Original articleMajor depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes
Section snippets
Study design and subjects
We carried out a case–control study, nested in the ESCAPE project (Epidemiologic Study of Acute Coronary syndromes and the Pathophysiology of Emotions), a prospective cohort study assessing the prognostic consequences and pathophysiologic mechanisms of depression in ACS patients. The protocol was approved by the Research Ethics Committees of the Montreal Heart Institute, and Hôpital du Sacré Coeur de Montréal. Between August 31, 1999, and August 2, 2001, patients in these hospitals who
Depressed patients
Among the 54 currently depressed cases, there were 20 patients (37.0%) with a previous depression. Four of the currently depressed (7.4%) had atypical depressions, and 11 (20.4%) had melancholic depressions. Some 31.5% had at least one current comorbid DSM-IV Axis I disorder, with the most common being generalized anxiety disorder (n = 11). Duration of the current episode of depression ranged from 2 weeks to 2.8 years (median duration, 2 months). One third were taking antidepressants (all
Discussion
The primary finding of this study is that major depression in acute coronary syndrome patients is associated with significantly lower plasma levels of ω-3 PUFAs, in particular of DHA. Although we did not observe the hypothesized differences in levels of EPA or AA, differences between the depressed and nondepressed went in the predicted direction. However, given the variance of the measures, the sample size was only large enough to detect medium effect sizes for EPA and AA (.30 to .50), and we
Acknowledgements
This research was supported by the Medical Research Council of Canada and an unrestricted grant from GlaxoSmithKline (Grant No. POP-37744 to NF-S, FL), the Charles A. Dana Foundation (NF-S, FL), the Fondation du Center Hospitalier de l'Université de Montréal (NF-S, FL), the Montreal Heart Institute Foundation (NF-S, FL), the Pierre David Fund (FL), and the Cardiovascular Health Network of the Fonds de la recherche en santé du Québec (PJ).
We thank J. Lespérance for angiographic coding, M.-C.
References (69)
- et al.
Depression as a risk factor for mortality after coronary artery bypass surgery
Lancet
(2003) Hormonal modulation of delta 6 and delta 5 desaturasesCase of diabetes
Prostaglandins Leukot Essent Fatty Acids
(2003)- et al.
N-3 polyunsaturated fatty acids in coronary heart diseaseA meta-analysis of randomized controlled trials
Am J Med
(2002) - et al.
Relation between depression after coronary artery bypass surgery and 12-month outcomeA prospective study
Lancet
(2001) - et al.
Behavioral effects of cytokinesAn insight into mechanisms of sickness behavior
Meth Neurosci
(1993) - et al.
Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients
J Affect Disord
(1998) - et al.
N-3 fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease
Am J Clin Nutr
(2003) - et al.
Plasma and erythrocyte membrane long chain polyunsaturated fatty acids in endogenous depression
Neurochem Int
(1981) - et al.
A prospective study of plasma fish oil levels and incidence of myocardial infarction in U.S. male physicians
J Am Coll Cardiol
(1995) N-3 long-chain polyunsaturated fatty acids reduce risk of coronary heart disease deathExtending the evidence to the elderly
Am J Clin Nutr
(2003)