title: Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction.
abstract: BACKGROUND
  While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI.
  
  
  METHODS
  We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables.
  
  
  RESULTS
  Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = -2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (β= 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (β = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (β = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (β = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels.
  
  
  CONCLUSIONS
  Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.
authors.affiliation: Department of Psychiatry, Shanxi Da Yi Hospital, Taiyuan, Shanxi 030032, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Psychiatry, Shanxi Da Yi Hospital, Taiyuan, Shanxi 030032, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Jia
authors.affiliation: Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Sa
authors.affiliation: Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Qiu
authors.affiliation: Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Statistics and Probability, Michigan State University, East Lansing, Michigan 48824, USA.
authors.forename: Yue-Hua
authors.initials: YH
authors.lastname: Cui
authors.affiliation: Department of Science and Technology, Shanxi Provincial Cardiovascular Hospital, Taiyuan, Shanxi 030024, China.
authors.forename: Yue-An
authors.initials: YA
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Shanxi Da Yi Hospital, Taiyuan, Shanxi 030032, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
authors.forename: Gui-Fen
authors.initials: GF
authors.lastname: Liu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism* / Q000523:psychology*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D019210:Troponin I / Q000378:metabolism
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain