Association of extent and severity of coronary atheromatosis with clinically undetected depression

• Published in: European heart journal Vol. 44; no. Supplement_2
• Main Authors: Babic, R, Dimitrijevic, S, Burazor, I
• Format: Journal Article
• Language: English
• Published: 09.11.2023
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehad655.2382

Abstract Background Comorbid depression is recognized among patients with cardiovascular diseases; however, it frequently remains clinically unrecognized. The reported prevalence of clinical depression among patients with cardiovascular diseases varies depending on the population characteristics and the clinical presentation of underlying cardiac disease. The association of comorbid depression with coronary artery disease is broadly reported; however, the causation is still putative. The data on the relation between the severity and extent of coronary atheromatosis versus the intensity of depressive symptoms are scarce. Purpose of the study Primary endpoint of this study was to determine the prevalence of previously undetected clinical depression among patients with chronic coronary syndromes referred for coronary angiography. The secondary endpoint was to assess the relationship between the extent and severity of coronary atheromatosis (evaluated by Gensini score) and the level of depression (assessed by Beck's Depression Inventory-II (BDI-II) questionnaire). Methods Single-center, cross-sectional observational study. Results Eighty-eight consecutive patients were enrolled in the study following signing the informed consent. The mean patient age was 63.8 ± 9.0 years, including 47 male and 41 female patients. Clinical depression (mild, moderate, or severe) was found in 20.5% of patients. The median value of BDI-II score was 6.5, with IQR of 8.25. The median value of Gensini score was 33.0, with IQR of 41.0. A strong positive linear correlation was found between BDI-II value and Gensini score (r=0.42, p<0.01). Significant differences in Gensini scores were found between 1st and 4th quartiles of BDI-II (p<0.01), and between the 1st and 2nd quartiles taken together and the 3rd and 4th taken together (p<0.05). Conclusion Unrecognized clinical depression (mild, moderate, and severe) is present to a sizable extent among patients with chronic coronary syndromes. Patients with chronic coronary syndromes and more pronounced depressive symptoms present with more severe and more extensive findings on coronary angiography compared to the patients with minimal depressive symptoms or without depression. These findings may be of significance for our future decision making in preventive cardiology.Correlation of BDI-II and Gensini scores