Pathophysiological mechanisms of the association between depression and acute coronary syndrome

• Autor(a) principal: Oliveira, Norma Alves de
• Data de Publicação: 2015
• Outros Autores: Filho, José Augusto Soares Barreto, Oliveira, Joselina Luzia Menezes de, Melo, Enaldo Vieira de, Coelho, Otávio Rizzi, Jorge, Juliana Goes, Sousa, Antônio Carlos Sobral
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Debates em Psiquiatria (Online)
• Texto Completo: https://revistardp.org.br/revista/article/view/162
• topic: Depressão; síndrome coronariana aguda; mecanismos fisiopatológicos; Depression; acute coronary syndrome; pathophysiological mechanisms

Depression has been associated with acute coronary syndrome (ACS) and can aggravate prognosis during and after hospitalization, regardless of traditional risk factors. Even though many studies emphasize the high prevalence and large impact of depression on prognosis, the condition is underdiagnosed and undertreated in most patients with ACS. One of the challenges in research has been to elucidate mechanisms underlying this association, especially psychosocial and pathophysiological ones. In this paper, we review the literature on the possible pathophysiological mechanisms involved in the association between depression and ACS. Examples of such pathophysiological mechanisms include inflammatory atherogenesis, immunological factors, increased platelet activity, altered heart rate, hematologic abnormalities, neuroendocrine factors, structural changes caused by vascular abnormalities, such as generalized vascular disease, fibrinolytic abnormalities, genetic factors, gender differences, hormonal fluctuations, and pharmacological treatment. Despite the recognized pathophysiological effect of the association between depression and ACS, few publications have investigated related mechanisms. The conduction of further studies may, in the future, provide a background for the scientific community so that the investigation of depression can become a part of the assessment and treatment of patients with ACS.