Abstract 10953: Endothelial Dysfunction in Patients With Acute Myocardial Infarction and Major Depressive Disorder
Background: Major depressive disorder (MDD) has been associated with a high cardiovascular morbidity and mortality; however the pathophysiological mechanisms responsible for this association have not been elucidated. The aim of this study was to assess whether MDD was related with vascular endothelial dysfunction in patients with acute myocardial infarction (AMI).
Methods: A cross-sectional study including 156 patients (116 men, 40 women) with acute myocardial infarction (AMI) was performed. A blood sample was collected before hospital discharge for C-reactive protein (CRP), IL-1, TNF-α and plasma nitrites/nitrates determination. In addition a brachial flow mediated vasodilation (FMD), a measure of endothelial function, and a structured clinical interview for MDD diagnosis were performed.
Results: Mean age of included subjects was 64±11.5 years. Twenty subjects (13.3%) were diagnosed with MDD. Subjects with MDD presented a lower FMD (3.5±2.04 % vs 6.1±3.4 %, p=0,02) and higher CRP values (160.2 ± 61.2 mg/L vs 72.9 ± 93.6 mg/L, p=0.02) compared to subjects without mood disorders. There were no differences in IL1 (3.5 ± 4.3 pg/ml vs 3.2 ± 2.8 pg/ml, p=0.77 ), TNF-α (5.7 ± 7.1 vs 2.9 ± 2.8, p=0.18), or nitrites/nitrates (0.23 ± 0.06 μmol/L vs 0.29 ± 0.13 μmol/L, p=0.3) concentrations. The association between MDD and high FMD values remained after adjusting by sociodemographic, biochemical, and physiological covariates.
Discussion: T his study presents evidence about a relationship between impaired FMD and depressive symptomatology in AMI patients. This and previous data suggest that the increased risk of new cardiovascular events in depressed patients with AMI could be mediated by endothelial dysfunction. (Colciencias support: 656649326174).
- © 2013 by American Heart Association, Inc.