Mental Disorders as a Risk Factor of Acute Coronary Syndrome

Mental disorders have been associated with traditional cardiovascular risk factors that may mediate the risk of acute coronary syndrome (ACS).

To estimate the association of ACS among patients with mental disorders, as compared with patients without mental disorders. Data Sources: MEDLINE, Embase, and PubMed were searched for studies between July 1, 2025, and date of database inception. Study Selection: Study screening was performed in duplicates with conflicts resolved upon consensus. Inclusion criteria were as follows: (1) observational or randomized study, (2) measured association with ACS (incident events, risk ratio, odds ratio, hazard ratio [HR]), and (3) investigated any clinical mental disorder (based on DSM and International Classification of Diseases) before ACS events. Data Extraction and Synthesis: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Data extraction was performed in duplicate and resolved on consensus. Data were quantitatively synthesized through random-effects meta-analysis. The National Institutes of Health Study Quality Assessment Tools were used to assess the quality of included studies. Studies were analyzed from January 1966 to October 2021. Main Outcomes and Measures: Association and/or risk of ACS.