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Genes associated with depression and coronary artery disease are enriched for cardiomyopathy and inflammatory phenotypes

Nature Mental Health (2024)Cite this article

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Abstract

Depression and coronary artery disease (CAD) are highly comorbid conditions. Approximately 40% of individuals who have one diagnosis will also develop the other within their lifetime. Despite the high prevalence of the comorbidity, the specific genes and pathways remain unknown. Here, by mapping known variants to genes, we identified genes, followed by pathways, that are associated with both depression and CAD. Next, we investigated the phenotypic consequences of the shared pathways in an electronic health record (EHR)-based setting. We identified 185 genes that were significantly associated with both depression and CAD and were enriched for inflammatory and cardiomyopathy phenotypes. We observed an increased rate of prevalent cardiomyopathy cases in individuals with comorbid depression–CAD compared with those with CAD alone in three large EHR datasets. The results of our study implicate genetically regulated inflammatory mechanisms in depression–CAD. Our results also raise the hypothesis that depression-associated CAD may be enriched for cardiomyopathy.

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Fig. 1: Overall schematic of the study.
Fig. 2: Genes associated with depression and CAD using S-MultiXcan.
Fig. 3: Forest plot illustrating the odds of prevalent cardiomyopathy in (m)dCAD compared with CAD.
Fig. 4: Forest plot illustrating the odds of incident cardiomyopathy in (m)dCAD compared with CAD.

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Data availability

Data are available from Vanderbilt University Medical Center with institutional restrictions that apply to the acquisition, use and dissemination of data. To request reasonable access to data for work conducted in a non-profit academic setting, please contact the Vanderbilt Institute for Clinical and Translational Research (research.support.services@vumc.org) and request an application to the Integrated Data Access and Services Core.

Code availability

The code for the analysis is available at https://bitbucket.org/davislabteam/depression-cad/src/master/.

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Acknowledgements

This research is supported by the American Heart Association Fellowship AHA827137 (K.S.), National Institute of Mental Health R56MH120736 (L.K.D.), National Institute of Mental Health R01 H118233 (L.K.D. and J.W.S.), National Institutes of Health 1F31MH124306-01A1 (J.M.S.), and National Institutes of Health 1R01HL140074 (Q.S.W.). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the paper. The de-identified EHR used at VUMC was supported by the National Center for Research Resources, Grant UL1 RR024975-01, and is now at the National Center for Advancing Translational Sciences, Grant 2 UL1 TR000445-06. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The dataset(s) used for the analyses described were obtained from Vanderbilt University Medical Center’s BioVU, which is supported by numerous sources: institutional funding, private agencies and federal grants. These include the NIH-funded Shared Instrumentation Grant S10RR025141, and CTSA grants UL1TR002243, UL1TR000445 and UL1RR024975. Genomic data are also supported by investigator-led projects that include U01HG004798, R01NS032830, RC2GM092618, P50GM115305, U01HG006378, U19HL065962 and R01HD074711, and additional funding sources listed at https://victr.vumc.org/biovu-funding/. The All of Us Research Program is supported by grants through the National Institutes of Health, Office of the Director: Regional Medical Centers: 1 OT2 OD026549, 1 OT2 OD026554, 1 OT2 OD026557, 1 OT2 OD026556, 1 OT2 OD026550, 1 OT2 OD026552, 1 OT2 OD026553, 1 OT2 OD026548, 1 OT2 OD026551 and 1 OT2 OD026555; IAA#: AOD 16037; Federally Qualified Health Centers: HHSN 263201600085U; Data and Research Center: 5 U2C OD023196; Biobank: 1 U24 OD023121; The Participant Center: U24 OD023176; Participant Technology Systems Center: 1 U24 OD023163; Communications and Engagement: 3 OT2 OD023205 and 3 OT2 OD023206; and Community Partners: 1 OT2 OD025277, 3 OT2 OD025315, 1 OT2 OD025337 and 1 OT2 OD025276. In addition to the funded partners, the All of Us Research Program would not be possible without the contributions made by its participants.

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Author notes

  1. These authors contributed equally: Hyunjoon Lee, Julia M. Sealock.

Authors and Affiliations

  1. Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Kritika Singh, Tyne Miller-Fleming, Peter Straub, Nancy J. Cox & Lea K. Davis

  2. Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA

    Kritika Singh, Tyne Miller-Fleming, Peter Straub, Nancy J. Cox, Emily C. Hodges & Lea K. Davis

  3. Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA

    Hyunjoon Lee & Jordan W. Smoller

  4. Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Hyunjoon Lee, Julia M. Sealock & Jordan W. Smoller

  5. Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA

    Hyunjoon Lee, Julia M. Sealock & Jordan W. Smoller

  6. Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA

    Julia M. Sealock

  7. Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Quinn S. Wells

  8. Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN, USA

    Emily C. Hodges

  9. Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN, USA

    Lea K. Davis

  10. Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    Lea K. Davis

  11. Department of Medicine and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA

    Lea K. Davis

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Contributions

K.S. and L.K.D. conceptualized and designed the work. K.S., J.M.S., T.M.-F., P.S. and H.L. implemented the computational procedures and performed data analysis. N.J.C., J.W.S., Q.S.W. and E.C.H. provided important clinical and intellectual insights. All authors read, edited and approved the final paper.

Corresponding author

Correspondence to Lea K. Davis.

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Competing interests

J.W.S. is a member of the Scientific Advisory Board of Sensorium Therapeutics (with equity) and has received an honorarium for an internal seminar Tempus Labs. He is a principal investigator of a collaborative study of the genetics of depression and bipolar disorder sponsored by 23andMe for which 23andMe provides analysis time as in-kind support but no payments. The other authors declare no competing interests.

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Nature Mental Health thanks Janitza Montalvo-Ortiz and the other, anonymous reviewer(s) for their contribution to the peer review of this work.

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Singh, K., Lee, H., Sealock, J.M. et al. Genes associated with depression and coronary artery disease are enriched for cardiomyopathy and inflammatory phenotypes. Nat. Mental Health (2024). https://doi.org/10.1038/s44220-024-00219-z

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