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. Conclusion: 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.
Highlights
Cardiovascular diseases (CVD), mainly coronary artery disease (CAD), including acute myocardial infarction (MI), are the most common reasons for mortality worldwide and imposing economic costs in developed countries [1]
Whereas these reports seem to be exaggerated, there is no doubt that the prevalence of depression after acute MI is significantly higher than a healthy population, portending the necessity for better psychiatric care to those suffering from acute MI [11]
We aimed to look for the association between hsCRP and the prevalence of depressive mood post-MI in patients with a variety of extent of atherosclerosis in arteries, measured as the carotid intima-media thickness (CIMT)
Summary
Cardiovascular diseases (CVD), mainly coronary artery disease (CAD), including acute myocardial infarction (MI), are the most common reasons for mortality worldwide and imposing economic costs in developed countries [1]. As we know, elevated levels of proinflammatory cytokines, including C-reactive protein (CRP) and interleukin-6 (IL-6), are associated with increased CV morbidity and mortality [13] These cytokines have been linked to the pathophysiology of atherosclerosis and diseases like depression [14]. 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. 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. The prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512] DOI:10.31661/gmj.v10i0.1512
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