Depression and anxiety independently associate with increased risk of major adverse cardiac events, partly mediated by heightened stress-related neural activity (P<0.05).
Cohort
Do depression and anxiety increase the risk of major adverse cardiac events (MACE) via stress-related neural, autonomic, and inflammatory pathways?
Depression and anxiety are independently associated with an increased risk of MACE, a relationship that is partly mediated by heightened stress-related neural activity and autonomic-immune dysregulation.
p-value: p=<0.05
BACKGROUND: Depression is linked to major adverse cardiac events (MACE), yet the role of stress-related neural activity-previously implicated in stress and anxiety in mediating this association remains unclear. Because anxiety and depression frequently co-occur and share neurobiological pathways, we hypothesized that the relationship between depression, anxiety, and their co-occurrence with MACE is partially mediated by increased stress-related neural activity and related autonomic-immune mechanisms. METHODS: F-fluorodeoxyglucose positron emission tomography/computed tomography imaging to assess stress-related neural activity, defined as the ratio of amygdala to background prefrontal cortical activity. Heart rate variability and CRP (C-reactive protein) served as indicators of autonomic activity and systemic inflammation. Depression and anxiety were determined at enrollment, and MACE was identified during follow-up using International Classification of Diseases codes. Each exposure (depression, anxiety, or concurrent anxiety plus depression) was modeled separately against study outcomes using linear and Cox regressions. RESULTS: <0.05). Similar associations were observed for anxiety or concurrent anxiety plus depression. CONCLUSIONS: Depression and anxiety independently associate with increased MACE risk, partly mediated by heightened stress-related neural activity and autonomic-immune dysregulation. The risk is greatest among those with both conditions, underscoring shared stress-related pathophysiology.
Abohashem et al. (Wed,) conducted a cohort in Depression and anxiety. Depression and/or anxiety was evaluated on Major adverse cardiac events (MACE) (p=<0.05). Depression and anxiety independently associate with increased risk of major adverse cardiac events, partly mediated by heightened stress-related neural activity (P<0.05).
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