Association of Somatic and Cognitive Depressive Symptoms and Biomarkers in Acute Myocardial Infarction: Insights from the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status Registry

• Type of Material: Article
• Authors: Kim G. Smolderen, Saint Luke's Mid America Heart and Vascular Institute; John A. Spertus, Saint Luke's Mid America Heart and Vascular Institute; Kimberly J. Reid, Saint Luke's Mid America Heart and Vascular Institute; Donna M. Buchanan, Saint Luke's Mid America Heart and Vascular Institute; Viola Vaccarino, Emory University; Judith H. Lichtman, Yale University; David B. Bekelman, Denver VA Medical Center; Paul S. Chan, Saint Luke's Mid America Heart and Vascular Institute
• Language: English
• Date: 2012-01-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Society of Biological Psychiatry.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.biopsych.2011.07.029
• Title of Journal or Parent Work: Biological Psychiatry
• ISSN: 0006-3223
• Volume: 71
• Issue: 1
• Start Page: 22
• End Page: 29
• Grant/Funding Information: Grant support was received from the National Heart, Lung, and Blood Institute Specialized Center of Clinically Oriented Research in Cardiac Dysfunction and Disease (grant no. P50 HL077113) and CV Therapeutics, Palo Alto, California.; Dr. Smolderen was supported by the Outcomes Research post-doctoral fellowship awarded by the American Heart Association Pharmaceutical Roundtable and David and Stevie Spina [grant no. AHA: 0875149N] and by the Netherlands Organization for Scientific Research [VENI grant no.: 916.11.179].
• Keywords: myocardial infarction; Neurosciences & Neurology; Neurosciences; inflammation; Life Sciences & Biomedicine; depressive symptoms; N-TERMINAL PROATRIAL; neurohormones; mechanisms; INFLAMMATORY BIOMARKERS; HEART-RATE-VARIABILITY; PROGNOSIS; SICKNESS BEHAVIOR; CARDIOVASCULAR-DISEASE; ACUTE CORONARY SYNDROMES; BRAIN NATRIURETIC PEPTIDE; Coagulation; Psychiatry; Science & Technology; C-REACTIVE PROTEIN; NATIONAL-HEART
• Research Categories: Biology, Neuroscience; Psychology, Physiological

Abstract

Background: Somatic depressive symptoms and certain biomarkers are each associated with worse acute myocardial infarction (AMI) prognosis, but the relationship between depressive symptom domains and inflammatory, neurohormonal, and coagulation markers is unknown. Methods: We examined the relationship between depressive symptoms and 1-month biomarker levels (high-sensitivity C-reactive protein [hs-CRP], N-terminal pro-brain natriuretic peptide [NT-proBNP], white blood cell [WBC], platelet counts) in 1265 AMI patients. Depressive symptoms (9-item Patient Health Questionnaire) were assessed during index hospitalization and categorized as somatic or cognitive. Using median regression models, the upper quartile of somatic and cognitive depression scores and each biomarker were compared with the lower three quartiles, adjusting for site, demographics, and clinical characteristics. Results: Although hs-CRP values were higher in patients with somatic symptoms, this association was attenuated after adjustment (B per SD increase =.02, 95% confidence interval:.00;.05, p =.07). WBC count was independently associated with somatic depressive symptoms (B per SD increase =.28, 95% confidence interval:.12;.44, p <.001). Cognitive depressive symptoms were not associated with hs-CRP or WBC count. Neither dimension was associated with NT-proBNP or platelet levels. For each biomarker, the depression dimensions explained <1% of their variation. Conclusions: Neither somatic nor cognitive depressive symptoms were meaningfully associated with hs-CRP, NT-proBNP, WBC, or platelet counts 1 month after AMI, suggesting that the association between depression and long-term outcomes may be unrelated to these biomarkers. Future research should explore other biomarkers to better illuminate pathways by which depression adversely impacts AMI prognosis.