PMID- 32916271
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20230412
IS  - 1090-2139 (Electronic)
IS  - 0889-1591 (Print)
IS  - 0889-1591 (Linking)
VI  - 90
DP  - 2020 Nov
TI  - Sex differences in the inflammatory response to stress and risk of adverse 
      cardiovascular outcomes among patients with coronary heart disease.
PG  - 294-302
LID - S0889-1591(20)31126-0 [pii]
LID - 10.1016/j.bbi.2020.09.001 [doi]
AB  - Stress may contribute to progression of coronary heart disease (CHD) through 
      inflammation, especially among women. Thus, we sought to examine whether 
      increased inflammatory response to stress among patients with CHD is associated 
      with a greater risk of cardiovascular events and whether this risk is higher in 
      women. We examined inflammatory biomarkers known to increase with mental stress 
      (speech task), including interleukin-6 (IL-6), monocyte chemoattractant protein-1 
      (MCP-1), and matrix metallopeptidase-9 (MMP-9) among 562 patients with stable 
      CHD. Inflammatory response, the difference between post-stress and resting 
      values, was examined as a predictor of major adverse cardiovascular events (MACE) 
      using subdistribution hazards models for competing risks adjusting for 
      demographics, cardiovascular risk factors, and medications. MACE was defined as a 
      composite endpoint of cardiovascular death, myocardial infarction, unstable 
      angina with revascularization, and heart failure. All biomarkers were 
      standardized. The mean age was 63 years (range 34-79) and 24% were women. During 
      a median follow-up of 3 years, 71 patients experienced MACE. Overall, there was 
      no significant association between inflammatory response to stress and risk of 
      MACE, but there were sex-based interactions for IL-6 (p = 0.001) and MCP-1 
      (p = 0.01). The risk of MACE increased 56% (HR: 1.56; 95% CI: 1.21, 2.01; 
      p = 0.001) and 30% (HR: 1.30; 95% 1.09, 1.55; p = 0.004) for each standard 
      deviation increase in IL-6 and MCP-1 response to mental stress for women, 
      respectively, while there was no association among men. Increased inflammation in 
      response to stress is associated with future adverse cardiovascular outcomes 
      among women with CHD.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Sullivan, Samaah
AU  - Sullivan S
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States. Electronic address: samaah.sullivan@emory.edu.
FAU - Young, An
AU  - Young A
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States.
FAU - Hammadah, Muhammad
AU  - Hammadah M
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Lima, Bruno B
AU  - Lima BB
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States.
FAU - Levantsevych, Oleksiy
AU  - Levantsevych O
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States.
FAU - Ko, Yi-An
AU  - Ko YA
AD  - Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 
      Emory University, Atlanta, GA, United States.
FAU - Pearce, Brad D
AU  - Pearce BD
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Shah, Amit J
AU  - Shah AJ
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States; Atlanta VA Medical 
      Center, Decatur, GA, United States.
FAU - Kim, Jeong Hwan
AU  - Kim JH
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Moazzami, Kasra
AU  - Moazzami K
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States.
FAU - Driggers, Emily G
AU  - Driggers EG
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Psychiatry and Behavioral Sciences, 
      Emory University School of Medicine, Atlanta, GA, United States.
FAU - Haffar, Ammer
AU  - Haffar A
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Ward, Laura
AU  - Ward L
AD  - Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 
      Emory University, Atlanta, GA, United States.
FAU - Herring, Isaias
AU  - Herring I
AD  - Grinnell College, Grinnell, IA, United States.
FAU - Hankus, Allison
AU  - Hankus A
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Lewis, Tene T
AU  - Lewis TT
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States.
FAU - Mehta, Puja K
AU  - Mehta PK
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Bremner, J Douglas
AU  - Bremner JD
AD  - Atlanta VA Medical Center, Decatur, GA, United States; Department of Psychiatry 
      and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United 
      States.
FAU - Raggi, Paolo
AU  - Raggi P
AD  - Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, 
      Canada.
FAU - Quyyumi, Arshed
AU  - Quyyumi A
AD  - Department of Medicine, Division of Cardiology, Emory University School of 
      Medicine, Atlanta, GA, United States.
FAU - Vaccarino, Viola
AU  - Vaccarino V
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA, United States; Department of Medicine, Division of Cardiology, Emory 
      University School of Medicine, Atlanta, GA, United States.
LA  - eng
GR  - R56 HL126558/HL/NHLBI NIH HHS/United States
GR  - R01 MH056120/MH/NIMH NIH HHS/United States
GR  - K24 HL077506/HL/NHLBI NIH HHS/United States
GR  - T32 HL130025/HL/NHLBI NIH HHS/United States
GR  - K23 HL127251/HL/NHLBI NIH HHS/United States
GR  - P01 HL086773/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
GR  - L30 HL148912/HL/NHLBI NIH HHS/United States
GR  - UL1 TR002378/TR/NCATS NIH HHS/United States
GR  - UG3 DA048502/DA/NIDA NIH HHS/United States
GR  - R61 HL138657/HL/NHLBI NIH HHS/United States
GR  - I01 RX003418/RX/RRD VA/United States
GR  - R38 AI140299/AI/NIAID NIH HHS/United States
GR  - R01 HL089650/HL/NHLBI NIH HHS/United States
GR  - K01 HL149982/HL/NHLBI NIH HHS/United States
GR  - P30 DK111024/DK/NIDDK NIH HHS/United States
GR  - KL2 TR000455/TR/NCATS NIH HHS/United States
GR  - R01 HL109413/HL/NHLBI NIH HHS/United States
GR  - R01 AG042127/AG/NIA NIH HHS/United States
GR  - K12 HD085850/HD/NICHD NIH HHS/United States
GR  - U54 AG062334/AG/NIA NIH HHS/United States
GR  - R01 NS064162/NS/NINDS NIH HHS/United States
GR  - R01 HL125246/HL/NHLBI NIH HHS/United States
GR  - R01 HL141205/HL/NHLBI NIH HHS/United States
GR  - R01 MH120262/MH/NIMH NIH HHS/United States
GR  - R01 HL095479/HL/NHLBI NIH HHS/United States
GR  - RF1 AG051633/AG/NIA NIH HHS/United States
GR  - DP3 DK094346/DK/NIDDK NIH HHS/United States
GR  - K24 MH076955/MH/NIMH NIH HHS/United States
GR  - R01 HL088726/HL/NHLBI NIH HHS/United States
GR  - P20 HL113451/HL/NHLBI NIH HHS/United States
GR  - P01 HL101398/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200908
PL  - Netherlands
TA  - Brain Behav Immun
JT  - Brain, behavior, and immunity
JID - 8800478
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cardiovascular System
MH  - *Coronary Artery Disease
MH  - Female
MH  - *Heart Failure
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Infarction
MH  - Risk Factors
MH  - Sex Characteristics
PMC - PMC7872132
MID - NIHMS1632057
OTO - NOTNLM
OT  - Cardiovascular events
OT  - Inflammation
OT  - Inflammatory response
OT  - Mental stress
OT  - Women
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2020/09/12 06:00
MHDA- 2021/04/28 06:00
PMCR- 2021/11/01
CRDT- 2020/09/11 20:12
PHST- 2020/05/27 00:00 [received]
PHST- 2020/08/28 00:00 [revised]
PHST- 2020/09/04 00:00 [accepted]
PHST- 2020/09/12 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/09/11 20:12 [entrez]
PHST- 2021/11/01 00:00 [pmc-release]
AID - S0889-1591(20)31126-0 [pii]
AID - 10.1016/j.bbi.2020.09.001 [doi]
PST - ppublish
SO  - Brain Behav Immun. 2020 Nov;90:294-302. doi: 10.1016/j.bbi.2020.09.001. Epub 2020 
      Sep 8.