Time-Specific Associations of Tumor Necrosis Factor-α Levels and Polymorphisms (-850 C/T or-308 G/A) With Suicidal Ideation in Acute Coronary Syndrome Patients

Abstract

Background: Considering the association of inflammation with suicide and acute coronary syndrome (ACS), we investigated the individual and interactive effects of serum tumor necrosis factor-alpha (sTNF alpha) levels and two polymorphisms (-850 C/T and -308 G/A) on suicidal ideation (SI) after ACS. Methods: The SI status using items on the Montgomery-angstrom sberg Depression Rating Scale (MADRS), related covariates including sociodemographic and clinical characteristics, sTNF alpha levels, and tumor necrosis factor-alpha (TNF-alpha) polymorphisms were evaluated in 969 patients within 2 weeks after ACS. Of the patients, 711 were evaluated 1 year later for SI. Multivariate logistic regression models were used to calculate individual and interactive associations after adjusting for the covariates. Results: Higher (vs. lower) sTNF alpha levels and the -850 C/T or T/T (vs. C/C) polymorphism were significantly associated with SI 2 weeks after ACS, while only higher sTNF alpha levels were significantly associated with SI after 1 year. Significant interactive effects were detected between sTNF alpha (higher) levels and the -850 C/T (C/C or C/T) polymorphism on SI 2 weeks after ACS and between the two (-850 CC or CT and -308 G/A or AA) polymorphisms on SI 1 year after ACS. Conclusions: The sTNF alpha level and two polymorphisms (-850C/T and -308 G/A), separately or in combination, could be time-specific biomarkers for SI in ACS. Focused interventions for ACS patients at risk of SI might reduce the suicidal burden in patients with ACS.