cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2011-2-53-59cardiovascular-1608Research ArticleИНФАРКТ МИОКАРДАMYOCARDIAL INFARCTIONПровоспалительные факторы и депрессия при инфаркте миокардаPro-inflammatory cytokines and depression in myocardial infarctionБарбарашО. Л.BarbarashO. L.

зав. кафедрой кардиологии и сердечно-сосудистой хирургии

Кемерово, Тел.: (384-2) 64 32 79 Факс: (384-2) 64 33 08

olb61@mail.ruЛебедеваН. Б.LebedevaN. B.

доцент кафедры последипломной подготовки врачей первичного звена здравоохранения и скорой медицинской помощи

Кемерово

КаретниковаВ. Н.KaretnikovaV. N.

доцент кафедры кардиологии и сердечно-сосудистой хирургии

Кемерово

БернсС. А.BernsS. A.

профессор кафедры кардиологии и сердечно-сосудистой хирургии

Кемерово

КашталапВ. В.KashtalapV. V.

зав. лабораторией патофизиологии мультифокального атеросклероза

Кемерово

БарбарашЛ. С.BarbarashL. S.

директор

Кемерово

 

Кемеровская государственная медицинская академияKemerovo State Medical AcademyУРАМН НИИ комплексных проблем сердечно-сосудистых заболеваний Сибирского отделения РАМНResearch Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences2011200420111025359Copyright © Барбараш О.Л., Лебедева Н.Б., Каретникова В.Н., Бернс С.А., Кашталап В.В., Барбараш Л.С., 20112011Барбараш О.Л., Лебедева Н.Б., Каретникова В.Н., Бернс С.А., Кашталап В.В., Барбараш Л.С.Barbarash O.L., Lebedeva N.B., Karetnikova V.N., Berns S.A., Kashtalap V.V., Barbarash L.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1608

Цель. Оценить взаимосвязь факторов воспаления с уровнем тревоги (Тр) и депрессии (Д) у пациентов с инфарктом миокарда (ИМ). Материал и методы. 100 пациентов с ИМ, находившихся на стационарном лечении по поводу Q-ИМ; cредний возраст пациентов — 62,0±1,3 года. Методы обследования психологического статуса: шкала депрессии Цунга, шкалы личностной и реактивной тревожности Спилбергера-Ханина. Для оценки взаимосвязи факторов воспаления с уровнями Тр и Д в качестве маркеров воспаления оценивались уровни интерлейкинов (ИЛ) ИЛ– 1β, ИЛ-6, ИЛ-8, ИЛ-10 и С-реактивного белка (СРБ). Результаты. Наличие у пациентов в ранние сроки после перенесенного ИМ симптомов Д и повышенной Тр ассоциируется с высоким риском развития в течение года сердечно-сосудистых событий. Среди пациентов с ИМ одного класса тяжести наличие симптомов Д и Тр ассоциировалось с более высоким уровнем провоспалительных цитокинов ИЛ-1β, ИЛ-6, ИЛ-8 и ИНФ-γ. Заключение. Одним их механизмов, определяющих неблагоприятный прогноз у данной категории пациентов, является активация субклинического воспаления.

Aim. To assess the associations between inflammatory factors and anxiety (A) and depression (D) levels in patients with myocardial infarction (MI). Material and methods. The study included 100 MI patients, hospitalised with a diagnosis of Q-wave MI (mean age 62,0±1,3 years). The methods of psychosocial status assessment included Zung depression scale and SpielbergerKhanin personal and reactive anxiety scales. The inflammatory markers of interest included interleukins (IL) 1-beta, IL-6, IL-8, IL-10, and C-reactive protein (CRP). Results. D and A symptoms in the early post-MI stage were associated with higher risk of cardiovascular events in the following year. Among MI patients with comparable MI severity, D and A symptoms were linked to higher levels of pro-inflammatory cytokines IL-1-beta, IL-8, IL-8, and INF-gamma. Conclusion. In MI patients with D and A symptoms, one of the mechanisms of poor prognosis is an activation of subclinical inflammation.

инфаркт миокардадепрессиятревожностьпровоспалительные цитокиныпрогнозMyocardial infarctiondepressionanxietypro-inflammatory cytokinesprognosisReferencesБуряковская Л.И., Полякова Е.О., Зорин А.В. и др. Активация тромбоцитов и маркеры воспаления у больных ишемической болезнью сердца с депрессией. Тер архив 2006; 10: 9-14.Буряковская Л.И., Полякова Е.О., Зорин А.В. и др. Активация тромбоцитов и маркеры воспаления у больных ишемической болезнью сердца с депрессией. Тер архив 2006; 10: 9-14.Васюк Ю.А., Лебедев А.В., Иванова С.В. и др. Депрессия при инфаркте миокарда — фактор или маркер риска? РМЖ 2006; 3: 47-9.Васюк Ю.А., Лебедев А.В., Иванова С.В. и др. Депрессия при инфаркте миокарда — фактор или маркер риска? РМЖ 2006; 3: 47-9.Краснов В.Н. Депрессии как диагностическая и терапевтическая проблема в общей медицинской практике. Клин фарм и мед 1999; 1: 22-4.Краснов В.Н. Депрессии как диагностическая и терапевтическая проблема в общей медицинской практике. Клин фарм и мед 1999; 1: 22-4.Albert CM, Chae CU. Rerode K.M. Phobic аnxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation 2005; 111: 480-7.Albert CM, Chae CU. Rerode K.M. Phobic аnxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation 2005; 111: 480-7.Bush DE, Ziegelstein RC, Tayback M, et al. Even minimal symptoms of depression increase mortality risk after myocardial infarction. Am J Cardiol 2001; 89: 112-6.Bush DE, Ziegelstein RC, Tayback M, et al. Even minimal symptoms of depression increase mortality risk after myocardial infarction. Am J Cardiol 2001; 89: 112-6.Bjerkeset O, Nordahl HM, Mykletun A. Anxiety and depression following myocardial infarction: gender differences in a 5-year prospective study. J Psychosom Res 2005; 58: 153-61.Bjerkeset O, Nordahl HM, Mykletun A. Anxiety and depression following myocardial infarction: gender differences in a 5-year prospective study. J Psychosom Res 2005; 58: 153-61.Bruce ML, Leaf PJ, Rozal GP. Psychiatric status and 9-year mortality data in the New Haven Epidemiologic Catchment Area Study. Am J Psychiatry 1994; 151: 716-21.Bruce ML, Leaf PJ, Rozal GP. Psychiatric status and 9-year mortality data in the New Haven Epidemiologic Catchment Area Study. Am J Psychiatry 1994; 151: 716-21.Brugada R, Wenger NK, Jacobson ТА, et al. Changes in plasma cholesterol levels after hospitalization for acute coronary events. Cardiology 1996; 87: 194-9.Brugada R, Wenger NK, Jacobson ТА, et al. Changes in plasma cholesterol levels after hospitalization for acute coronary events. Cardiology 1996; 87: 194-9.Broadley AJ, Korszan A, Jones CJ. Arterial endothelian function is impraired in treated depression. Heart 2002; 88: 521-3.Broadley AJ, Korszan A, Jones CJ. Arterial endothelian function is impraired in treated depression. Heart 2002; 88: 521-3.Carney RM, Blumenthal JA, Freedland KE. Depression and late mortality after myocardial infarction in the enhancing recovery in coronary heart disease (ENRICHD) study. Psychosom Med 2004; 66: 466-74.Carney RM, Blumenthal JA, Freedland KE. Depression and late mortality after myocardial infarction in the enhancing recovery in coronary heart disease (ENRICHD) study. Psychosom Med 2004; 66: 466-74.Dauglas KM, Taylor AJ, O’Malley PG. Relationship between depression and C-reactive protein in a screening population. Psychosom Med 2004; 66: 679-83.Dauglas KM, Taylor AJ, O’Malley PG. Relationship between depression and C-reactive protein in a screening population. Psychosom Med 2004; 66: 679-83.Empana JP, Sykes DH, Luc MD. Contributions of depressive mood and circulation inflammatory markers to coronary heart disease in healthy European men. Circulation 2005; 111: 2299-305.Empana JP, Sykes DH, Luc MD. Contributions of depressive mood and circulation inflammatory markers to coronary heart disease in healthy European men. Circulation 2005; 111: 2299-305.Ford DE, Erlinger TP. Depression and C-reactive protein in US adults^ data from the third National Health and Nutrition Examination Survey. Arch Intern Med 2004; 164: 1010-4.Ford DE, Erlinger TP. Depression and C-reactive protein in US adults^ data from the third National Health and Nutrition Examination Survey. Arch Intern Med 2004; 164: 1010-4.Frasure-Smith N, Lesperance MD, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation 1995; 91: 999-1004.Frasure-Smith N, Lesperance MD, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation 1995; 91: 999-1004.Guck TP, Kavan MG, Elsasser GN. Assessment and treatment of depression following myocardial infarction. Am Fam Phys 2001; 64: 157-67.Guck TP, Kavan MG, Elsasser GN. Assessment and treatment of depression following myocardial infarction. Am Fam Phys 2001; 64: 157-67.Hermann N, Sing-Manoux A, Shipley M. Do psychological factors affect inflammation and incident coronary heart disease? Arterioscl Thromb and Vasc Biol 2008; 28: 1398.Hermann N, Sing-Manoux A, Shipley M. Do psychological factors affect inflammation and incident coronary heart disease? Arterioscl Thromb and Vasc Biol 2008; 28: 1398.Hemingway H, Marmot M. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. Br Med J 1999; 318: 1460-7.Hemingway H, Marmot M. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. Br Med J 1999; 318: 1460-7.Howren M, Lamkin DM, Suls J. Assоsiation of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009;71: 171-86.Howren M, Lamkin DM, Suls J. Assоsiation of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009;71: 171-86.Kop WJ, Gottdiener JS. The role of immune system in the relationship between depression and coronary heart disease. Psychosom Med 2005; 67(Suppl. 1): 37-41.Kop WJ, Gottdiener JS. The role of immune system in the relationship between depression and coronary heart disease. Psychosom Med 2005; 67(Suppl. 1): 37-41.Kawachi I, Sparrow D. Symptoms of anxiety and risk of coronary heart disease: the normative aging study. Circulation 1994; 90: 2225-9.Kawachi I, Sparrow D. Symptoms of anxiety and risk of coronary heart disease: the normative aging study. Circulation 1994; 90: 2225-9.Kiecolt-Glaser JK, Glaser R. Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002; 53: 873-6.Kiecolt-Glaser JK, Glaser R. Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002; 53: 873-6.Kubera M, Lin AH, Kenis G, et al. Anti-inflammatory effects of antidepressants through suppression of the interferon-gamma/interleukin-10 production ratio. J Clin Psychopharm 2001; 21: 199-206.Kubera M, Lin AH, Kenis G, et al. Anti-inflammatory effects of antidepressants through suppression of the interferon-gamma/interleukin-10 production ratio. J Clin Psychopharm 2001; 21: 199-206.Levine J, Barak Y, Chengappa KN, et al. Cerebrospinal cytokine levels in patients with acute depression. Neuropsychobiology 1999; 40: 171-6.Levine J, Barak Y, Chengappa KN, et al. Cerebrospinal cytokine levels in patients with acute depression. Neuropsychobiology 1999; 40: 171-6.Li JJ, Guo YL, Yang YJ. Enhancing anti-inflammatory cytokine IL-10 may be beneficial for acute coronary syndrome. Med Hypotheses 2005; 65: 103-6.Li JJ, Guo YL, Yang YJ. Enhancing anti-inflammatory cytokine IL-10 may be beneficial for acute coronary syndrome. Med Hypotheses 2005; 65: 103-6.Lane D, Carroll D, Lip GY. Anxiety, depression, and prognosis after myocardial infarction. Is there a causal association? JACC 2003; 42: 1808-10.Lane D, Carroll D, Lip GY. Anxiety, depression, and prognosis after myocardial infarction. Is there a causal association? JACC 2003; 42: 1808-10.Lett HS, Blumanthal JA, Babyak MA. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med 2004; 66: 305-15.Lett HS, Blumanthal JA, Babyak MA. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med 2004; 66: 305-15.Ladwig K, Hoberg E, Basch R. Psychological comorbidity in patients with alarming chest pain symptoms. Psychosom Med 1998; 48: 46-54.Ladwig K, Hoberg E, Basch R. Psychological comorbidity in patients with alarming chest pain symptoms. Psychosom Med 1998; 48: 46-54.Loppnow H, Libby P. Proliferating or interleukin 1-activated human vascular smooth muscle cells secrete copious interleukin 6. J Clin Invest 1990; 85: 731-8.Loppnow H, Libby P. Proliferating or interleukin 1-activated human vascular smooth muscle cells secrete copious interleukin 6. J Clin Invest 1990; 85: 731-8.Musselman DL, Evans DL, Nemeroff CB. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry1998; 55: 580-92.Musselman DL, Evans DL, Nemeroff CB. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry1998; 55: 580-92.Murphy JM, Monson RR, Olivier DC. Affective disorders and mortality. A general population study. Arch Gen Psychiatry 1987; 44: 473-80.Murphy JM, Monson RR, Olivier DC. Affective disorders and mortality. A general population study. Arch Gen Psychiatry 1987; 44: 473-80.Miller GE, Stetler CA. Clinical depression and inflammatory risk markers for coronary heart disease. Am J Cardiol 2002; 90: 1279-83.Miller GE, Stetler CA. Clinical depression and inflammatory risk markers for coronary heart disease. Am J Cardiol 2002; 90: 1279-83.Mayou RA, Gill D, Thompson DR. Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med 2000; 62: 212-9.Mayou RA, Gill D, Thompson DR. Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med 2000; 62: 212-9.Maes M, Scharpe S, Meltzer HY, Bosmans E, et al. Relationship between interleukin-6 activity, acute phase proteins, and function of the hypothalamic-pituitary axis in severe depression. Psychiatry Res 1993; 49: 11-27.Maes M, Scharpe S, Meltzer HY, Bosmans E, et al. Relationship between interleukin-6 activity, acute phase proteins, and function of the hypothalamic-pituitary axis in severe depression. Psychiatry Res 1993; 49: 11-27.Orus J, Roig T, Peresz VF, et al. Prognostic value of serum cytokines in patients with congestive heart failure. J Heart Lung Transplant 2000; 19: 419-25.Orus J, Roig T, Peresz VF, et al. Prognostic value of serum cytokines in patients with congestive heart failure. J Heart Lung Transplant 2000; 19: 419-25.O’Brien SM, Scott LV, Dinan TG. Antidepressant therapy and C– reactive protein levels. Br J Psychiatry 2006; 188: 449-52.O’Brien SM, Scott LV, Dinan TG. Antidepressant therapy and C– reactive protein levels. Br J Psychiatry 2006; 188: 449-52.Pasic J, Levy WC, Sullivan MD. Cytokines in depression and Heart Failure. Psychosom Med 2003; 65: 181-93.Pasic J, Levy WC, Sullivan MD. Cytokines in depression and Heart Failure. Psychosom Med 2003; 65: 181-93.Pitzalis MV, Iacovielo M, Todarello O, et al. Depression but not anxiety influences the autonomic control of heart rate after myocardial infarction. Am Heart J 2001; 141: 765-71.Pitzalis MV, Iacovielo M, Todarello O, et al. Depression but not anxiety influences the autonomic control of heart rate after myocardial infarction. Am Heart J 2001; 141: 765-71.Pennix BW, Kritchevsky SB, Yaffe K. Inflammatory markers and depressed mood in older persons: results from the health, aging, and body composition study. Biol Psychiatry 2003; 54: 566-72.Pennix BW, Kritchevsky SB, Yaffe K. Inflammatory markers and depressed mood in older persons: results from the health, aging, and body composition study. Biol Psychiatry 2003; 54: 566-72.Rauchhaus M, Doehner W, Francis DP, et al. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 2000; 102: 3060-7.Rauchhaus M, Doehner W, Francis DP, et al. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 2000; 102: 3060-7.Suarez EC, Lewis JG. Enhanced excрression of cytokines and chemokynes by blood monocytes to in vitro lipopolysaccharide stimulation are associated with hostility and severity of depressive symptoms in healthy women. Psychoneuroendocrinology 2004; 29: 119-28.Suarez EC, Lewis JG. Enhanced excрression of cytokines and chemokynes by blood monocytes to in vitro lipopolysaccharide stimulation are associated with hostility and severity of depressive symptoms in healthy women. Psychoneuroendocrinology 2004; 29: 119-28.Sheps DS, Rozanski A. From feeling blue to clinical depression: exploring the pathogenicity of depressive symptoms and their management in cardiac practice. Psychosom Med 2005; 67: 2-5.Sheps DS, Rozanski A. From feeling blue to clinical depression: exploring the pathogenicity of depressive symptoms and their management in cardiac practice. Psychosom Med 2005; 67: 2-5.Sorensen C, Brandes A, Hendricks O. Depression assessed over 1-year survival in patients with myocardial infarction. Act Psychiatr Scand 2006; 113: 290-7.Sorensen C, Brandes A, Hendricks O. Depression assessed over 1-year survival in patients with myocardial infarction. Act Psychiatr Scand 2006; 113: 290-7.Steptoe A, Kunz-Ebrecht SR, Owen N. Lack of association between depressive symptoms and markers of immune and vascular inflammation in middle-aged men and women. Psychol Med 2003; 33: 667-74.Steptoe A, Kunz-Ebrecht SR, Owen N. Lack of association between depressive symptoms and markers of immune and vascular inflammation in middle-aged men and women. Psychol Med 2003; 33: 667-74.Stewart AH, North FM, West TM. Depression and cardiovascular morbidity and mortality: cause or consequence? Eur Heart J 2003; 24: 2027-37.Stewart AH, North FM, West TM. Depression and cardiovascular morbidity and mortality: cause or consequence? Eur Heart J 2003; 24: 2027-37.Toker S, Shirom A. The assosiation between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women. J Occup Health Psychol 2005; 4: 344-62.Toker S, Shirom A. The assosiation between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women. J Occup Health Psychol 2005; 4: 344-62.Van den Biggelaa AH, Gussekloo J, de Craen AJ, et al. Inflammation and interleukin-1 signaling network contribute to depressive symptoms but not cognitive decline in old age. Exp Gerontol 2007; 42: 693-701.Van den Biggelaa AH, Gussekloo J, de Craen AJ, et al. Inflammation and interleukin-1 signaling network contribute to depressive symptoms but not cognitive decline in old age. Exp Gerontol 2007; 42: 693-701.

The authors declare that there are no conflicts of interest present.