The association between fibrinogen reactivity to mental stress and high-sensitivity cardiac troponin T in healthy adults

PSYCHONEUROENDOCRINOLOGY

卷:59

Article

Lazzarino, Antonio Ivan¹  Hamer, Mark¹  Gaze, David²  Collinson, Paul²  Rumley, Ann³  Lowe, Gordon³  Steptoe, Andrew¹ 

[1] UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England

[2] St Georges Healthcare NHS Trust, Clin Blood Sci, Chem Pathol, London SW17 0QT, England

[3] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow G12 8TA, Lanark, Scotland

关键词: Stress;    Psychological;    Fibrinogen;    Troponin T;    Atherosclerosis;    Allostasis;   

DOI  :  10.1016/j.psyneuen.2015.05.002

来源: Elsevier

【 摘 要 】

Background: Plasma fibrinogen is considered as a positive mediator between mental stress and cardiovascular disease because it is an acute-phase protein released in response to mental stress and a coagulation factor. However those three factors have never been studied together within a single integrated framework, using cardiac troponin T as a marker of cardiovascular risk. Methods: 491 disease-free men and women aged 53-76 were tested for fibrinogen levels before, immediately after, and following recovery from standardized mental stress tasks. We measured plasma cardiac troponin T using a high-sensitivity assay (HS-CTnT) and coronary calcification using electron-beam dual-source computed tomography. Results: The average fibrinogen concentration increased by 5.1% (s.d. = 7.3) in response to stress and then tended to return to baseline values. People with higher baseline fibrinogen values had smaller increases (blunted responses) following the stress task (P=0.001), and people with higher stress responses showed better recovery (P < 0.001). In unadjusted analyses, higher baseline fibrinogen was associated with higher chances of having detectable HS-CTnT (P=0.072) but, conversely, higher fibrinogen response was associated with lower chances of having detectable HS-CTnT (P=0.007). The adjustment for clinical, inflammatory, and haemostatic factors, as well as for coronary calcification eliminated the effect of baseline fibrinogen, whereas the negative association between fibrinogen response and HS-CTnT remained robust: the odds of detectable HS-CTnT halved for each 10% increase in fibrinogen concentration due to stress (OR = 0.49, P=0.007, 95% CI = 0.30-0.82). Conclusions: Greater fibrinogen responses to mental stress are associated with lower likelihood of detectable high-sensitivity troponin T plasma concentration. A more dynamic fibrinogen response appears to be advantageous for cardiovascular health. (C) 2015 The Authors. Published by Elsevier Ltd.

【 授权许可】

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