The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes

Am J Psychiatry. 2004 Feb;161(2):271-7. doi: 10.1176/appi.ajp.161.2.271.


Objective: This study was conducted to determine whether or not depression is associated with higher levels of inflammatory markers in patients recovering from acute coronary syndromes.

Method: Plasma levels of soluble intercellular adhesion molecule 1 (sICAM-1) and interleukin-6 (IL-6) and the serum level of C-reactive protein were measured in 481 patients 2 months after hospitalization for acute coronary syndromes. Diagnosis of major depression was based on the Structured Clinical Interview for DSM-IV.

Results: Depressed patients showed significantly higher sICAM-1 levels, a difference that remained significant after adjustment for potential confounders (gender, smoking, presence of metabolic syndrome). Although there was no significant association between depression and IL-6, there was an interaction between depression and statin therapy for levels of C-reactive protein. Depressed patients not taking statins had markedly higher C-reactive protein levels than did nondepressed patients. There was no relationship with depression in those receiving statins.

Conclusions: These results suggest chronic endothelial activation among depressed patients after acute coronary syndromes. Further research is needed to determine whether or not higher levels of sICAM-1 may identify a subgroup of depressed patients at particularly high risk for cardiac events among patients with established coronary artery disease or among those without previous coronary artery disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • C-Reactive Protein / metabolism*
  • Comorbidity
  • Coronary Disease / blood*
  • Coronary Disease / epidemiology
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / epidemiology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / blood
  • Intercellular Adhesion Molecule-1 / blood*
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Prevalence


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Interleukin-6
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein