Abstract Body (Do not enter title and authors here): Introduction: The prevalence of psychological disorders have been increasing, especially since the COVID-19 pandemic. Multiple mechanisms such as medication nonadherence, negative coping behaviors, and systemic inflammation may mediate the potential effects of depression and anxiety on atherosclerosis.
Question: Is there an association of depression or anxiety with the presence of plaque assessed by coronary computed tomography angiography (CCTA) among adults free of clinical coronary artery disease (CAD)?
Aim: We aim to examine the association of psychological factors with CCTA-based plaque, as they may be key targets for prevention and CCTA could be considered for enhanced risk characterization.
Methods: This cross-sectional study analyzed baseline data from the community-based Miami Heart Study (MiHeart). Depression was assessed by the Patient Health Questionnaire 8-item scale with a score ≥10 indicating binary depression. Anxiety was assessed by the Generalized Anxiety Disorder 7-item questionnaire with a score ≥10 demonstrating binary anxiety. The outcome was the binary presence of any plaque on CCTA. Multivariable logistic regression models were adjusted for potential confounders and clinically relevant risk factors. Sensitivity analyses further examined the severity of depressive symptoms, severity of anxiety symptoms, individuals with either depression or anxiety, and individuals with both depression and anxiety as predictors of coronary plaque.
Results: Of the 2,356 individuals (mean age 53.4±6.8 years), 50.4% were men and 47.1% were of Hispanic ethnicity. Depression and anxiety were reported in 143 (6.1%) and 224 (9.5%) of individuals, respectively. CCTA-identified plaque was present in 49.0% of participants with depression and 54.0% of those with anxiety, and plaque presence did not significantly differ when compared to those without depression or without anxiety, respectively. There were no significant associations between depression and plaque (adjusted odds ratio [aOR]: 1.03; 95%CI [0.70, 1.52]; p=0.891) or between anxiety and plaque (aOR: 1.27; 95%CI [0.93, 1.73]; p=0.138) in all regression models. On sensitivity analysis, there were also no statistically significant associations found.
Conclusion: Our study found no association of depression, anxiety, their combination, or their severity with coronary plaque on CCTA in asymptomatic adults. To our knowledge, this is the first large study on this topic utilizing CCTA data in a U.S. population.