The Role of Psychoneuroimmunological Processes in Pathogenesis of Coronary Artery Disease



Bagherian R¹ ; Andalib A² Show Affiliations
Source: Journal of Isfahan Medical School Published:2010

Abstract

It is well established that psychological factors can act as risk factors for acute coronary syndromes. While evidences indicate effects of psychological factors on immune system, the role of this system in progression of coronary artery disease and its clinical manifestations was confirmed. It seems that the relationship of psychological factors and coronary artery disease (CAD) is mediated in part by immune system parameters. The purpose of this review is to describe psychoneuroimmunological pathways involved in coronary disease progression and documents that the stage of coronary disease is a major determinant of pathophysiological mechanisms accounting for the association between psychological risk factors, immune system parameters, and acute coronary syndromes. Psychological risk factors for coronary artery disease can be classified into three categories. Chronic psychological risk factors (e.g., hostility and low socioeconomic status) are important at early disease stages, episodic factors (e.g., depression and exhaustion) are involved in the transition from stable to unstable atherosclerotic plaques, and acute psychological triggers (e.g., mental stress and anger) can promote myocardial ischemia and plaque rupture. The psychoneuroimmunological pathways are described for each of these three types of psychological risk factors for acute coronary syndromes.