Increased Coronary Events in Depressed Cardiovascular Patients: 5-HT2A Receptor as Missing Link?
Abstract
Objective Major depressive disorder and depressive symptoms have been identified as independent risk factors for cardiac morbidity and mortality in patients with ischemic heart disease. Increased susceptibility to platelet activation has been proposed as one of the mechanisms by which depression acts as a significant risk factor for thrombotic events. In this review, data on platelet activation and platelet aggregation measures in depressed patients with or without concomitant cardiovascular disease are given. Data on the influence of antidepressants on parameters of platelet activation are summarized. Methods A literature search was done by checking MEDLINE Advanced and PsycInfo from 1990 to 2003 and through checking the bibliographies of these sources. The following key words were used for this search: platelet activation, platelet aggregation, depression, depressive disorder, ischemic heart disease, calcium, and serotonin. Results There is an indication of enhanced platelet activation and aggregation in depressed patients. Next, patients with a depressive disorder show signs of a hyperactive platelet 5-HT2A receptor signal transduction system as measured by increased platelet calcium mobilization after stimulation of platelets with serotonin. Conclusions Depression appears to be associated with an increased susceptibility for serotonin-mediated platelet activation. Upregulation and/or increased sensitivity of 5-HT2A/1B receptors and downregulated 5-HT transporter receptors…
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Chronic distress is associated with detrimental processes, including hypercoagulability, dyslipidemia, impaired glucose control, and increased inflammatory processes and impaired immune responses.
“Specifically, chronic distress is associated with detrimental processes, including hypercoagulability, dyslipidemia, 112-114 impaired glucose control, 115,116 and increased inflammatory processes and impaired immune responses. 95,117,118”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [113]
Cites
Malison, R. T., Price, L. H., Berman, R., van Dyck, C. H., Pelton, G. H., Carpenter, L., Sanacora, G., Owens, M. J., Nemeroff, C. B., Rajeevan, N., et al. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00272-8 · Cited by 496 · see citing works
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Lloyd-Jones, D. M., Allen, N. B., Anderson, C. A. M., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001078 · Cited by 2,785 · see citing works
The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice
Rozanski, A., Blumenthal, J. A., Davidson, K. W., Saab, P. G., & Kubzansky, L. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.12.005 · Cited by 1,238 · see citing works
Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865 · see citing works
- Authors
- Schins, A., Honig, A., Crijns, H., Baur, L., & Hamulyák, K.
- Affiliations
- Maastricht University Medical Centre (NL)
- ORCID
- Honig, Adriaan
- Venue
- Psychosomatic Medicine
- Published
- 2003-09
- Volume
- 65
- Issue
- 5
- Pages
- 729-737
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W1970853546
- Cited by
- 103
- References
- 1
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 2 · 2017: 2 · 2016: 6 · 2015: 8 · 2014: 3 · 2013: 4 · 2012: 6
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- depression, cardiovascular disease, ischemic heart disease, platelet activation, platelet aggregation, 5-HT2A receptor, serotonin, thromboembolic events, antidepressants, 5-HT transporter, cardiovascular risk factors
- MeSH terms
- Antidepressive Agents, Blood Platelets, Cardiovascular Diseases, Depression, Depressive Disorder, Humans, Models, Biological, Platelet Aggregation, Serotonin, Platelet Activation, Comorbidity, Myocardial Ischemia, Thrombophilia, Calcium Signaling, Genetic Predisposition to Disease, Receptor, Serotonin, 5-HT2A
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