Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome

Research output: Contribution to journalArticlepeer-review


Depression is associated with heart failure independent of traditional cardiovascular disease risk factors. Enhanced platelet activation has been suggested as a potential mechanism and has been associated with negative inotropic effects that can affect left ventricular ejection fraction (LVEF). We examined 131 consecutive acute coronary syndrome (ACS) patients to assess whether depression increased the risk for developing LV dysfunction, and to determine the effects of platelet serotonin signaling in this relationship. Major depression was assessed using the Structured Clinical Interview and depressive symptoms were measured using the Beck Depression Inventory (BDI), with BDI ≥ 10 defined as abnormal. LV dysfunction was defined as LVEF ≤ 45%. Platelet serotonin response was measured by serotonin augmented platelet aggregation and platelet serotonin receptor density. Mean age of ACS participants was 59 years, 78.6% male and 74.0% Caucasian. 34.4% of patients had a reduced LVEF ≤ 45% on presentation. Almost half (47.0%) of patients had BDI ≥ 10 and 18.0% had major depressive disorder. Platelet serotonin response was found to be augmented in depressed patients with low LVEF compared to depressed patients with normal LVEF (p < 0.020). However, the presence of LV dysfunction was found to be similar in both depressed (32.3%) and non-depressed (36.2%) patients (p = 0.714). This suggests alternative factors contribute to poor cardiovascular outcomes in depressed patients that are independent of LV function in post ACS patients.

Original languageEnglish (US)
Pages (from-to)693-700
Number of pages8
JournalJournal of Thrombosis and Thrombolysis
Issue number3
StatePublished - Apr 2021


  • Acute coronary syndrome
  • Depression
  • Ejection fraction
  • Left ventricular dysfunction
  • Platelets
  • Serotonin

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome'. Together they form a unique fingerprint.

Cite this