title: Inflammation Markers and Major Depressive Disorder in Patients With Chronic Heart Failure: Results From the Sertraline Against Depression and Heart Disease in Chronic Heart Failure Study.
abstract: BACKGROUND
  Major depressive disorder (MDD) and chronic heart failure (CHF) have in common heightening states of inflammation, manifested by elevated inflammation markers such as C-reactive protein. This study compared inflammatory biomarker profiles in patients with CHF and MDD to those without MDD.
  
  
  METHODS
  The study recruited patients admitted to inpatient care for acute heart failure exacerbations, after psychiatric diagnostic interview. Patients with Beck Depression Inventory (BDI) scores lower than 10 and with no history of depression served as the nondepressed reference group (n = 25). MDD severity was defined as follows: mild (BDI 10-15; n = 48), moderate (BDI 16-23; n = 51), and severe (BDI ≥ 24; n = 33). A Bio-Plex assay measured 18 inflammation markers. Ordinal logistic models were used to examine the association of MDD severity and biomarker levels.
  
  
  RESULTS
  Adjusting for age, sex, statin use, body mass index, left ventricular ejection fraction, tobacco use, and New York Heart Association class, the MDD overall group variable was significantly associated with elevated interleukin (IL)-2 (p = .019), IL-4 (p = .020), IL-6 (p = .026), interferon-γ (p = .010), monocyte chemoattractant protein 1 (p = .002), macrophage inflammatory protein 1β (p = .003), and tumor necrosis factor α (p = .004). MDD severity subgroups had a greater probability of elevated IL-6, IL-8, interferon-γ, monocyte chemoattractant protein 1, macrophage inflammatory protein 1β, and tumor necrosis factor α compared with nondepressed group. The nondepressed group had greater probability of elevated IL-17 (p < .001) and IL-1β (p < .01).
  
  
  CONCLUSIONS
  MDD in patients with CHF was associated with altered inflammation marker levels compared with patients with CHF who had no depression. Whether effective depression treatment will normalize the altered inflammation marker levels requires further study.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00078286.
authors.affiliation: From the Department of Psychiatry & Behavioral Sciences (Xiong), University of California at Davis, Davis, California; Departments of Community and Family Medicine (Prybol), Psychiatry & Behavioral Sciences (Boyle, Krishnan, Jiang), Immunology and Dermatology (Hall, Streilein), and Internal Medicine, Division of Cardiology (Rogers, O'Connor, Jiang), Duke University Medical Center, Durham, North Carolina; and Department of Psychiatry (Steffens), University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Glen L
authors.initials: GL
authors.lastname: Xiong
authors.forename: Kevin
authors.initials: K
authors.lastname: Prybol
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Boyle
authors.forename: Russell
authors.initials: R
authors.lastname: Hall
authors.forename: Robert D
authors.initials: RD
authors.lastname: Streilein
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.forename: Ranga
authors.initials: R
authors.lastname: Krishnan
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rogers
authors.forename: Christopher M
authors.initials: CM
authors.lastname: O'Connor
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline