PCI vs thrombolysis in acute myocardial infarction: a prospective study on the effects of cardiac and psychological risk factors on prognosis and quality of life SUBSTUDY: Endothelial dysfunction in ACS patients with and without depression

It is evident from previous studies that post-MI depression negatively affects
prognosis. However, the mechanisms by which depression exerts this negative
effect are still largely unclear, although there several candidate mechanisms
have been identified. One potential mechanism could be arterial endothelial
dysfunction, since this is a characteristic present in both cardiac patients
and depressed psychiatric patients.

the proposed study will examine the differences in flow-mediated vasodilatation
of the brachial artery in depressed and non-depressed post-MI patients.

This is a single-center observational study, embedded in a large longitudinal
multi-center study examining the effects of post-MI depression on prognosis.

There may be some, relatively small, discomfort associated with the
administration of nitroglycerin, since the vasodilatation it causes, may also
cause headache. Otherwise, there is minimal risk and therefore minimal burden
associated with this study. We chose post-MI patients specifically because we
aim to examine potential mechanisms of disease in subgroups (depressed vs.
non-depressed) of this patient group.