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

Abstract：

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.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Frasure-Smith N,Lespérance F,Irwin MR,Sauvé C,Lespérance J,Théroux P

doi

10.1016/j.biopsych.2006.09.029

subject

Has Abstract

pub_date

2007-08-15 00:00:00

pages

302-8

issue

4

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(06)01216-9

journal_volume

62

pub_type

杂志文章,多中心研究

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