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Background: Depression and coronary artery disease (CAD) are often linked. The aim of this study is to explore the effects of depression on the incidence of adverse events, and to correlate platelet activation with such events.
Methods: Patients with acute coronary syndrome (N=135) or stable CAD (N=152) were assessed for depressive symptoms using the Beck Depression Inventory (BDI). Rates of major and minor adverse events at 12-month follow-up were correlated with severity of depression. Platelet aggregation was measured using increasing epinephrine-augmented serotonin or adenosine diphosphate (ADP). Results were expressed as the agonist concentration producing half-maximal effect (EC50).
Results: Patients with BDI>10 experienced significantly more minor adverse events (p<0.001) and there was a trend toward increased incidence of major events at 12-month follow-up (p=0.055). The occurrence of ≥1 minor event was correlated with increased platelet response to serotonin, but did not reach significance (p=0.18).
Conclusion: Depressive symptoms are associated with increased incidence of minor adverse events, with a trend toward increased major events. Increased platelet response to serotonin did not reach statistical significance leaving the role for serotonin-driven platelet activation unproven. These results demonstrate the deleterious impact of even minor depressive symptoms in cardiac patients. The role of platelet function in this relationship deserves further inquiry.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-343
- 2017 American College of Cardiology Foundation