Pathophysiological Mechanisms and Pharmaceutical Interventions of Myocardial Infarction with Depression

Review Pathophysiological Mechanisms and Pharmaceutical Interventions of Myocardial Infarction with Depression Mingyang Xu 1, Yinxiang Wei 2, Zhenhui Wang 1, Yaohui Wang 2, Xiaoming Zhong 3,*, and Qiying Chen 4,* 1 School of medicine, Henan University, Kaifeng 475000, China. 2 Joint National Laboratory for Antibody Drug Engineering, Henan University, Kaifeng 475004, China. 3 Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng 475000, China. 4 Department of Cardiology, Huashan Hospital, Fudan University, Shanghai 200040, China. * Correspondence: Xiaoming Zhong (zxm10020202@126.com); Qiying Chen (chenqiying@huashan.org.cn)     Received: 23 March 2023 Accepted: 10 May 2023   Abstract: The strong association between acute myocardial infarction (AMI) and major depression disorder（MDD）is a universally accepted. Patients with AMI complicated by MDD often have poor prognosis. Most early studies focused on how AMI leads to MDD, but there are few reports on depression-induced AMI. In terms of mechanism, inflammation, the hypothalamic-pituitary-adrenal axis (HPA axis) and brain-gut axis may be involved in the occurrence and development of MDD after AMI. The inflammatory injury, abnormal sympathetic and vagal nerve activity, HPA axis overactivation, overeating and some therapeutic medicine administration in patients with MDD can also be risk factors for AMI. Both behavioral and pharmaceutical interventions are important for the treatment of AMI with MDD. More drugs are being developed and tested. At present, there are still many issues, needing to be addressed, in the diagnosis, pathogenesis, intervention strategies and therapeutic drugs for AMI with MDD. To aid clinical diagnosis and treatment, this review classifies the existing studies on AMI complicated with MDD, and also includes some of our considerations.