Background
We investigated the impact of depression and inflammatory markers, assessed 2 months
after acute coronary syndrome (ACS), on major adverse cardiac events over 2 years
(MACEs; cardiac death, survived myocardial infarction, survived cardiac arrest, and
nonelective revascularization).
Methods
Depression symptoms (Beck Depression Inventory-II; BDI-II), major depression, C-reactive
protein (CRP), interleukin-6, and soluble intercellular adhesion molecule were assessed
in 741 ACS patients (including 602 men).
Results
Some 102 (78 men) experienced at least one MACE. Beck Depression Inventory-II scores
of ≥14 predicted MACEs (p = .007). The increase in risk was marked in men (hazard ratio [HR] = 1.96, 95% confidence
interval [CI] = 1.24–3.09, p = .004), with little evidence of a relationship in women (p = .85). Subsequent analyses were limited to men. Results were similar after covariate
adjustment (HR = 1.72, 95% CI = 1.07–2.77, p = .024). C-reactive protein levels were also associated with increased MACE risk
(adjusted HR for CRP ≥ 2.0 mg/L = 1.67, 95% CI = 1.07–2.62, p = .025). C-reactive protein levels and BDI-II scores interacted in predicting MACEs.
Men with both BDI-II scores of ≥14 and CRP of ≥2.0 mg/L experienced an increase in
risk similar to those with only one of these factors.
Conclusions
In men assessed 2 months after ACS, depression and CRP are overlapping prognostic
risks. Patients with either risk may benefit from similar therapies.
Key Words
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Article info
Publication history
Published online: January 09, 2007
Accepted:
September 29,
2006
Received in revised form:
September 13,
2006
Received:
July 13,
2006
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
