No abstract

Symptoms of depression following MI do not predict longer-term survival, although measures of disease severity and discharge medication status do. Previous positive results for depression and cardiac mortality in MI patients could reflect the occasional confounding of depression with disease severity.

Abstract-Several studies have implied an association between Chlamydia pneumoniae (C. pneumoniae) and cardiovascular disease. Our study was designed to determine whether this organism is associated with severe essential hypertension in a multiracial British population. Antibodies to C. pneumoniae were measured by microimmunofluorescence in 123 patients with chronic severe hypertension and 123 control subjects, matched for ethnic origin, age, sex, and smoking habit, admitted to the same hospital with various noncardiovascular, nonpulmonary disorders. Previous infection was defined by IgG 64 to 256, provided that there was no detectable IgM. Multiple regression analyses of matched and unmatched data were used to investigate the influences of antibody levels and potential confounding factors (ethnic origin, age, sex, smoking habit, diabetes mellitus, and social deprivation) on hypertension. A portion of the hypertensive patients underwent echocardiography, estimation of left ventricular mass index, and measurements of fibrinogen, D-dimer, and von Willebrand factor concentrations. Thirty-five percent of hypertensive patients and 17.9% of matched control subjects had antibody titers consistent with previous C. pneumoniae infection. The hypertensive patients differed significantly from their matched control subjects in their level of previous infection, with an odds ratio of 2.5 (95% confidence interval, 1.3 to 4.7). There were no significant differences in antibody levels between patients with left ventricular hypertrophy and those without it. Fibrinogen, D-dimer, and von Willebrand factor concentrations were not significantly associated with antibody levels. These data support an association of C. pneumoniae with severe essential hypertension. They provide no evidence of a predisposition to develop left ventricular hypertrophy in hypertensive patients with C. pneumoniae infection or of associations with hypercoagulability or endothelial dysfunction. (Hypertension. 1998;31:589-594.)

No abstract

We examined the association between depression and anxiety and recurrent coronary heart disease events during the first 12 months subsequent to myocardial infarction. The Beck Depression Inventory and the State-Trait Anxiety Inventory were completed during hospitalization by 288 myocardial infarction patients. Peel Index score and Killip class were used as indices of disease severity. The 12-month incidence of recurrent coronary heart disease events (fatal and non-fatal) was determined. Eighty-two patients experienced recurrent coronary heart disease events, including 27 cardiac fatalities, during follow-up. Whereas the Peel Index differentiated patients who experienced recurrent events from those who did not (OR 3.00, 95% CI 1.46-6.20), symptoms of depression (OR 0.97, 95% CI 0. 55-1.70) and anxiety (OR 1.00, 95% CI 0.98-1.02) were unrelated to outcome. Depression and anxiety did not predict subsequent coronary heart disease events and were not associated with either Peel Index scores or Killip class.