Abstract 11348: Severe Depressive Symptoms Are Associated With Elevated Endothelin-1 in Younger Patients With Acute Coronary Syndrome
Introduction: Depression increases the risk of acute coronary syndrome (ACS) and contributes to post-ACS morbidity and mortality. The pathways linking depression to poor post-ACS prognosis require further elucidation. Endothelin (ET) -1 is a potent endogenous vasoconstrictor which has been linked to adverse post-ACS outcomes in previous studies. The aim of this study was to examine the relationship of depressive symptom severity to circulating ET-1 in younger ACS patients.
Hypothesis: We assessed the hypothesis that depressive symptom severity would be positively related to ET-1 plasma level in males ≤ 50 years of age and females ≤ 55 years of age with ACS.
Methods: The subjects (n=153) were among participants of a larger longitudinal investigation on effects of genetics and depression on ACS outcomes. A blood sample furnished by patients was assayed for ET-1. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) II. ET-1 values were trasformed using a square root of logarithmic transformed ET-1 (ET-1T). BDI-II scores were classified into 4 categories using conventional thresholds demarcating the lower limits of mild, moderate and severe depressive symptoms (the scores of 14, 20 and 29, respectively). The relationship of categorized BDI-II score to ET-1T was examined in simple and multivariable linear regression models. The most parsimonious model was selected using automated stepwise selection process.
Results: Categorized BDI-II score was related to ET-1T in both unadjusted (F=3.074, p=0.030) and multivariable parsimonious (F=2.989, p=0.033) models, with ET-1T being significantly higher in patients with severe depressive symptoms (BDI-II score ≥29) than in those with minimal symptoms (BDI-II score <14). Supplementary exploratory analyses demonstrated significant interactive effect of race and categorized BDI-II score on ET-1T level (F=2.209, p=0.030).
Conclusion: In conclusion, in this sample of younger ACS patients, severe depressive symptoms were associated with elevated circulating ET-1. This link may identify a vulnerability to poor post-ACS prognosis. Longitudinal research should examine whether ET-1 mediates the relationship of depressive symptoms to long-term post-ACS outcomes.
- © 2013 by American Heart Association, Inc.