Brain-derived neurotrophic factor, depressive symptoms and somatic comorbidity in patients with coronary heart disease

Acta Neuropsychiatr. 2021 Feb;33(1):22-30. doi: 10.1017/neu.2020.31. Epub 2020 Sep 24.

Abstract

Objective: Depression and coronary heart disease (CHD) are highly comorbid conditions. Brain-derived neurotrophic factor (BDNF) plays an important role in cardiovascular processes. Depressed patients typically show decreased BDNF concentrations. We analysed the relationship between BDNF and depression in a sample of patients with CHD and additionally distinguished between cognitive-affective and somatic depression symptoms. We also investigated whether BDNF was associated with somatic comorbidity burden, acute coronary syndrome (ACS) or congestive heart failure (CHF).

Methods: The following variables were assessed for 225 hospitalised patients with CHD: BDNF concentrations, depression [Patient Health Questionnaire-9 (PHQ-9)], somatic comorbidity (Charlson Comorbidity Index), CHF, ACS, platelet count, smoking status and antidepressant treatment.

Results: Regression models revealed that BDNF was not associated with severity of depression. Although depressed patients (PHQ-9 score >7) had significantly lower BDNF concentrations compared to non-depressed patients (p = 0.04), this was not statistically significant after controlling for confounders (p = 0.15). Cognitive-affective symptoms and somatic comorbidity burden each closely missed a statistically significant association with BDNF concentrations (p = 0.08, p = 0.06, respectively). BDNF was reduced in patients with CHF (p = 0.02). There was no covariate-adjusted, significant association between BDNF and ACS.

Conclusion: Serum BDNF concentrations are associated with cardiovascular dysfunction. Somatic comorbidities should be considered when investigating the relationship between depression and BDNF.

Keywords: BDNF; acute coronary syndrome; coronary heart disease; depression; heart failure; somatic comorbidity.

Publication types

  • Observational Study

MeSH terms

  • Acute Coronary Syndrome / metabolism
  • Aged
  • Antidepressive Agents / therapeutic use
  • Brain-Derived Neurotrophic Factor / blood*
  • Case-Control Studies
  • Comorbidity
  • Coronary Disease / complications*
  • Coronary Disease / metabolism
  • Coronary Disease / psychology*
  • Cost of Illness
  • Cross-Sectional Studies
  • Depression / etiology*
  • Depression / metabolism
  • Depression / psychology
  • Female
  • Germany / epidemiology
  • Heart Failure / metabolism
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Severity of Illness Index
  • Smoking / epidemiology

Substances

  • Antidepressive Agents
  • Brain-Derived Neurotrophic Factor