Mommersteeg Paula M C, Meeuwis Stefanie H, Denollet Johan, Widdershoven Jos W, Aarnoudse Wilbert, Westerhuis Bert L W J J M, Kop Willem Johan
CoRPS - Center of Research on Psychology in Somatic Diseases, P.O. Box 90153, 5000 LE Tilburg, Tilburg University, The Netherlands.
CoRPS - Center of Research on Psychology in Somatic Diseases, P.O. Box 90153, 5000 LE Tilburg, Tilburg University, The Netherlands.
J Psychosom Res. 2014 Nov;77(5):426-9. doi: 10.1016/j.jpsychores.2014.09.020. Epub 2014 Oct 2.
The majority of acute coronary syndromes occur in the absence of obstructive coronary artery disease (CAD), and the underlying biobehavioral processes are not well understood. Depressive symptoms and anxiety are predictive of prognosis, and have been associated with markers of inflammation that play a role in atherosclerosis. This study examines whether depressive symptoms and anxiety are associated with higher levels of high-sensitive C-reactive protein (hs-CRP) and fibrinogen in patients with non-obstructive CAD.
Patients with non-obstructive CAD ("wall irregularities", stenosis<60%, N=414, mean age 62.1 ± 9.3 years, 52% women) in the TweeSteden Mild Stenosis (TWIST) observational cohort study completed the Hospital Anxiety and Depression Scale (HADS). Blood samples were analyzed for hs-CRP and fibrinogen. The cross-sectional association of anxiety and depressive symptoms with hs-CRP and fibrinogen, adjusting for covariates, was examined by multivariate regression analysis.
Depressive symptoms were positively associated with hs-CRP level (β=.135, p=.009), but not fibrinogen (β=.075, p=.153), adjusted for age and sex. Additional adjustments for sociodemographic, disease severity and lifestyle factors rendered the association non-significant. In the fully adjusted model, depressive symptoms were not associated with hs-CRP (β=.036, p>0.10) and BMI was the only variable that was independently associated with hs-CRP (β=.203, p<.001). No associations were observed for anxiety with either hs-CRP or fibrinogen (p>0.10).
Among patients with non-obstructive CAD, depressive symptoms and anxiety were not independently associated with hs-CRP and fibrinogen.
大多数急性冠脉综合征发生在无阻塞性冠状动脉疾病（CAD）的情况下，其潜在的生物行为过程尚未完全明确。抑郁症状和焦虑可预测预后，且与在动脉粥样硬化中起作用的炎症标志物有关。本研究旨在探讨在非阻塞性CAD患者中，抑郁症状和焦虑是否与高敏C反应蛋白（hs-CRP）和纤维蛋白原水平升高相关。
在特温斯特登轻度狭窄（TWIST）观察性队列研究中，非阻塞性CAD（“血管壁不规则”，狭窄<60%，N = 414，平均年龄62.1±9.3岁，52%为女性）患者完成医院焦虑抑郁量表（HADS）。对血样进行hs-CRP和纤维蛋白原分析。通过多变量回归分析检验焦虑和抑郁症状与hs-CRP和纤维蛋白原的横断面关联，并对协变量进行调整。
调整年龄和性别后，抑郁症状与hs-CRP水平呈正相关（β = 0.135，p = 0.009），但与纤维蛋白原无关（β = 0.075，p = 0.153）。进一步对社会人口统计学、疾病严重程度和生活方式因素进行调整后，该关联无统计学意义。在完全调整模型中，抑郁症状与hs-CRP无关（β = 0.036，p>0.10），且BMI是唯一与hs-CRP独立相关的变量（β = 0.203，p<0.001）。未观察到焦虑与hs-CRP或纤维蛋白原有关联（p>0.10）。
在非阻塞性CAD患者中，抑郁症状和焦虑与hs-CRP和纤维蛋白原无独立关联。
