Kang Hee-Ju, Kim Ju-Wan, Lee Ju-Yeon, Kim Sung-Wan, Shin Il-Seon, Hong Young Joon, Ahn Youngkeun, Jeong Myung-Ho, Kim Jae-Min
Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.
Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea.
Front Psychiatry. 2021 Sep 23;12:739823. doi: 10.3389/fpsyt.2021.739823. eCollection 2021.
Considering the association of inflammation with suicide and acute coronary syndrome (ACS), we investigated the individual and interactive effects of serum tumor necrosis factor-alpha (sTNFα) levels and two polymorphisms (-850 / and -308 /) on suicidal ideation (SI) after ACS. The SI status using items on the Montgomery-Åsberg Depression Rating Scale (MADRS), related covariates including sociodemographic and clinical characteristics, sTNFα levels, and tumor necrosis factor-alpha (TNF-α) polymorphisms were evaluated in 969 patients within 2 weeks after ACS. Of the patients, 711 were evaluated 1 year later for SI. Multivariate logistic regression models were used to calculate individual and interactive associations after adjusting for the covariates. Higher (vs. lower) sTNFα levels and the -/ or (vs. C/C) polymorphism were significantly associated with SI 2 weeks after ACS, while only higher sTNFα levels were significantly associated with SI after 1 year. Significant interactive effects were detected between sTNFα (higher) levels and the - or polymorphism on SI 2 weeks after ACS and between the two (-850 or and - or ) polymorphisms on SI 1 year after ACS. The sTNFα level and two polymorphisms (-850C/ and -308 ), separately or in combination, could be time-specific biomarkers for SI in ACS. Focused interventions for ACS patients at risk of SI might reduce the suicidal burden in patients with ACS.
考虑到炎症与自杀及急性冠状动脉综合征（ACS）之间的关联，我们研究了血清肿瘤坏死因子-α（sTNFα）水平及两种多态性（-850 / 和 -308 /）对ACS后自杀意念（SI）的个体及交互作用。在969例ACS患者发病后2周内，使用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）项目评估SI状态，并评估包括社会人口统计学和临床特征、sTNFα水平以及肿瘤坏死因子-α（TNF-α）多态性在内的相关协变量。其中711例患者在1年后接受SI评估。采用多变量逻辑回归模型在调整协变量后计算个体及交互关联。较高（vs. 较低）的sTNFα水平以及 -/ 或 （vs. C/C）多态性与ACS后2周的SI显著相关，而仅较高的sTNFα水平与1年后的SI显著相关。在ACS后2周，检测到sTNFα（较高）水平与 - 或 多态性对SI有显著交互作用；在ACS后1年，检测到两种（-850 或 与 - 或 ）多态性对SI有显著交互作用。sTNFα水平及两种多态性（-850C/ 和 -308 ）单独或联合起来，可能是ACS中SI的时间特异性生物标志物。对有SI风险的ACS患者进行有针对性的干预可能会减轻ACS患者的自杀负担。
