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European Heart Journal Advance Access originally published online on July 4, 2008
European Heart Journal 2008 29(18):2212-2217; doi:10.1093/eurheartj/ehn326
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Association between C-reactive protein and generalized anxiety disorder in stable coronary heart disease patients

Bettina Bankier1,*, Justine Barajas2, Abelardo Martinez-Rumayor2 and James L. Januzzi2

1 Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
2 Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

Received 2 December 2007; revised 16 June 2008; accepted 19 June 2008; online publish-ahead-of-print 4 July 2008.

* Corresponding author: Department of Psychiatry and Psychotherapy, Medical University Vienna, Währinger Gürtel 18–20, A-1090 Vienna, Austria. Tel: +43 1 40400 3603, Fax: +43 1 40400 3605, Email: bettina.bankier{at}meduniwien.ac.at

Aims: Comprehensive evaluation of major depressive disorder (MDD), anxiety disorder, and MDD in conjunction with anxiety disorder in stable coronary heart disease (CHD) patients, including cardiac biomarkers such as C-reactive protein (CRP), troponin T (TnT), and amino-terminal pro-B-type brain natriuretic peptide (NT-proBNP).

Methods and results: Cross-sectional study of a consecutive series of 120 stable CHD outpatients (n = 30 with MDD, n = 30 with anxiety disorder, n = 30 with MDD and anxiety disorder, n = 30 with no psychiatric disorder). Psychiatric diagnoses were established by using the structured clinical interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV). Binomial logistic regression analyses using cut-off scores of biomarkers as dependent variables showed associations between CRP and generalized anxiety disorder (GAD) (P = 0.04), and education (P = 0.004), whereas MDD, and MDD and anxiety disorder did not reach the significance level. TnT showed relationships with hyperlipidaemia (P = 0.009), history of obesity or overweight (P = 0.04), and education (P = 0.04). NT-proBNP was associated with type II diabetes (P = 0.005).

Conclusion: After adjusting for relevant demographic, medical, and psychiatric co-variables, CRP was associated with GAD.

Key Words: C-reactive protein • Generalized anxiety disorder • Stable CHD


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