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

• Published in: The American journal of psychiatry 2004-02, Vol.161 (2), p.271-277
• Main Authors: Lespérance, François, Frasure-Smith, Nancy, Théroux, Pierre, Irwin, Michael
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Biological and medical sciences; Body Mass Index; C-Reactive Protein - metabolism; Comorbidity; Coronary Disease - blood; Coronary Disease - epidemiology; Coronary vessels; Depression; Depressive Disorder, Major - blood; Depressive Disorder, Major - epidemiology; Disease; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - blood; Intercellular Adhesion Molecule-1 - blood; Interleukin-6 - blood; Male; Medical sciences; Mental depression; Middle Aged; Mood disorders; Obesity - epidemiology; Other diseases. Semiology; Patients; Prevalence; Proteins; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.161.2.271

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 (sICAM-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.