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
