Relation of depression, natural killer cell function, and infections after coronary artery bypass in women.
BACKGROUND
After hospital discharge for coronary artery bypass grafting (CABG), infection is a common cause of morbidity. Although depression has been associated with immune dysfunction, its role in post-CABG infection is unknown.


OBJECTIVE
The purpose of this study was to: 1) compare natural killer cell cytotoxicity (NKCC) and post-hospitalization infections in depressed and non-depressed women after CABG; and 2) test whether NKCC mediated the relationship between post-discharge depression and infections.


METHODS
Sixty-seven women recovering from CABG were assessed for depression prior to hospital discharge and followed for six months. Major depression was identified by a structured clinical interview. Infections were identified by patient report using the Modified Health Review and by medical chart audit.


RESULTS
Compared to non-depressed women after CABG, women with major depression had reduced NKCC, more all-cause infections, and more self-reported illnesses. Although NKCC did not mediate the relationship between depression and wound (i.e. incisional) infections after CABG, it did mediate the relationship between depression and non-wound infections, including pneumonias and upper respiratory infections.


CONCLUSIONS
For the first six months after CABG, women with major depression are at increased risk for infections. Natural killer cell cytotoxicity may be related to this phenomenon, particularly to non-wound infections.
Doering
Lynn V
LV
UCLA School of Nursing, Los Angeles, CA 90095-6918, United States. ldoering@sonnet.ucla.edu
Martínez-Maza
Otoniel
O
Vredevoe
Donna L
DL
Cowan
Marie J
MJ
D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000523:psychology; D003863:Depression / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007239:Infections / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D007694:Killer Cells, Natural / Q000276:immunology*; D016014:Linear Models; D008137:Longitudinal Studies; D008609:Mental Status Schedule; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016387:Women's Health
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