Coronary and Aortic Calcification in Women With a History of Major Depression

Agatisa, Patricia K.; Matthews, Karen A.; Bromberger, Joyce T.; Edmundowicz, Daniel; Chang, Yue‐Fang; Sutton-Tyrrell, Kim

doi:10.1001/archinte.165.11.1229

Cited by 110 publications

(69 citation statements)

References 39 publications

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“…[8][9][10][11] Arterial calcification not only weakens vasomotor responses but also affects atherosclerotic plaque stability. Emerging evidence suggests that atherosclerotic plaques with microcalcifications located in thin fibrous cap are prone to rupture, particularly in regions with high background stress.…”

Section: Discussionmentioning

confidence: 99%

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Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques

et al. 2013

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Background-Statins are not effective in reducing atherosclerotic plaques of the abdominal aorta, and accumulating evidence suggests that bisphosphonates have the potential to induce the regression of atherosclerotic plaques of the abdominal aorta. Methods and Results-A prospective, randomized, open-label, blinded-end-point trial involving 108 participants with hypercholesterolemia was conducted. Participants received 20 mg atorvastatin daily, 400 mg etidronate daily, or both drugs daily. The primary end point was the percent change in maximal vessel wall thickness of atherosclerotic plaques in the thoracic and abdominal aortas as measured by magnetic resonance imaging after 12 months of treatment. In both the combination therapy and atorvastatin groups, maximal vessel wall thickness of the thoracic aorta was reduced by 13.8% (95% confidence interval, −16.4 to −11.3) and 12.3% (95% confidence interval, −14.9 to −9.7), respectively. These reduction rates were comparable between groups (P=0.61). Meanwhile, in the etidronate group, maximal vessel wall thickness of the thoracic aorta remained unchanged (2.2%; 95% confidence interval, −0.3 to 4.8). Conversely, maximal vessel wall thickness of the abdominal aorta was reduced more effectively in the combination therapy group (−11.4%) than in the atorvastatin group (−0.9%; P<0.001) and the etidronate group (5.5%; P=0.006). Conclusions-Atorvastatin plus etidronate combination therapy for 12 months significantly reduced both thoracic and abdominal aortic plaques, whereas atorvastatin monotherapy reduced only thoracic aortic plaques and etidronate monotherapy reduced only abdominal aortic plaques. The effectiveness of combination therapy in reducing atherosclerotic plaques in the abdominal aorta was significantly greater than for both atorvastatin and etidronate monotherapy.

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Section: Discussionmentioning

confidence: 99%

“…5,7 Calcified atherosclerotic plaques in the abdominal aorta are closely associated with the incidence of cardiovascular disease. [8][9][10][11] Furthermore, calcified atherosclerotic plaques in the abdominal aorta, as quantified by lateral lumbar radiographs, are independent predictors of coronary heart disease 12 and congestive heart failure. 13 …”

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confidence: 99%

Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques

et al. 2013

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“…Post-ACS patients with incident depression should therefore be identified so that appropriate attention and management can ensue. It is worth noting that there are two recent reports of female patient samples, one disease-free and one with suspected myocardial ischemia, in which a reported history of depression or treatment history for depression predicted coronary calcification or cardiac risk (Agatisa, 2005 andRutlegde, 2006, respectively). These are obviously different patient samples than ours, and the results point to the possibility that the risks for ACS incidence are possibly different than those for recurrence of an ACS event.…”

Section: Discussionmentioning

confidence: 99%

Incident and recurrent major depressive disorder and coronary artery disease severity in acute coronary syndrome patients

Goodman

Shimbo

Haas

et al. 2008

Journal of Psychiatric Research

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There is recent evidence that acute coronary syndrome (ACS) patients with first time incident major depressive disorder (MDD) and those with recurrent MDD represent different subtypes among individuals with ACS and comorbid depression. However, few studies have examined whether or not these subtypes differ in coronary artery disease (CAD) severity. We assessed whether those with incident MDD (in-hospital MDD and negative for history of MDD) or recurrent MDD (in-hospital MDD and a positive history of MDD) differ in angiographically documented CAD severity. Within 1 week of admission for ACS, 88 patients completed a clinical interview to assess current and past diagnosis of MDD. CAD severity was assessed in all patients by coronary angiography. A hierarchical regression analysis showed that neither in-hospital MDD status, nor history of MDD were significant predictors of CAD severity, but the interaction term between in-hospital MDD status and history of MDD was a significant predictor of CAD severity, after controlling for age, sex and ethnicity. Follow-up analyses showed that patients with first-time, incident MDD had significantly more severe CAD compared to patients with recurrent MDD (p = 0.043). To conclude, our study adds to the growing evidence that patients with incident MDD should be considered as a clinically distinct subtype from those with recurrent MDD. Possible mechanisms for differing CAD severity by angiogram between these two subtypes are proposed and implications for prognosis and treatment are discussed. KeywordsAcute Coronary Syndrome; Coronary Artery Disease; Myocardial Infarction; Angiogram; Incident Major Depressive Disorder; Recurrent Major Depressive Disorder Extensive research has shown that comorbid major depressive disorder (MDD) after an acute coronary syndrome (ACS) event is an independent prognostic marker of increased morbidity and mortality (Barth et al., 2004;van Melle et al., 2004 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (Thombs et al., 2006), and of these MDD patients, 50% or more have had depression symptoms in the past. Recent evidence suggests that patients who experience depression after ACS for the first time (incident depression) may represent a clinically distinct subtype when compared with depressed ACS patients who have had depressive symptoms in the past (recurrent depression). NIH Public AccessThe literature indicates that the extent to which comorbid MDD after ACS impacts future medical prognosis might be dependent on whether patients experience incident or recurrent depression. However, the evidence is mixed ...

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“…Ten years later, those with hostility scores above the median were twofold more likely to have coronary atherosclerosis as documented by calcium via high speed CT [17•]. In a different study, depression was linked to vascular calcification in women [18]. After adjustment for other cardiovascular risk factors, a history of major recurrent depression was associated with an OR of 2.46 for any coronary calcium, 2.71 for severe coronary calcification, and 3.39 for severe aortic calcification [18].…”

Section: Introductionmentioning

confidence: 99%

Behavioral cardiology: Recognizing and addressing the profound impact of psychosocial stress on cardiovascular health

Das¹,

O’Keefe²

2006

Curr Atheroscler Rep

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Psychosocial stress exerts independent adverse effects on cardiovascular health. The recent INTERHEART study reported that psychosocial stress accounted for approximately 30% of the attributable risk of acute myocardial infarction. Prospective studies consistently indicate that hostility, depression, and anxiety are all related to increased risk of coronary heart disease and cardiovascular death. A sense of hopelessness, in particular, appears to be strongly correlated with adverse cardiovascular outcomes. Time urgency and impatience have not been consistently related to risk of coronary disease, but do increase the likelihood of developing hypertension. Psychosocial stress appears to adversely affect autonomic and hormonal homeostasis, resulting in metabolic abnormalities, inflammation, insulin resistance, and endothelial dysfunction. Additionally, stress is often associated with self-destructive behavior and noncompliance with medications. Psychosocial stress is a highly modifiable risk and many factors have been shown to be protective. These include psychosocial support, regular exercise, stress reduction training, sense of humor, optimism, altruism, faith, and pet ownership. Simple screening questions are available to reliably indicate a patient at risk for psychosocial stress-related health problems.

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Coronary and Aortic Calcification in Women With a History of Major Depression

Cited by 110 publications

References 39 publications

Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques

Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques

Incident and recurrent major depressive disorder and coronary artery disease severity in acute coronary syndrome patients

Behavioral cardiology: Recognizing and addressing the profound impact of psychosocial stress on cardiovascular health

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