Abstract 1135: Somatic and Cognitive Depressive Symptoms and hs-C Reactive Protein in Acute MI: Insights From the TRIUMPH Registry
Objectives: Both depression and inflammation adversely influence cardiovascular prognosis in acute myocardial infarction (AMI) patients. New evidence has linked somatic, but not cognitive, depressive symptoms to worse outcomes. We hypothesized that somatic, but not cognitive depressive symptoms, are positively associated with inflammation, as measured by high sensitivity C reactive protein (hs-CRP) after AMI.
Methods: In the multi-site Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients’ Health Status (TRIUMPH) study, baseline depressive symptoms (8-item Patient Health Questionnaire) and baseline hs-CRP levels (median time from AMI admission to blood draw of 3 days; interquartile range [IQR]: 2; 4) were available in 2,381 patients. The association between baseline somatic and cognitive depressive symptoms with baseline hs-CRP levels was evaluated using hierarchical linear models, which adjusted for enrollment site, severity of AMI, socio-demographics, comorbidities, and medication use.
Results: The median baseline hs-CRP (mg/L) for the cohort was 1.9 (IQR: 0.7; 4.4). In unadjusted linear correlation models, somatic depressive symptoms were positively associated with baseline hs-CRP (β=0.28 per standard deviation increase, 95% confidence interval [CI]: 0.01; 0.54, p=0.04), whereas cognitive symptoms were not (β=−0.05, 95%CI: −0.33; 0.22, p=0.69). After adjustment, the association between somatic symptoms and higher baseline hs-CRP levels persisted (β=0.35, 95%CI: 0.07; 0.62, p=.01).
Conclusions: We confirm that somatic, but not cognitive, depressive symptoms are positively associated with inflammation as measured by hs-CRP levels during the index AMI hospitalization. The relationship between somatic depressive symptoms, inflammation and adverse AMI prognosis warrants further testing.