{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:57:44Z","timestamp":1785430664910,"version":"3.56.0"},"reference-count":78,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea, Oradea, Romania"},{"id":[{"id":"https:\/\/ror.org\/00wzhv093","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Depression is a frequent but underrecognized comorbidity in ST-segment elevation myocardial infarction (STEMI) and is associated with adverse cardiovascular outcomes. The interplay between pre-existing depression, systemic inflammation, and major adverse cardiovascular and cerebrovascular events (MACCE) in STEMI remains insufficiently explored. This study aimed to investigate this interplay in a cohort of patients with STEMI. Methods: This retrospective observational cohort study included 292 consecutive patients with STEMI admitted between September 2023 and September 2024. Depression was identified through pre-existing psychiatric diagnoses. Inflammatory markers (C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII)) and echocardiographic parameters, including left ventricular ejection fraction (LVEF), were collected at baseline and 12-month follow-up. In-hospital and 12-month MACCE were defined as composite endpoints. Results: Depression was present in 21.2% of patients. Patients with depression exhibited significantly higher CRP, NLR, SII, 48-h troponin levels, no-reflow incidence, and longer hospitalization. In-hospital MACCE occurred in 24.2% versus 11.7% of patients (p = 0.014), driven mainly by recurrent myocardial infarction, with a trend toward severe heart failure. At 12 months, MACCE occurred in 53.22% of patients with depression versus 23.5% of patients without (p &lt; 0.001). Independent predictors of 12-month MACCE included depression (OR 3.35), baseline SII (OR 4.89 per 1000 units), baseline CRP (OR 1.48 per 10 mg\/L), and 12-month LVEF (OR 0.69 per 5% increase). No significant interaction was observed between depression and inflammatory or functional parameters. Conclusions: Pre-existing depression was independently associated with increased in-hospital and 12-month MACCE risk in patients with STEMI. Future prospective studies should assess whether treating depression improves long-term STEMI outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics16142178","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:55:21Z","timestamp":1783990521000},"page":"2178","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Hidden Burden of Depression in STEMI: Effects on Early Complications and 12-Month MACCE"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2982-2387","authenticated-orcid":false,"given":"Alexandra","family":"Herla\u0219-Pop","sequence":"first","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-8177","authenticated-orcid":false,"given":"Andrei-Flavius","family":"Radu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Radu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela S.","family":"Bungau","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-6592","authenticated-orcid":false,"given":"Delia Mirela","family":"Tit","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8674-0839","authenticated-orcid":false,"given":"Ana Marina","family":"Marian","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bihor County Clinical Emergency Hospital, 65 Gheorghe Doja Street, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Vlad","family":"Babe\u015f","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bihor County Clinical Emergency Hospital, 65 Gheorghe Doja Street, 410169 Oradea, Romania"},{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7514-172X","authenticated-orcid":false,"given":"Elena Emilia","family":"Babes","sequence":"additional","affiliation":[{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Cardiology Department, Bihor County Clinical Emergency Hospital, 65 Gheorghe Doja Street, 410169 Oradea, Romania"},{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the Management of Acute Coronary Syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. 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