Depression, C-reactive protein and two-year major adverse cardiac events in men after acute coronary syndromes.

TitleDepression, C-reactive protein and two-year major adverse cardiac events in men after acute coronary syndromes.
Publication TypeJournal Article
Year of Publication2007
AuthorsFrasure-Smith N, Lespérance F, Irwin MR, Sauvé C, Lespérance J, Théroux P
JournalBiol Psychiatry
Date Published2007 Aug 15
KeywordsAdult, Aged, Aged, 80 and over, Angina, Unstable, Biomarkers, C-Reactive Protein, Chi-Square Distribution, Depressive Disorder, Female, Follow-Up Studies, Humans, Inflammation Mediators, Interleukin-6, Male, Middle Aged, Myocardial Infarction, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Factors

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 > or =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 > or = 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 > or =14 and CRP of > or =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.

Alternate JournalBiol. Psychiatry
PubMed ID17210140