018 The Role of Inflammatory Markers in Sleep in Individuals Post-Myocardial Infarction

Abstract

Abstract Introduction Despite positive secondary prevention strategies post myocardial infarction (MI), including statin use and lifestyle changes, 32% of the annual MIs are recurrent (MIR). As coronary heart disease is related to atherosclerosis, a chronic inflammatory process, and sleep is associated with cardiovascular disease and innate immunity, understanding the role of sleep and inflammation and MIR is important in developing interventions to improve sleep, reduce inflammation, and delay or prevent MIR. This study aimed to explore the role of sleep quality and inflammatory markers on MIRs. Methods We conducted a secondary analysis of cross-sectional data of individuals (N=156) having at least one or more MIs within the last 3 to 7 years. Using the hypothalamus-pituitary-adrenal axis model (Irwin, 2019), we tested sleep quality (Pittsburgh Sleep Quality Index [PSQI]) predicting MIR, using inflammatory markers (hs C-Reactor Protein [CRP], Interleukin-1ß [IL-1ß] and Tumor Necrosis Factor alpha [TNFα]) as the simultaneous indirect paths. Race, sex and body mass index (BMI) were also examined using moderated mediation. Results The sample ranged in age from 34 to 92 (M = 65.37, SD = 12.13), BMI averaged 31.11 (SD = 7.34), and was comprised of mostly male (57.1%) and White adults (67.9%). PSQI predicted only IL-1ß (ß= .02; p < .01). IL-1ß predicted MIR (ß = .80, p = .05). The direct effect of PSQI to MIR was not significant (p =.12), the indirect path via IL-1ß was. This relationship was not moderated by race, sex, nor BMI. Conclusion IL-1ß is an inflammatory marker elevated after acute MI which does not reflect our selected sample. Inflammation may be an important marker of risk for MIR in those with poor sleep quality. Future studies should examine other markers of inflammation and sleep in those with MIR. Support (if any):