Depressed patients tend to have more frequent chest pain, even in the absence of coronary artery disease, report cardiologists.
The findings suggest pain and depression may share a common neurochemical pathway, says Salim Hayek, a cardiology research fellow with Emory Clinical Cardiovascular Research Institute.
“Depression is a common and well-recognized risk factor for the development of heart disease,” Hayek says. “Patients with known heart disease and depression tend to experience chest pain more frequently.
“However until now, it was not known whether that association was dependent on underlying coronary artery disease. Although our findings do not establish causality, they do suggest that depression is an important confounder of the relationship between chest pain and heart disease.”
More Depression, More Frequent Chest Pain
The study included 5,825 adults enrolled in the Emory Cardiovascular Biobank between 2004 and 2013. The biobank is a prospective registry of patients undergoing cardiac catheterization at three Emory Healthcare sites in Atlanta. Biobank patients had an average age of 63 years, with 65 percent male and 22 percent African-American.
Prior to cardiac catheterization, patients completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and the Seattle Angina Questionnaire to assess chest pain frequency in the past month. The presence and severity of coronary artery disease was determined by angiogram. Patients completed the same questionnaires at one and five years post-procedure.
