title: Inflammatory biomarkers in patients with posttraumatic stress disorder caused by myocardial infarction and the role of depressive symptoms.
abstract: OBJECTIVE
  Inflammation might link posttraumatic stress disorder (PTSD) with an increased risk of cardiovascular events. We explored the association between PTSD and inflammatory biomarkers related to cardiovascular morbidity and the role of co-morbid depressive symptoms in this relationship.
  
  
  METHODS
  We investigated 15 patients with interviewer-rated PTSD caused by myocardial infarction (MI) and 29 post-MI patients with no PTSD. All patients completed the depression subscale of the Hospital Anxiety and Depression Scale and had blood collected to determine inflammatory markers of increased cardiovascular risk.
  
  
  RESULTS
  Controlling for demographic and medical covariates, patients with PTSD had higher leptin levels than patients with no PTSD (p = 0.038, explained variance 10.4%); this difference became nonsignificant when controlling for depressive symptoms. After controlling for depressive symptoms, PTSD patients had higher interleukin-6 (p = 0.041; explained variance 10%), lower C-reactive protein (p = 0.022, explained variance 12.1%), and lower soluble CD40 ligand (p = 0.016, explained variance 13.4%) than patients without PTSD. After controlling for PTSD status, depressive symptoms correlated with soluble CD40 ligand (r = 0.45, p = 0.002) and with C-reactive protein (r = 0.29, p < 0.07).
  
  
  CONCLUSIONS
  The findings provide further evidence for altered inflammation in PTSD. Comorbid depressive symptoms ought to be considered to disentangle the unique associations of PTSD caused by MI and systemic inflammation.
authors.affiliation: Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital and University of Bern, CH-3010 Bern, Switzerland. roland.vonkaenel@insel.ch
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Stefan
authors.initials: S
authors.lastname: Begré
authors.forename: Chiara C
authors.initials: CC
authors.lastname: Abbas
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Gander
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D023201:CD40 Ligand / Q000032:analysis / Q000097:blood; D015897:Comorbidity; D003866:Depressive Disorder / Q000276:immunology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000032:analysis / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D020738:Leptin / Q000032:analysis / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology* / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000276:immunology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D020738:Leptin; D023201:CD40 Ligand