Influence of Serotonin Transporter Gene Polymorphism on Depressive Symptoms and New Cardiac Events after Acute Myocardial Infarction

为了研究S等位基因是否与AMI后的抑郁症状和心脏事件相关，我们对2509名基因型AMI患者的抑郁症状和新的心脏事件进行了前瞻性研究。携带S等位基因的患者抑郁症状较不携带S等位基因的患者更为常见（48.3%比35.0%，P=0.02）。多因素分析显示，S等位基因与抑郁症状独立相关（优势比2.19;95% CI 1.21 ~ 3.98， P=0.01）。心脏事件（心源性死亡、血运重建术、心力衰竭、再梗死、心律失常和不稳定心绞痛）在携带S等位基因的患者中比不携带S等位基因的患者更频繁（31.3%比22.3%，P=-0.046）。多因素Cox回归分析显示，S等位基因与心脏事件风险增加之间存在关联(危险比（HR）， 1.69；95% CI, 1.03 ~ 2.78；P = 0.04)。然而，在调整抑郁症状后，风险比变得不显著（HR; 1.30, 95% Ch 0.84 ~ 2.01， P=0.24）。5-HTTLPR中的S等位基因与AMI后患者抑郁症状介导的后续心脏事件风险增加相关，至少部分相关。

To investigate whether the S allele was associated with depressive symptoms and cardiac events after AMI, we prospectively examined depressive symptoms and new cardiac events in 2,509 genotyped AMI patients.Depressive symptoms were more common in patients with the S allele than in those without it (48.3% vs. 35.0%, P=0.02). Multivariate analysis revealed that the S allele was independently associated with depressive symptoms (odds ratio, 2.19; 95% CI, 1.21 to 3.98, P=0.01). Cardiac events (cardiac death, revascularization, heart failure, reinfarction, arrhythmia, and unstable angina) were more frequent in patients with the S allele than in those without it (31.3% vs. 22.3%, P=-0.046). Multivariate Cox regression analysis revealed an association between the S allele and increased risk of cardiac events (hazard ratio (HR), 1.69; 95% CI, 1.03 to 2.78; P=0.04). However, the HR became unsignificant after adjustment for depressive symptoms (HR; 1.30, 95% Ch 0.84 to 2.01, P=0.24).The S allele in the 5-HTTLPR is associated with an increased risk of subsequent cardiac events which is mediated, at least in part, by the depressive symptoms in patients after AMI.