title: Association of somatic and cognitive depressive symptoms and biomarkers in acute myocardial infarction: insights from the translational research investigating underlying disparities in acute myocardial infarction patients' health status registry.
abstract: BACKGROUND
  Somatic depressive symptoms and certain biomarkers are each associated with worse acute myocardial infarction (AMI) prognosis, but the relationship between depressive symptom domains and inflammatory, neurohormonal, and coagulation markers is unknown.
  
  
  METHODS
  We examined the relationship between depressive symptoms and 1-month biomarker levels (high-sensitivity C-reactive protein [hs-CRP], N-terminal pro-brain natriuretic peptide [NT-proBNP], white blood cell [WBC], platelet counts) in 1265 AMI patients. Depressive symptoms (9-item Patient Health Questionnaire) were assessed during index hospitalization and categorized as somatic or cognitive. Using median regression models, the upper quartile of somatic and cognitive depression scores and each biomarker were compared with the lower three quartiles, adjusting for site, demographics, and clinical characteristics.
  
  
  RESULTS
  Although hs-CRP values were higher in patients with somatic symptoms, this association was attenuated after adjustment (B(per SD increase) = .02, 95% confidence interval: .00; .05, p = .07). WBC count was independently associated with somatic depressive symptoms (B(per SD increase) = .28, 95% confidence interval: .12; .44, p < .001). Cognitive depressive symptoms were not associated with hs-CRP or WBC count. Neither dimension was associated with NT-proBNP or platelet levels. For each biomarker, the depression dimensions explained <1% of their variation.
  
  
  CONCLUSIONS
  Neither somatic nor cognitive depressive symptoms were meaningfully associated with hs-CRP, NT-proBNP, WBC, or platelet counts 1 month after AMI, suggesting that the association between depression and long-term outcomes may be unrelated to these biomarkers. Future research should explore other biomarkers to better illuminate pathways by which depression adversely impacts AMI prognosis.
authors: Saint Luke's Mid America Heart and Vascular Institute, 4401 Wornall Road, Kansas City, MO 64111, USA. k.g.e.smolderen@gmail.com
authors: Kim G
authors: KG
authors: Smolderen
authors: John A
authors: JA
authors: Spertus
authors: Kimberly J
authors: KJ
authors: Reid
authors: Donna M
authors: DM
authors: Buchanan
authors: Viola
authors: V
authors: Vaccarino
authors: Judith H
authors: JH
authors: Lichtman
authors: David B
authors: DB
authors: Bekelman
authors: Paul S
authors: PS
authors: Chan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001792:Blood Platelets; D002097:C-Reactive Protein / Q000378:metabolism; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000097:blood / Q000209:etiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments; D011379:Prognosis; D012042:Registries; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D057170:Translational Research, Biomedical; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein