title: Influence of depression and anxiety on circulating endothelial progenitor cells in patients with acute coronary syndromes.
abstract: OBJECTIVE
  Circulating endothelial progenitor cells (EPCs) are related to endothelial function and progression of coronary artery disease. There is evidence of decreased numbers of circulating EPCs in patients with a current episode of major depression. We investigated the relationships between the level of circulating EPCs and depression and anxiety in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  Patients with ACS admitted to three Cardiology Intensive Care Units were evaluated by the SCID-I to determine the presence of lifetime and/or current mood and anxiety disorders according to DSM-IV criteria. The EPCs were defined as CD133(+) CD34(+) KDR(+) and evaluated by flow cytometry. All patients underwent standardized cardiological and psychopathological evaluations. Parametric and nonparametric statistical tests were performed where appropriate.
  
  
  RESULTS
  Out of 111 ACS patients, 57 were found to have a DSM-IV lifetime or current mood or anxiety disorder at the time of the inclusion in the study. The ACS group with mood or anxiety disorders showed a significant decrease in circulating EPC number compared with ACS patients without affective disorders. In addition, EPC levels correlated negatively with severity of depression and anxiety at index ACS episode.
  
  
  CONCLUSIONS
  The current study indicates that EPCs circulate in decreased numbers in ACS patients with depression or anxiety and, therefore, contribute to explore new perspectives in the pathophysiology of the association between cardiovascular disorders and affective disorders.
authors.affiliation: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Felice
authors.forename: Rossella
authors.initials: R
authors.lastname: Di Stefano
authors.forename: Stefano
authors.initials: S
authors.lastname: Pini
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Mazzotta
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Bovenzi
authors.forename: Daniele
authors.initials: D
authors.lastname: Bertoli
authors.forename: Marianna
authors.initials: M
authors.lastname: Abelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Borelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cardini
authors.forename: Lisa
authors.initials: L
authors.lastname: Lari
authors.forename: Camilla
authors.initials: C
authors.lastname: Gesi
authors.forename: Paola
authors.initials: P
authors.lastname: Michi
authors.forename: Doralisa
authors.initials: D
authors.lastname: Morrone
authors.forename: Luigi
authors.initials: L
authors.lastname: Gnudi
authors.forename: Alberto
authors.initials: A
authors.lastname: Balbarini
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000523:psychology; D000368:Aged; D001008:Anxiety Disorders / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003866:Depressive Disorder / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D066026:Endothelial Progenitor Cells / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
keywords: acute coronary syndromes; anxiety; depression; endothelial progenitor cells