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ACUTE CORONARY SYNDROMES AND DEPRESSION: ROLE OF CIRCULATING ENDOTHELIAL PROGENITOR CELLS
E1371 JACC March 12, 2013 Volume 61, Issue 10
Prevention Acute Coronary Syndromes and Depression: Role of Circulating Endothelial Progenitor Cells Poster Contributions Poster Sessions, Expo North Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Risk Factors, from Tooth Loss to Resistin Abstract Category: 24. Prevention: Clinical Presentation Number: 1147-17 Authors: Francesca Felice, Rossella Di Stefano, Stefano Pini, Gianfranco Mazzotta, Francesco M. Bovenzi, Daniele Bertoli, Alessandro Muccignat, Yuri Micchi, Marianna Abelli, Lucia Borelli, Paola Michi, Camilla Gesi, Lisa Lari, Claudia Oligieri, Alessandra Cardini, Alberto Balbarini, University of Pisa, Pisa, Italy Background: Depression and cardiovascular disease are two of the most common disorders in developed countries. In particular, depression has been identified as a risk factor for an adverse prognosis and reduced survival in patients with acute coronary syndrome (ACS). Moreover, the number of endothelial progenitor cells (EPCs) is an independent predictor of clinical outcomes in patients with ACS. The aim was to evaluate the impact of depression on EPC levels in patients with ACS. Methods: Study population consisted of 88 non-consecutive ACS patients (20 females, 68 males; n=62 STEMI, age 58±11 years; n=26 NSTEMI, age 60±7 years), out of them, 44 had a diagnosis of current or previous mood or anxiety disorder (MDE) at the time of the inclusion in the study. Control groups were: 16 healthy subjects (5 females, 11 males, age 50±9 years) and 20 patients with current MDE without a history of cardiovascular diseases (8 females, 12 males, age 48±13 years). Circulating EPCs (CD133+/KDR+/CD34+) were evaluated by flow cytometry analysis. The presence of a current or previous MDE was evaluated using the Structured Clinical Interview for DSM-IV Diagnosis (SCID-I). Results: ACS patients with MDE showed a significant decrease in circulating EPC number compared to ACS patients without MDE (P<0.0001). The ACS study population was then subdivided into STEMI and NSTEMI patients, and inside each group again patients with MDE showed a significant decrease in circulating EPCs compared to others (P<0.0001). Finally, the change in EPC count correlated negatively with Hamilton Depression Rating Scale in patient with ACS (r = - 0.34, P= 0.0028). Conclusions: We showed that ACS patients with MDE have a reduced number of circulating EPCs compared to ACS patient without MDE, suggesting that the presence of MDE reduce the response of bone-marrow to acute ischemic events. Considering the reparative role of EPCs in ACS patients, we suppose that patients with MDE might be protected less than patients without MDE. Finally, our results suggest that individuals either with cardiovascular risk factors or with definite cardiovascular diseases, such as ACS, should be screened for depression.
Prevention Acute Coronary Syndromes and Depression: Role of Circulating Endothelial Progenitor Cells Poster Contributions Poster Sessions, Expo North Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Risk Factors, from Tooth Loss to Resistin Abstract Category: 24. Prevention: Clinical Presentation Number: 1147-17 Authors: Francesca Felice, Rossella Di Stefano, Stefano Pini, Gianfranco Mazzotta, Francesco M. Bovenzi, Daniele Bertoli, Alessandro Muccignat, Yuri Micchi, Marianna Abelli, Lucia Borelli, Paola Michi, Camilla Gesi, Lisa Lari, Claudia Oligieri, Alessandra Cardini, Alberto Balbarini, University of Pisa, Pisa, Italy Background: Depression and cardiovascular disease are two of the most common disorders in developed countries. In particular, depression has been identified as a risk factor for an adverse prognosis and reduced survival in patients with acute coronary syndrome (ACS). Moreover, the number of endothelial progenitor cells (EPCs) is an independent predictor of clinical outcomes in patients with ACS. The aim was to evaluate the impact of depression on EPC levels in patients with ACS. Methods: Study population consisted of 88 non-consecutive ACS patients (20 females, 68 males; n=62 STEMI, age 58±11 years; n=26 NSTEMI, age 60±7 years), out of them, 44 had a diagnosis of current or previous mood or anxiety disorder (MDE) at the time of the inclusion in the study. Control groups were: 16 healthy subjects (5 females, 11 males, age 50±9 years) and 20 patients with current MDE without a history of cardiovascular diseases (8 females, 12 males, age 48±13 years). Circulating EPCs (CD133+/KDR+/CD34+) were evaluated by flow cytometry analysis. The presence of a current or previous MDE was evaluated using the Structured Clinical Interview for DSM-IV Diagnosis (SCID-I). Results: ACS patients with MDE showed a significant decrease in circulating EPC number compared to ACS patients without MDE (P<0.0001). The ACS study population was then subdivided into STEMI and NSTEMI patients, and inside each group again patients with MDE showed a significant decrease in circulating EPCs compared to others (P<0.0001). Finally, the change in EPC count correlated negatively with Hamilton Depression Rating Scale in patient with ACS (r = - 0.34, P= 0.0028). Conclusions: We showed that ACS patients with MDE have a reduced number of circulating EPCs compared to ACS patient without MDE, suggesting that the presence of MDE reduce the response of bone-marrow to acute ischemic events. Considering the reparative role of EPCs in ACS patients, we suppose that patients with MDE might be protected less than patients without MDE. Finally, our results suggest that individuals either with cardiovascular risk factors or with definite cardiovascular diseases, such as ACS, should be screened for depression.