Depression and Subclinical Coronary Atherosclerosis in Adults Without Clinical Coronary Artery Disease

Abstract

Background The relationship between depression and subclinical coronary atherosclerosis in asymptomatic individuals is not clear. We evaluated this relationship in a Korean population. Methods and Results We analyzed 3920 individuals (mean age 54.7±7.9 years and 2603 men [66.4%]) with no history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography and screening for depression using the Beck Depression Inventory as part of a general health examination. The degree and extent of subclinical coronary atherosclerosis were evaluated by coronary computed tomographic angiography, and ≥50% diameter stenosis was defined as significant. Participants were categorized into groups of those with or without depression using the Beck Depression Inventory scores ≥16 as a cutoff value. Of the study participants, 272 (6.9%) had a Beck Depression Inventory score of 16 or higher. After adjustment for cardiovascular risk factors, depression was not significantly associated with any coronary plaque (adjusted odds ratio [OR], 1.05 [95% CI, 0.78–1.41]; P =0.746), calcified plaque (OR, 0.95 [95% CI, 0.71–1.29]; P =0.758), noncalcified plaque (OR, 1.31 [95% CI, 0.79–2.17]; P =0.305), mixed plaque (OR, 1.16 [95% CI, 0.60–2.23]; P =0.659), or significant coronary artery stenosis (OR, 1.22 [95% CI, 0.73–2.03]; P =0.450). In the propensity score‐matched population (n=1318) as well, none of the coronary artery disease measures of subclinical coronary atherosclerosis were statistically significantly associated with depression (all P >0.05). Conclusions In this large cross‐sectional study with asymptomatic individuals undergoing coronary computed tomographic angiography and Beck Depression Inventory evaluation, depression was not associated with an increased risk of subclinical coronary atherosclerosis.