Two-year prognosis after acute coronary syndrome in younger patients: Association with feeling depressed in the prior year, and BDI-II score and Endothelin-1

Abstract

Objective To examine the effects of depressive symptoms and Endothelin (ET) -1 on 2-year prognosis in younger patients with acute coronary syndrome (ACS). Depression is associated with poor post-ACS prognosis; however, few investigations have focused on younger patients. Importantly, the studies that did emphasize younger patients suggested that the influence of depression on prognosis could be more robust in younger subgroups. The particular links between depression and poor prognosis in younger patients have yet to be definitively determined. ET-1 is a potent endogenous vasoconstrictor that has been previously linked to adverse post-ACS outcomes. Methods The sample (n=153) included male (age ≤50 years) and female (age ≤55 years) ACS patients. Blood samples for ET-1 assessment were collected within 2–3h of ACS hospital admission. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) II within 2–5 days of admission. The primary outcome was defined as a composite of major adverse cardiovascular events (MACE), including recurrent myocardial infarction, emergent coronary revascularization, and all-cause mortality within 2 years after index admission. Results During the follow-up period, 23 patients experienced MACE. Neither the BDI-II score nor ET-1 predicted MACE in unadjusted analyses or in analyses adjusted for demographic characteristics, comorbidities and troponin levels. In the supplementary analyses, feeling depressed in the year preceding ACS predicted MACE. Conclusions In this cohort of younger ACS patients, feeling depressed in the year preceding ACS admission predicted MACE in the 2 years after baseline ACS event, while neither the BDI-II score, nor circulating ET-1 level predicted this outcome.

Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome.

“…Our results confirm the well-established detrimental effect of incident depression on cardiac prognosis (Frasure-Smith & Lespérance, 2008; Yammine et al, 2017). We suggest that clinicians should both keep in mind the possible risk factors for its development (Ossola, Paglia, et al, 2015) and, given the associated burden (Szpakowski, Qiu, Masih, Kurdyak, & Wijeysundera, 2017), treat the disorder (Gerra et al, 2014; Mavrides & Nemeroff, 2013; Smolderen, Buchanan, et al, 2017) and related conditions (Carney, Freedland, Steinmeyer, Rubin, & Rich, 2016).…”

“…MACEs occur in 15% of subjects in the 2 years after an acute coronary syndrome (Yammine et al, 2017), and depression occurs in up to 20% of them (Thombs et al, 2006). We therefore estimated an initial population of 400 subjects, so that, with a dropout rate of 10% per year in a cardiac population (Worcester, Murphy, Mee, Roberts, & Goble, 2004), would have resulted in approximately 300 subjects at follow-up with 45 MACE and 60 depressive episodes.…”

“…It is possible that the studies supporting the latter hypothesis are biased by the effect of long-lasting depressive and cardiac illnesses (Lespérance, Frasure-Smith, Talajic, & Bourassa, 2002; Stenman, Holzmann, & Sartipy, 2016). For example, evaluating subjects in the early stages of coronary disease, a recent study failed to find a correlation between depression and acute coronary syndrome (ACS) severity (Pelletier et al, 2014), whereas another (Yammine, Frazier, Padhye, Sanner, & Burg, 2017) found that only previous, but not current, depressive symptoms predict subsequent major cardiac events.…”

Artificial Intelligent System for Automatic Depression Level Analysis Through Visual and Vocal Expressions

“…They concluded that participants with high symptom severity tend to express more emotions associated with contempt, and smile less. Yammine et al [35] examined the effects caused by depression to younger patients of both genders. The samples (n = 153) completed the Beck depression inventory II (BDI-II) questionnaire which indicated that the mean BDI-II score of 20.7 (borderline clinically If deep learning is utilized, then deep features are extracted from the frames, otherwise a set of hand-crafted features are extracted.…”

Temperament and Depression After a First Acute Coronary Syndrome

“…Moreover, 1 in 10 patients with ACS develop depressive symptoms within the following year (Thombs et al, 2006). Depression itself seems to have a negative impact on cardiac prognosis (Lichtman et al, 2014), but the role played by anxiety (de Jager et al, 2018;Ossola et al, 2018), severity of depressive symptoms, and recurrence of the episodes (Osler et al, 2016;Yammine et al, 2017;Zuidersma et al, 2011) is still object for debate.…”