Predictive value of homocysteine for depression after acute coronary syndrome.
We investigated roles of plasma homocysteine and MTHFR gene in relation to risks and treatment responses of depression in ACS. A sample of 969 patients with recent ACS were recruited and 711 followed 1 year later. In addition, of 378 baseline participants with depressive disorder, 255 were randomized to a 24-week double blind trial of escitalopram (N = 127) or placebo (N = 128). A higher homocysteine concentration was independently associated with prevalent depressive disorder at baseline irrespective of MTHFR genotype; and with both incident and persistent depressive disorder at follow-up only in the presence of TT genotype. MTHFR genotype was not itself associated with depressive disorder after ACS. No associations were found with 24-week antidepressant treatment responses. Plasma homocysteine could be a biomarker for depressive disorder particularly in the acute phase of ACS. Focused interventions for those with higher homocysteine level and MTHFR TT genotype might reduce the risk of later depressive disorder.
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Hee Ju
HJ
Kang
King's College London, Institute of Psychiatry, London, UK.
Robert
R
Stewart
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Kyung Yeol
KY
Bae
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Sung Wan
SW
Kim
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Il Seon
IS
Shin
Gwangju Center, Korea Basic Science Institute, Gwangju, Korea.
Hyuno
H
Kang
Gwangju Center, Korea Basic Science Institute, Gwangju, Korea.
Won Jin
WJ
Moon
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
Young Joon
YJ
Hong
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
Youngkeun
Y
Ahn
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
Myung Ho
MH
Jeong
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Jin Sang
JS
Yoon
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Jae Min
JM
Kim
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000523:psychology*; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics; D015283:Citalopram / Q000008:administration & dosage; D003863:Depression / Q000097:blood* / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D056910:Republic of Korea
D000928:Antidepressive Agents; D014408:Biomarkers, Tumor; D015283:Citalopram; D006710:Homocysteine; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)
MTHFR C677T polymorphism; acute coronary syndrome; biomarkers; depression; homocysteine