Abstract：
Background: Elevated levels of C-reactive protein (CRP) are associated with both an increased risk of cardiovascular disease (CVD) and depression. We aimed to test the hypothesis that a self-report history of depression is associated with a smaller decrease in CRP levels from hospital admission to 3-month follow-up in patients with acute myocardial infarction (MI). Methods: We assessed 183 patients (median age 59 years; 84% men) with verified MI for a self-report history of lifetime depression and plasma CRP levels within 48 h of an acute coronary intervention and again for CRP levels at three months. CRP values were categorized according to their potential to predict CVD risk at hospital admission (acute inflammatory response: 0 to <5 mg/L, 5 to <10 mg/L, 10 to <20 mg/L, and ≥20 mg/L) and at 3 months (low-grade inflammation: 0 to <1 mg/L, 1 to <3 mg/L, and ≥3 mg/L). Additionally, in a subsample of 84 patients showing admission CRP levels below 20 mg/L, changes in continuous CRP values over time were also analyzed. Results: After adjustment for a range of potentially important covariates, depression history showed a significant association with a smaller decrease in both CRP risk categories (r = 0.261, p < 0.001) and log CRP levels (r = 0.340, p = 0.005) over time. Conclusions: Self-reported history of depression may be associated with persistently elevated systemic inflammation three months after MI. This finding warrants studies to test whether lowering of inflammation in patients with an acute MI and a history of depression may improve prognosis.
摘要：
背景：C反应蛋白（CRP）水平升高与心血管疾病（CVD）和抑郁症的风险增加有关。我们旨在检验以下假设：从入院到3个月随访，急性心肌梗死（MI）患者的自我报告抑郁症史与CRP水平下降幅度较小有关。方法：我们评估了183例确诊MI患者（中位年龄59岁；84％为男性）在急性冠状动脉介入治疗后48小时内的自我报告抑郁史和血浆CRP水平，并在3个月时再次评估CRP水平。CRP值根据其预测入院时CVD风险的潜力进行分类（急性炎症反应：0至<5mg/L，5至<10mg/L，10至<20mg/L，≥20mg/L）和3个月时（低度炎症：0至<1mg/L，1至<3mg/L，且≥3mg/L)。此外,在84名入院CRP水平低于20mg/L的患者的子样本中，同时分析了连续CRP值随时间的变化.结果：在调整了一系列潜在重要的协变量后，抑郁症病史显示,随着时间的推移,两种CRP风险类别(r=0.261,p<0.001)和logCRP水平(r=0.340,p=0.005)均有较小的下降.结论：自我报告的抑郁症史可能与MI后三个月持续升高的全身炎症有关。这一发现值得研究以测试急性MI和抑郁症史患者的炎症降低是否可以改善预后。
