The relationship between depressive symptom severity and circulating level of endothelin-1 in males ≤ 50 years of age and females ≤ 55 years of age with ACS
Background 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.^ Aim To examine the relationship of depressive symptom severity to circulating ET-1 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 interactive 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 was treated as a transformed continuous variable (ET-1T = log10 1+ET-1 ). BDI-II scores were classified into four categories using conventional thresholds demarcating the lower limits of mild, moderate, and severe levels of 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/ethnicity and categorized BDI-II score on ET-1T level (F=2.209, p=0.030). ^ Conclusions 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. ^
Health Sciences, Mental Health|Psychology, Psychobiology|Health Sciences, General
Yammine, Luba, "The relationship between depressive symptom severity and circulating level of endothelin-1 in males ≤ 50 years of age and females ≤ 55 years of age with ACS" (2013). Texas Medical Center Dissertations (via ProQuest). AAI3574407.