Depression and thyroid axis function in coronary artery disease: impact of cardiac impairment and gender.
BACKGROUND
Increased rates of depression are reported in coronary artery disease (CAD). In heart disease, depression increases disability, reduces quality of life, and increases mortality.


OBJECTIVE
The study was undertaken to examine the relationship between depression and thyroid axis function in patients with CAD.


METHODS
In all, 73 patients with CAD, consecutively admitted to a cardiac rehabilitation hospital, were assessed for depression using the Hospital Anxiety and Depression scale (HADS). Blood was drawn for assessment of thyroid axis hormones and the N-amino terminal fragment of the pro-B-type natriuretic peptide (NT-pro BNP).


RESULTS
The patients with CAD with depressive symptoms had a higher prevalence of cardiac failure (p = 0.04), higher NT-pro BNP concentrations (p = 0.02), and lower free triiodothyronine (T3) concentrations (p = 0.04) than patients with CAD but without depressive symptoms. They also showed a strong trend (p = 0.058) toward a higher incidence of the low T3 syndrome. Higher NT-pro BNP concentrations were related to lower total T3 concentrations (r = -0.294, p = 0.011) and to higher reverse T3 concentrations (r = 0.353, p = 0.002). In men, higher scores of depression were related to lower total T3 concentration (r = -0.289, p = 0.034) and to higher NT-pro BNP concentration (r = 0.380, p = 0.005).


CONCLUSIONS
These findings suggest that symptoms of depression in patients with CAD are associated with changes in thyroid axis function and with cardiac impairment, especially in men.
Bunevicius
Robertas
R
Institute of Psychophysiology and Rehabilitation, Kaunas University of Medicine, Palanga, Lithuania. robertas_bunevicius@med.unc.edu
Varoneckas
Giedrius
G
Prange
Arthur J
AJ
Hinderliter
Alan L
AL
Gintauskiene
Vilte
V
Girdler
Susan S
SS
D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications / Q000523:psychology*; D015994:Incidence; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013960:Thyroid Function Tests; D014284:Triiodothyronine / Q000097:blood
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain