Impact of depression on circulating endothelial progenitor cells in patients with acute coronary syndromes

Aims: Depression has been identified as a risk factor for an adverse prognosis and reduced survival in patients with acute coronary syndrome (ACS). 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: Out of 74 ACS patients [23 non-ST-segment elevation myocardial infarction (NSTEMI), 48 STEMI], 36 had a diagnosis of major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) criteria at the time of the inclusion in the study. Control groups were as follows: 15 healthy individuals and 18 patients with current MDE without a history of cardiovascular diseases. EPCs were defined as CD34RCD133RKDRR and evaluated by flow cytometry. All patients underwent standardized cardiological and psychopathological evaluations. Parametric and nonparametric statistical tests were performed wherever appropriate. Results: ACS patients with MDE showed a significant decrease in circulating EPC number compared with ACS patients without MDE (P <0.001). The ACS study population was then subdivided into STEMI and NSTEMI groups, and inside each group again patients with MDE showed a significant decrease in circulating CD34RCD133RKDRR EPCs compared with others (P <0.001). Conclusion: We showed that ACS patients with MDE have a reduced number of circulating CD34RCD133RKDRR cells compared with ACS patients without MDE, suggesting that the presence of MDE reduces 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

Ruolo delle EPCs nei pazienti con SCA e disturbi depressivi

Valutazione dei livelli di Endothelial Progenitor Cells (EPCs) in pazienti affetti da Sindrome Coronarica Acuta (SCA) in comorbidità con disturbi depressivi. I pazienti con SCA sono stati reclutati presso due centri specializzati: 1.Unità Operativa Complessa di Cardiologia della ASL5 di La Spezia 2.Unità di Cardiologia dell’Ospedale di Lucca Come controllo sono stati reclutati pazienti presso il Day-Hospital dell’Unità Operativa 2 di Psichiatria dell’Azienda Ospedaliera Universitaria Pisana. L'identificazione e la quantificazione dell'EPCs (CD34+/CD133+/KDR+)è stata effettuata mediante tecnica FACS (Fluorescence Activated Cells Sorter). Inoltre, le CD34+ sono state valutate secondo il protocollo HISAGE (International Society of Hematotherapy and Graft Engineering) I pazienti sono stati suddivisi in: 1.Pazienti con SCA 2.Pazienti con SCA in comorbidità con dist.depressivi 3.Pazienti affetti solo da dist. depressivi (controlli) L'analisi statistica(ANOVA)con analisi post hoc LSD (minima differenza significativa) di Fisher ha analizzato e confrontato i risultati dei gruppi di studio, dimostrando una correlazione tra disturbi depressivi, livelli di EPCs e, di conseguenza, cardiopatia ischemica