title: High sensitivity C reactive protein, fibrinogen levels and the onset of major depressive disorder in post-acute coronary syndrome.
abstract: BACKGROUND
  Major depression disorder (MDD) is a common condition in patients suffering from acute coronary syndrome (ACS), and depression is a risk factor for mortality following an ACS. Growing evidence suggests that there is an intricate interplay between atherosclerosis, inflammation and depression. The aim of this study was to investigate the role of atherosclerosis-induced inflammation in the mediation of MDD.
  
  
  METHODS
  87 patients without depression were recruited at the time of an ACS, evaluated at 3 and 7 days and followed at 1, 3 and 9 months for the occurrence of a MDD as assessed by structured interviews (MINI). At each time point, they were monitored for inflammatory markers (high sensitivity C Reactive Protein {hsCRP} and fibrinogen), cardiovascular risk factors and atherosclerosis burden. Association between possible predictive characteristics and depression was assessed using a multivariable logistic regression model.
  
  
  RESULTS
  The overall incidence of MDD, in this population, was 28.7% [95% CI: 19.5 - 39.4] during the 9-month follow up period. Elevated hsCRP was not associated with depression onset after an ACS (adjusted OR: 1.07 [0.77 - 1.48]; p = 0.70), and similarly no association was found with fibrinogen. Furthermore, we found no association between hsCRP, fibrinogen or atherosclerosis burden at any time-point, and the occurrence of a MDD (or HDRS-17 and MADRS). The only factor associated with depression occurrence after an ACS was a previous personal history of depression (adjusted OR: 11.02 [2.74 to 44.34]; p = 0.0007).
  
  
  CONCLUSIONS
  The present study shows that after an ACS, patients treated with optimal medications could have a MDD independent of elevated hsCRP or fibrinogen levels. Personal history of depression may be a good marker to select patients who should be screened for depression after an ACS.
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, CEPTA, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 PESSAC Cedex, F-33000, Bordeaux, France. marianne.lafitte@chu-bordeaux.fr.
authors.forename: Marianne
authors.initials: M
authors.lastname: Lafitte
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, CEPTA, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 PESSAC Cedex, F-33000, Bordeaux, France. sandrine.psy.tastet@wanadoo.fr.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Tastet
authors.affiliation: CHU de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, F-33000, Bordeaux, France. Paul.Perez@isped.u-bordeaux2.fr.
authors.forename: Paul
authors.initials: P
authors.lastname: Perez
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, CEPTA, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 PESSAC Cedex, F-33000, Bordeaux, France. marieserise@gmail.com.
authors.forename: Marie-Aimée
authors.initials: MA
authors.lastname: Serisé
authors.affiliation: CHU de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, F-33000, Bordeaux, France. Anne-Sophie.Grandoulier@isped.u-bordeaux2.fr.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Grandoulier
authors.affiliation: CHU de Bordeaux, Pôle Universitaire de Psychiatrie, F-33000, Bordeaux, France. Bruno.aouizerate@u-bordeaux.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Aouizerate
authors.affiliation: CHU de Bordeaux, Unité Neurovasculaire, F-33000, Bordeaux, France. igor.sibon@chu-bordeaux.fr.
authors.forename: Igor
authors.initials: I
authors.lastname: Sibon
authors.affiliation: INRA, Nutrition et Neurobiologie intégrée, UMR 1286, F-33000, Bordeaux, France. lucile.capuron@bordeaux.inra.fr.
authors.forename: Lucile
authors.initials: L
authors.lastname: Capuron
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, CEPTA, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 PESSAC Cedex, F-33000, Bordeaux, France. thierry.couffinhal@u-bordeaux.fr.|Univ. Bordeaux, Adaptation cardiovasculaire à l'ischémie, U1034, F-33600, Pessac, France. thierry.couffinhal@u-bordeaux.fr.|INSERM, Adaptation cardiovasculaire à l'ischémie, U1034, F-33600, Pessac, France. thierry.couffinhal@u-bordeaux.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Couffinhal
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000523:psychology*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications; D003865:Major Depressive Disorder / Q000097:blood* / Q000209:etiology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein