title: BDNF val66met polymorphism and depressive disorders in patients with acute coronary syndrome.
abstract: BACKGROUND
  Brain-derived neurotrophic factor (BDNF) may be the key to understanding the development of depression in patients with acute coronary syndrome (ACS), as it is associated with both conditions. Because the expression of BDNF is influenced by genetic polymorphisms, in this study we investigated the association between the BDNF polymorphism val66met and both the risk of depression in ACS and the treatment response.
  
  
  METHODS
  Among the 969 patients with recent ACS at baseline, 711 were re-evaluated after 1 year of follow-up. Depressive disorder status was assessed according to the DSM-IV criteria both at baseline and at follow-up. Baseline prevalence, follow-up incidence, and the persistence of depression were also determined. Of the 378 patients diagnosed with depression at baseline, 255 were randomized to a 24-week double-blind placebo-controlled trial of escitalopram; the remaining 123 received the usual care. Associations between the BDNF val66met polymorphism and both depression status and treatment response were investigated using logistic regression models.
  
  
  RESULTS
  The prevalence and persistence, but not the incidence of depressive disorders were significantly associated with BDNF met alleles. Patients in the escitalopram group who carried the met allele had a significantly higher rate of remission than those who did not. Depressive disorders tended to persist at 1 year in patients managed with placebo or medical treatment only, and particularly those patients positive for BDNF met alleles, although the difference was not statistically significant.
  
  
  CONCLUSIONS
  The generalizability should be considered since this study conducted in a single center.
  
  
  CONCLUSIONS
  ACS patients positive for BDNF met alleles are vulnerable to depressive disorders at baseline and to its persistence. Antidepressant treatment may be effective in this subgroup of patients and may prevent the persistence of depression.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Kyung-Yeol
authors.initials: KY
authors.lastname: Bae
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea. Electronic address: jmkim@chonnam.ac.kr.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D000483:Alleles; D000928:Antidepressive Agents / Q000627:therapeutic use; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics*; D015283:Citalopram / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D019208:Brain-Derived Neurotrophic Factor; D015283:Citalopram
keywords: Acute coronary syndrome; BDNF; Depression; Escitalopram; Polymorphism