BackgroundThe purpose of this research was to explore the underlying mechanisms of cognitive impairments in patients with coronary heart disease (CHD) who exhibit depressive symptoms. This was accomplished by recording Event-related potentials (ERPs) during the emotional Stroop task, with a specific focus on the temporal dynamics of attentional bias towards various emotional words.MethodsWe selected 17 CHD patients with depressive symptoms and 23 CHD patients without depression using a convenience sampling method from the Affiliated Hospital of Weifang Medical University. Each participant completed an emotional Stroop color-word task, and ERPs were recorded during the task to examine cognitive processing.ResultsCHD patients with depressive symptoms exhibited generally smaller amplitudes of N1, N2, P3 and longer latency of P3 compared to CHD patients without depression. Specifically, the N1 amplitude of negative words was smaller and the P3 amplitude of negative words was larger in the CHD with depressive group compared to the CHD group. Furthermore, within the group of CHD patients with depressive symptoms, negative words elicited a smaller N1 amplitude and larger P3 amplitude compared to positive and neutral words.ConclusionsCHD patients with depressive symptoms demonstrate decreased attentional resources, leading to cognitive impairments. Notably, significant attentional bias occurs during both early and later stages of cognitive processing. This bias is primarily characterized by an enhanced automatic processing of negative information at the early stage and difficulty disengaging from such information at the later stage. These findings contribute to the existing literature on the cognitive neural mechanisms underlying depression in CHD patients.