Prospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2020; 8(7): 1232-1240
Published online Apr 6, 2020. doi: 10.12998/wjcc.v8.i7.1232
Depression and myocardial injury in ST-segment elevation myocardial infarction: A cardiac magnetic resonance imaging study
Zhao-Qing Sun, Tong-Tong Yu, Yue Ma, Quan-Mei Ma, Yun-Di Jiao, Dong-Xu He, Jia-KeWu, Zong-Yu Wen, Xiao-Nan Wang, Yang Hou, Zhi-Jun Sun
Zhao-Qing Sun, Tong-Tong Yu, Yun-Di Jiao, Dong-Xu He, Jia-KeWu, Zong-Yu Wen, Zhi-Jun Sun, Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Yue Ma, Quan-Mei Ma, Xiao-Nan Wang, Yang Hou, Department of Radiology, Shenyang 110004, Liaoning Province, China
Author contributions: Sun ZQ designed the study and wrote the paper; Sun ZJ designed the study and revised the paper; Jiao YD, He DX, Wu JK, and Wen ZY collected the patient’s clinical data; Yu TT analyzed the data; Wang XN performed the CMR for the patients; Ma Y and Ma QM performed the CMR analyses; Hou Y verified the CMR results.
Supported by the National Key R& D Program of China, No. 2018YFC1311600.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Shengjing Hospital of China Medical University Research Ethics Committee (No.2016PS373K).
Clinical trial registration statement: This study is registered at ClinicalTrials.gov. The registration identification number is No. 2016PS373K.
Informed consent statement: Abandoned specimens and clinical data were used in this study, which had no effect on the routine diagnosis and treatment of patients. Patients signed informed consent via fingerprint on an electronic form that was part of the hospital electronic information management system during hospitalization.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The data used to support the findings of this study are available from the corresponding author upon request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Jun Sun, MD, PhD, Professor, Director, Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. sunzj@sj-hospital.org
Received: December 21, 2019
Peer-review started: December 21, 2019
First decision: January 17, 2020
Revised: February 25, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: April 6, 2020
Abstract
BACKGROUND

Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes. However, the association between depression and myocardial injury on cardiac magnetic resonance (CMR) in patients with ST-segment elevation myocardial infarction (STEMI) has still not been assessed.

AIM

To assess the association between depression and myocardial injury on CMR in patients with STEMI.

METHODS

A total of 107 STEMI patients undergoing primary percutaneous coronary intervention (P-PCI) were analyzed in this prospectivecohort study. Each subject completed the Patient Health Questionnaire-9 (PHQ-9) to assess the presence and severity of depressive symptoms. CMR was performed at a median of 3 d after P-PCI for quantifying post-MI myocardial injury. Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.

RESULTS

In this study, 19 patients (17.8%) were diagnosed with major depression identified by the PHQ-9 ≥ 10. PHQ-9 was analyzed both as a continuous variable and dichotomous variable. After multivariable adjustment, the proportion of patients with large infarction size was significantly higher in the major depression group (PHQ-9 ≥ 10) (OR: 4.840, 95%CI: 1.122–20.868, P =0.034). When the PHQ-9 was evaluated as a continuous variable, after multivariable adjustment, an increased PHQ-9 score was associated with an increased risk of large infarction size (OR: 1.226, 95%CI: 1.073–1.401, P =0.003).

CONCLUSION

In patients with STEMI undergoing PCI, depression was independently associated with a large infarction size.

Keywords: Depression, Patient Health Questionnaire-9, Myocardial injury, ST-segment elevation myocardial infarction, Cardiac magnetic resonance

Core tip: This is a prospective study with 107 ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention(P-PCI).The association between depression and myocardial injury measured on cardiac magnetic resonance was evaluated. Depression could predict large infarction size in patients with STEMI undergoing P-PCI .