Is Serotonin-Driven Platelet Activation the Link Between Depression and Cardiovascular Events?

cardiac heart muscle microscope
cardiac heart muscle microscope
Depressive symptoms are associated with increased incidence of adverse cardiovascular events.

WASHINGTON, DC — Depressive symptoms are linked to increased incidence of adverse cardiac events, according to research presented at the American College of Cardiology 2017 Scientific Sessions.

Researchers from Johns Hopkins Bayview Medical Center in Baltimore, Maryland, evaluated the effects of depression on the incidence of adverse events. They also went on to correlate platelet activation with adverse events.

They assessed a total of 287 patients (n=135 patients with acute coronary syndrome; n=152 patients with stable coronary artery disease) for depressive symptoms according to the Beck Depression Inventory. 

Patients who experienced a significant number of minor adverse events (P <.001) scored higher than 10, with a trend toward increased incidents of major events at 12-month follow-up (P =.055).

The list of minor adverse events includes:

  • Bleeding (major and minor)
  • Recurrent chest pain
  • New electrocardiogram changes without biomarker elevation
  • Asymptomatic biomarker elevation
  • Hospitalization (cardiac and noncardiac)
  • Elective revascularization (percutaneous coronary intervention or coronary artery bypass graft)
  • Target vessel revascularization in patients initially treated with percutaneous coronary intervention
  • New-onset congestive heart failure

Researchers also measured platelet aggregation using increasing epinephrine-augmented serotonin or adenosine diphosphate, but although the occurrence of ≥1 minor event was correlated with increased platelet response to serotonin, this relationship was not statistically significant (P =.18).

Although more research needs to be conducted on the role for serotonin-driven platelet activation, the study’s results did demonstrate a direct relationship between both minor and major depressive symptoms and adverse effects in cardiac patients, with a trend toward increased major events.


Ashvetiya T, Williams M. The Relationship between Depression and the Adverse Cardiovascular Events: Examining Serotonin-Driven Platelet Activation as a Factor. Presented at: American College of Cardiology 2017 Scientific Sessions; March 17-19, 2017; Washington, DC. Abstract 1126-343. 

This article originally appeared on Psychiatry Advisor