Effects of Gender-Specific Differences, Inflammatory Response, and Genetic Variation on the Associations Among Depressive Symptoms and the Risk of Major Adverse Coronary Events in Patients With Acute Coronary Syndrome.

TitleEffects of Gender-Specific Differences, Inflammatory Response, and Genetic Variation on the Associations Among Depressive Symptoms and the Risk of Major Adverse Coronary Events in Patients With Acute Coronary Syndrome.
Publication TypeJournal Article
Year of Publication2018
AuthorsSanner, J, Grove, ML, Yu, E, F Moeller, G, Cron, SG, Boerwinkle, E, Morrison, AC, Frazier, L
JournalBiol Res Nurs
Date Published2018 03
KeywordsAcute Coronary Syndrome, Aged, Depression, Female, Genetic Variation, Humans, Inflammation, Male, Middle Aged, Prospective Studies, Risk Assessment, Sex Factors

Depressive symptoms independently contribute to major adverse coronary events (MACEs), with the biological immune response to depression being a likely mediator of this relationship. To determine whether genetic- and/or gender-specific phenotypic differences contribute to associations among depressive symptoms, inflammatory response, and risk of MACE in patients with acute coronary syndrome (ACS), we conducted a prospective study of 1,117 ACS patients to test a gender-specific model in which depressive symptoms (Beck Depression Inventory-II [BDI-II]) are associated with risk of MACE. Cox proportional hazards models were used to model time to incident MACE and determine whether single-nucleotide polymorphisms (SNPs) in specific inflammatory protein-coding genes and depressive symptoms interact to influence levels of inflammatory proteins or risk of MACE. Females had significantly higher high-sensitivity C-reactive protein and monocyte chemoattractant protein-1 levels. Depression status differed by gender (29.9% of females and 21.1% of males had BDI-II scores indicative of depression [ p = .0014]). Depressive symptoms were associated with MACE; however, the interaction between these symptoms and gender was not significant. SNPs and depressive symptoms did not interact to influence inflammation or MACE. More females than males had BDI-II scores indicative of depression, yet the association between positive depressive symptom status and MACE did not vary by gender. Nor did the SNPs interact with depressive symptoms to influence inflammation or MACE. It remains of interest to identify a high-risk subgroup of ACS patients with genetic polymorphisms that result in immunoinflammatory dysregulation in the presence of depressive symptoms.

Alternate JournalBiol Res Nurs
PubMed ID29298497
PubMed Central IDPMC5942525
Grant ListR01 NR010235 / NR / NINR NIH HHS / United States
UL1 TR000371 / TR / NCATS NIH HHS / United States

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