and serum levels of FGF21, β-klotho, mBDNF, and proBDNF were determined.Results: In SCAD patients, Gensini scores—denoting the degree of coronary arteriostenosis—were significantly greater in the DS group than in the NDS group. There was also a positive correlation between the Gensini scores and the SDS scores. Patients in the SCAD group demonstrated a lower serum FGF21. Serum β-klotho, mBDNF, and mBDNF/proBDNF were also significantly lower in the DS group than in the NDS group. Furthermore, β-klotho and mBDNF were negatively correlated with the SDS scores. Additionally, SCAD patients were divided into lower- and higher-level groups using hierarchical cluster analysis, with the results highlighting that patients in the lower mBDNF group had a higher incidence of DS.Conclusions: The depression score was positively correlated with the severity of coronary artery stenosis, and serum FGF21, β-klotho, mBDNF, and proBDNF were closely related to the development of DS in patients with SCAD. These observations suggest FGF21, β-klotho, mBDNF, and proBDNF as potential diagnostic and/or therapeutic targets for SCAD with co-morbid depression.

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