Xu Linjie, Zhai Xu, Shi Dazhuo, Zhang Ying
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School of Beijing University of Chinese Medicine, Beijing, China.
Front Psychiatry. 2024 Feb 9;15:1328048. doi: 10.3389/fpsyt.2024.1328048. eCollection 2024.
Coronary heart disease (CHD), a cardiovascular condition that poses a significant threat to human health and life, has imposed a substantial economic burden on the world. However, in contrast to conventional risk factors, depression emerges as a novel and independent risk factor for CHD. This condition impacts the onset and progression of CHD and elevates the risk of adverse cardiovascular prognostic events in those already affected by CHD. As a result, depression has garnered increasing global attention. Despite this growing awareness, the specific mechanisms through which depression contributes to the development of CHD remain unclear. Existing research suggests that depression primarily influences the inflammatory response, Hypothalamic-pituitary-adrenocortical axis (HPA) and Autonomic Nervous System (ANS) dysfunction, platelet activation, endothelial dysfunction, lipid metabolism disorders, and genetics, all of which play pivotal roles in CHD development. Furthermore, the effectiveness and safety of antidepressant treatment in CHD patients with comorbid depression and its potential impact on the prognosis of CHD patients have become subjects of controversy. Further investigation is warranted to address these unresolved questions.
冠心病（CHD）是一种对人类健康和生命构成重大威胁的心血管疾病，给全球带来了沉重的经济负担。然而，与传统风险因素不同的是，抑郁症已成为冠心病新的独立风险因素。这种情况影响冠心病的发病和进展，并增加已患冠心病患者发生不良心血管预后事件的风险。因此，抑郁症日益受到全球关注。尽管人们对此的认识不断提高，但抑郁症导致冠心病发生的具体机制仍不清楚。现有研究表明，抑郁症主要影响炎症反应、下丘脑-垂体-肾上腺皮质轴（HPA）和自主神经系统（ANS）功能障碍、血小板活化、内皮功能障碍、脂质代谢紊乱和遗传学，所有这些在冠心病的发生发展中都起着关键作用。此外，抗抑郁治疗在合并抑郁症的冠心病患者中的有效性和安全性及其对冠心病患者预后的潜在影响已成为争议话题。有必要进行进一步研究以解决这些未解决的问题。
