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Research: KWAIJTAAL and co-workers,
Listed in Issue 149
Abstract
KWAIJTAAL and co-workers, Department of Medical Microbiology, University Hospital Maastricht, P. Debeyeplein 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands, martijnkwaijtaal@gmail.com, have investigated the effects of exhaustion in patients with coronary heart disease.
Background
Macrophage migration inhibitory factor (MIF), a protein secreted by immune cells and the pituitary gland, may be associated with coronary artery disease and the mental state of coronary patients. The first origin of MIF suggests positive, the second negative associations. The aim of this study was to explore the direction of the association of MIF with coronary heart disease and of MIF with exhaustion.
Methodology
Participants were 194 patients who had been recently treated by percutaneous coronary intervention and who were exhausted at the start of the study. Half entered a behavioural intervention program. MIF was measured in blood collected 6 weeks after coronary intervention and 6 and 18 months later. A single measurement of MIF was also available for 129 age- and sex-matched healthy individuals (control group).
Results
At baseline, MIF in coronary patients was significantly lower than in the reference group (p < .01). New cardiac events occurred twice as often in the lowest quartile than in the highest quartile of MIF concentrations. However, the association was not significant (p = .52). During follow up, MIF concentrations increased significantly in coronary patients (p < .001). At 18 months, MIF concentrations were significantly lower in the exhausted patients than in the nonexhausted patients (p = .02).
Conclusion
The data are suggestive of a negative association of MIF with coronary heart disease and of MIF with exhaustion. The observation that those patients who remained exhausted had lower concentrations of MIF fits into earlier observations that suggested that exhausted coronary patients may be characterized by a hypoactivity of the hypothalamic-pituitary-adrenocortical axis.
References
Kwaijtaal M et al. Exhaustion is associated with low macrophage migration inhibitory factor expression in patients with coronary artery disease. Psychosomatic Medicine 69 (1): 68-73, Jan-Feb 2007.
