Abstract:
BACKGROUND:Some cases of acute coronary syndrome (ACS) may be triggered by emotional states such as anger, but it is not known if acute depressed mood can act as a trigger. METHODS:295 men and women with a verified ACS were studied. Depressed mood in the two hours before ACS symptom onset was compared with the same period 24 hours earlier (pair-matched analysis), and with usual levels of depressed mood, using case-crossover methods. RESULTS:46 (18.2%) patients experienced depressed mood in the two hours before ACS onset. The odds of ACS following depressed mood were 2.50 (95% confidence intervals 1.05 to 6.56) in the pair-matched analysis, while the relative risk of ACS onset following depressed mood was 4.33 (95% confidence intervals 3.39 to 6.11) compared with usual levels of depressed mood. Depressed mood preceding ACS onset was more common in lower income patients (p = .032), and was associated with recent life stress, but was not related to psychiatric status. CONCLUSIONS:Acute depressed mood may elicit biological responses that contribute to ACS, including vascular endothelial dysfunction, inflammatory cytokine release and platelet activation. Acute depressed mood may trigger potentially life-threatening cardiac events.
journal_name
Biol Psychiatryjournal_title
Biological psychiatryauthors
Steptoe A,Strike PC,Perkins-Porras L,McEwan JR,Whitehead DLdoi
10.1016/j.biopsych.2006.03.041subject
Has Abstractpub_date
2006-10-15 00:00:00pages
837-42issue
8eissn
0006-3223issn
1873-2402pii
S0006-3223(06)00475-6journal_volume
60pub_type
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