The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes
The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes
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DOI：
10.1176/appi.ajp.161.2.271
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发表时间：
2004-02-01
影响因子：
17.7
通讯作者：
Irwin, M
中科院分区：
文献类型：
--
作者：
Lespérance, F;Frasure-Smith, N;Irwin, M
目的：本研究旨在确定抑郁症是否与急性冠脉综合征恢复期患者炎症标志物水平升高相关。方法：测定了 481 名急性冠脉综合征患者住院 2 个月后的血浆可溶性细胞间粘附分子 1 (sICAY-1) 和白细胞介素 6 (IL-6) 水平以及血清 C 反应蛋白水平。重度抑郁症的诊断基于 DSM-IV 的结构化临床访谈。结果：抑郁症患者的 sICAM-1 水平显着升高，在调整潜在混杂因素（性别、吸烟、是否存在代谢综合征）后，这一差异仍然显着。尽管抑郁症和 IL-6 之间没有显着关联，但抑郁症和他汀类药物治疗之间的 C 反应蛋白水平存在相互作用。未服用他汀类药物的抑郁症患者的 C 反应蛋白水平明显高于非抑郁症患者。接受他汀类药物治疗的患者与抑郁症没有关系。结论。这些结果表明，急性冠脉综合征后抑郁症患者的内皮细胞会出现慢性激活。需要进一步的研究来确定较高水平的 sICAM-1 是否可以在患有冠状动脉疾病的患者或既往没有冠状动脉疾病的患者中识别出心脏事件风险特别高的抑郁症患者亚组。
Objective: This study was conducted to determine whether or not depression is associated with higher levels of inflammatory markers in patients recovering from acute coronary syndromes.Method: Plasma levels of soluble intercellular adhesion molecule 1 (sICAY-1) and interleukin-6 (IL-6) and the serum level of C-reactive protein were measured in 481 patients 2 months after hospitalization for acute coronary syndromes. Diagnosis of major depression was based on the Structured Clinical Interview for DSM-IV.Results: Depressed patients showed significantly higher sICAM-1 levels, a difference that remained significant after adjustment for potential confounders (gender, smoking, presence of metabolic syndrome). Although there was no significant association between depression and IL-6, there was an interaction between depression and statin therapy for levels of C-reactive protein. Depressed patients not taking statins had markedly higher C-reactive protein levels than did nondepressed patients. There was no relationship with depression in those receiving statins.Conclusions. These results suggest chronic endothelial activation among depressed patients after acute coronary syndromes. Further research is needed to determine whether or not higher levels of sICAM-1 may identify a subgroup of depressed patients at particularly high risk for cardiac events among patients with established coronary artery disease or among those without previous coronary artery disease.