Abstract 15367: Depression Symptom Patterns as Predictors of Metabolic Syndrome and Cardiac Events in Symptomatic Women With Suspected Myocardial Ischemia: The Women’s Ischemia Syndrome Evaluation (WISE & WISE-CVD) Projects

Abstract

Introduction: Ischemic Heart Disease (IHD) risk in women includes biomedical, behavioral, and psychosocial contributors. Among psychosocial contributors, recent studies suggest that depression, especially somatic symptoms of depression such as anhedonia and low energy, may play a disproportionate role in the development of both IHD risk factors and major adverse cardiovascular events (MACE). Methods: We examined relationships between cognitive/somatic symptoms of depression and metabolic syndrome (MetS) in two independent cohorts of women with suspected IHD. In the Women’s Ischemia Syndrome Evaluation (WISE, NCT00000554), we also examined depression and MetS as predictors of all-cause mortality and MACE over a median 9.3-year follow-up. The sample from WISE included 641 women with suspected ischemia with or without obstructive coronary artery disease (CAD). The WISE-Coronary Vascular Dysfunction (WISE-CVD, NCT00832702) consisted of 359 women with suspected ischemia and no obstructive CAD (INOCA). Somatic, cognitive, and total depressive symptoms were measured via the Beck Depression Inventory (BDI). MetS was assessed according to the AHA’s ATP-III criteria. Results: (See attached table) In both the WISE and WISE-CVD samples, somatic symptoms of depression were associated with MetS diagnosis and MetS severity, while cognitive symptoms were not. Within the WISE sample, using Cox Proportional Hazard Regression, both somatic symptoms and MetS diagnosis were significant predictors of all-cause mortality and MACE, while cognitive symptoms were not. Conclusions: In two independent samples of women undergoing coronary angiography for suspected myocardial ischemia, somatic symptoms of depression were uniquely associated with both MetS and all-cause mortality and MACE, and both somatic symptoms of depression and MetS independently predicted all-cause mortality and MACE.