Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder
Abstract
Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusions: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512]References
Mohseni J, Kazemi T, Maleki M, Beydokhti H. A systematic review on the prevalence of acute myocardial infarction in Iran. Heart Views. 2017;18(4):125.
https://doi.org/10.4103/HEARTVIEWS.HEARTVIEWS_71_17
PMid:29326775 PMCid:PMC5755193
Douglas LM. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th edition.
Kazemi T, Sharifzadeh GH, Hosseinaii F. Epidemiology of trend of acute myocardial infraction in Birjand between 2002-2006 years. IJE. 2009;4(3):35-41.
Ahmadi A, Soori H, Mehrabi Y, Etemad K, Khaledifar A. Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry. Kardiol Pol. 2015;73(6):451-7.
https://doi.org/10.5603/KP.a2014.0230
PMid:25428813
Sajjadi H, Nasri H, Mehrabi Y, Etemad K, Ahmadi A, Soori H. Current status of the clinical epidemiology of myocardial infarction in men and women: A national cross-sectional study in Iran. Int J Prev Med. 2015;6(1):14.
https://doi.org/10.4103/2008-7802.151822
PMid:25789146 PMCid:PMC4362287
Kessler RC, Bromet EJ. The Epidemiology of Depression Across Cultures. Annu Rev Public Health. 2013;34(1):119-38.
https://doi.org/10.1146/annurev-publhealth-031912-114409
PMid:23514317 PMCid:PMC4100461
Watkins LL, Schneiderman N, Blumenthal JA, Sheps DS, Catellier D, Taylor CB, et al. Cognitive and somatic symptoms of depression are associated with medical comorbidity in patients after acute myocardial infarction. Am Heart J. 2003;146(1):48-54.
https://doi.org/10.1016/S0002-8703(03)00083-8
Zheng X, Zheng Y, Ma J, Zhang M, Zhang Y, Liu X, Chen L, Yang Q, Sun Y, Wu J, Yu B. Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: a systematic review and meta-analysis. Heart & Lung. 2019;48(1):1-7.
https://doi.org/10.1016/j.hrtlng.2018.09.011
PMid:30366575
Serpytis P, Navickas P, Lukaviciute L, Navickas A, Aranauskas R, Serpytis R, Deksnyte A, Glaveckaite S, Petrulioniene Z, Samalavicius R. Gender-based differences in anxiety and depression following acute myocardial infarction. Arq Bras Cardiol. 2018;111(5):676-83.
https://doi.org/10.5935/abc.20180161
PMid:30156607 PMCid:PMC6248233
Bagherian R, Maroofi M, Gol MF, Zare F. Prevalence of anxiety, depression and coping styles in myocardial infarction patients hospitalized in Isfahan hospitals. J Mazandaran Uni Med Sci. 2010;20(77):36-45.
Araste M. Comparison of the prevalence and intensity of depression in patients admitted after acute coronary syndrome and patient with cataract. J Fundam Ment Health. 2008;10(38):141-8.
De Jonge P. Depression after myocardial infarction is a risk factor for declining health related quality of life and increased disability and cardiac complaints at 12 months. Heart. 2006;92(1):32-9.
https://doi.org/10.1136/hrt.2004.059451
PMid:15890765 PMCid:PMC1860990
Rosenson RS, Koenig W. Utility of inflammatory markers in the management of coronary artery disease. Am J Cardiol. 2003;92(1):10-8.
https://doi.org/10.1016/S0002-9149(03)00504-6
Janszky I, Lekander M, Blom M, Georgiades A, Ahnve S. Self-rated health and vital exhaustion, but not depression, is related to inflammation in women with coronary heart disease. Brain Behav Immun. 2005 ;19(6):555-63.
https://doi.org/10.1016/j.bbi.2005.01.001
PMid:16214026
Bahramali E, Askari A, Zakeri H, Farjam M, Dehghan A, Zendehdel K. Fasa Registry on Acute Myocardial Infarction (FaRMI): Feasibility Study and Pilot Phase Results. Lazzeri C, editor. PLOS ONE. 2016;11(12):e0167579.
https://doi.org/10.1371/journal.pone.0167579
PMid:27907128 PMCid:PMC5132161
Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, Lisheng L, Writing group on behalf of the participating experts of the WHO consultation for revision of WHO definition of myocardial infarction. World Health Organization definition of myocardial infarction: 2008-09 revision. Int J Epidemiol. 2011;40(1):139-46.
https://doi.org/10.1093/ije/dyq165
PMid:20926369
Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian‐language version of the Beck Depression Inventory‐Second edition: BDI‐II‐PERSIAN. Depression and anxiety. 2005;21(4):185-92.
https://doi.org/10.1002/da.20070
PMid:16075452
Larsen KK. Depression following myocardial infarction--an overseen complication with prognostic importance. Dan Med J. 2013;60(8): 4689.
Poole L, Dickens C, Steptoe A. The puzzle of depression and acute coronary syndrome: reviewing the role of acute inflammation. J Psychosom Res. 2011;71(2):61-8.
https://doi.org/10.1016/j.jpsychores.2010.12.009
PMid:21767684 PMCid:PMC3143279
De Martino RR, Eldrup-Jorgensen J, Nolan BW, Stone DH, Adams J, Bertges DJ, Cronenwett JL, Goodney PP, Vascular Study Group of New England. Perioperative management with antiplatelet and statin medication is associated with reduced mortality following vascular surgery. J Vasc Surg. 2014;59(6):1615-21.
https://doi.org/10.1016/j.jvs.2013.12.013
PMid:24439325 PMCid:PMC4279233
Cubero-Gallego H, Romaguera R, Ariza-Sole A, Gómez-Hospital JA, Cequier A. Revascularization strategies in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease: urgent or staged?. Cardiovasc Diagn The. 2017;7(2):82.
https://doi.org/10.21037/cdt.2017.01.15
PMid:28748154 PMCid:PMC5509925
Goldstein CM, Gathright EC, Garcia S. Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team. Patient Prefer Adherence. 2017;11:547.
https://doi.org/10.2147/PPA.S127277
PMid:28352161 PMCid:PMC5359120
Dhar AK, Barton DA. Depression and the link with cardiovascular disease. Frontiers in psychiatry. 2016;7:33.
https://doi.org/10.3389/fpsyt.2016.00033
PMid:27047396 PMCid:PMC4800172
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