Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia

There is increasing evidence demonstrating that psychiatric conditions elevate the risk of developing accelerated atherosclerosis and early-onset cardiovascular disease (CVD), including myocardial infarction (MI). Several mechanisms contribute to this observation. The dysfunction of the autonomic ne...

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Main Authors: Leong Tung Ong, Ching-Hui Sia
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Biology
Subjects:
Online Access:https://www.mdpi.com/2079-7737/14/4/336
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author Leong Tung Ong
Ching-Hui Sia
author_facet Leong Tung Ong
Ching-Hui Sia
author_sort Leong Tung Ong
collection DOAJ
description There is increasing evidence demonstrating that psychiatric conditions elevate the risk of developing accelerated atherosclerosis and early-onset cardiovascular disease (CVD), including myocardial infarction (MI). Several mechanisms contribute to this observation. The dysfunction of the autonomic nervous system and hyperactivity of the hypothalamic–pituitary–adrenal axis in these patients contribute to the development of MI. Additionally, patients with underlying psychiatric disorders often have abnormal levels of anti-inflammatory and pro-inflammatory cytokines, which can lead to early vascular damage and subsequent atherosclerosis. Elevated PAI-1 levels, reduced tPA activity, and the decreased brain-derived neurotrophic factor (BDNF), influenced by coagulation and inflammation, may contribute to depression and its link to MI. Oxidative stress, marked by increased reactive species and impaired antioxidant defenses, is associated with cellular damage and has been consistently implicated in schizophrenia and bipolar disorder, potentially contributing to myocardial infarction. Finally, molecular genetic studies have indicated that psychiatric disorders and myocardial infarction may share potential pleiotropic genes. The interplay between the psychiatric conditions and myocardial infarction underscores the importance of integrated care approaches to manage both mental and physical health.
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spelling doaj-art-d7a504b73ea94c6285ea59fcd3d329942025-08-20T02:17:24ZengMDPI AGBiology2079-77372025-03-0114433610.3390/biology14040336Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and SchizophreniaLeong Tung Ong0Ching-Hui Sia1Department of Cardiology, National University Heart Centre, Singapore 119228, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore 119228, SingaporeThere is increasing evidence demonstrating that psychiatric conditions elevate the risk of developing accelerated atherosclerosis and early-onset cardiovascular disease (CVD), including myocardial infarction (MI). Several mechanisms contribute to this observation. The dysfunction of the autonomic nervous system and hyperactivity of the hypothalamic–pituitary–adrenal axis in these patients contribute to the development of MI. Additionally, patients with underlying psychiatric disorders often have abnormal levels of anti-inflammatory and pro-inflammatory cytokines, which can lead to early vascular damage and subsequent atherosclerosis. Elevated PAI-1 levels, reduced tPA activity, and the decreased brain-derived neurotrophic factor (BDNF), influenced by coagulation and inflammation, may contribute to depression and its link to MI. Oxidative stress, marked by increased reactive species and impaired antioxidant defenses, is associated with cellular damage and has been consistently implicated in schizophrenia and bipolar disorder, potentially contributing to myocardial infarction. Finally, molecular genetic studies have indicated that psychiatric disorders and myocardial infarction may share potential pleiotropic genes. The interplay between the psychiatric conditions and myocardial infarction underscores the importance of integrated care approaches to manage both mental and physical health.https://www.mdpi.com/2079-7737/14/4/336myocardial infarctionpsychiatric disordersanxiety disordermajor depressive disorderbipolar disorderschizophrenia
spellingShingle Leong Tung Ong
Ching-Hui Sia
Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
Biology
myocardial infarction
psychiatric disorders
anxiety disorder
major depressive disorder
bipolar disorder
schizophrenia
title Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
title_full Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
title_fullStr Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
title_full_unstemmed Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
title_short Pathophysiological Links Between Myocardial Infarction and Anxiety Disorder, Major Depressive Disorder, Bipolar Disorder and Schizophrenia
title_sort pathophysiological links between myocardial infarction and anxiety disorder major depressive disorder bipolar disorder and schizophrenia
topic myocardial infarction
psychiatric disorders
anxiety disorder
major depressive disorder
bipolar disorder
schizophrenia
url https://www.mdpi.com/2079-7737/14/4/336
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