Published online before print May 2, 2005, doi: 10.1161/01.CIR.0000164203.54111.AE
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(Circulation. 2005;111:2299-2305.)
© 2005 American Heart Association, Inc.
Epidemiology |
Contributions of Depressive Mood and Circulating Inflammatory Markers to Coronary Heart Disease in Healthy European Men
The Prospective Epidemiological Study of Myocardial Infarction (PRIME)
From INSERM Avenir, Epidemiology of Sudden Death in the Population, Villejuif, France (J.P.E., X.J.); France MONICA Project Coordinating Centre, INSERM U258, Paul Brousse Hospital, Villejuif, France (J.P.E., A.B., X.J., P.D.); School of Psychology (D.H.S.) and Department of Epidemiology and Public Health (A.E.), Queen’s University, Belfast, Northern Ireland; Queen’s University, Belfast, Northern Ireland (D.H.S.); Department of Atherosclerosis, SERLIA-INSERM UR325, Institut Pasteur de Lille, Lille, France (G.L.); Department of Hematology, Faculty of Medicine, INSERM U626, Marseilles, France (I.J.-V.); Strasbourg MONICA Project, Department of Epidemiology and Public Health, Faculty of Medicine, Strasbourg, France (D.A., B.H.); Toulouse MONICA Project, INSERM U558, Purpan University, Toulouse, France (J.F., J.B.R.); Lille MONICA Project, INSERM U508, Institut Pasteur de Lille, Lille, France (P.A., M.M.); and Department of Cardiology, European Hospital G Pompidou, Paris, France (X.J.).
Correspondence to Dr J.P. Empana, INSERM Avenir-U258, Hopital Paul Brousse, 16 Av Paul Vaillant Couturier, 94807 Villejuif Cedex, France. E-mail empana{at}vjf.inserm.fr
Received June 29, 2004; revision received January 3, 2005; accepted January 25, 2005.
Background— Data on the possible association between depressive disorders and inflammatory markers are scarce and inconsistent. We investigated whether subjects with depressive mood had higher levels of a wide range of inflammatory markers involved in coronary heart disease (CHD) incidence and examined the contribution of these inflammatory markers and depressive mood to CHD outcome.
Methods and Results— We built a nested case-referent study within the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study of healthy middle-aged men from Belfast and France. We considered the baseline plasma sample from 335 future cases (angina pectoris, nonfatal myocardial infarction, coronary death) and 670 matched controls (2 controls per case). Depressive mood characterized men whose baseline depression score (13-item modification of the Welsh depression subscale) was in the fourth quartile (mean score, 5.75; range, 4 to 12). On average, men with depressive mood had 46%, 16%, and 10% higher C-reactive protein, interleukin-6, and intercellular adhesion molecule-1 levels, respectively, independently of case-control status, social characteristics, and classic cardiovascular risk factors; no statistical difference was found for fibrinogen. The odds ratios of depressive mood for CHD were 1.35 (95% CI, 1.05 to 1.73) in univariate analysis and 1.50 (95% CI, 1.04 to 2.15) after adjustment for social characteristics and classic cardiovascular risk factors. The latter odds ratio remained unchanged when each inflammatory marker was added separately, and in this analysis, each inflammatory marker contributed significantly to CHD event risk.
Conclusions— These data support an association of depressive mood with inflammatory markers and suggest that depressive mood is related to CHD even after adjustment for these inflammatory markers.
Key Words: coronary disease • depressive disorder • epidemiology • inflammation • risk factors
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Circulation 2005 111: 2275.
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