Table 5.
Resting values of inflammatory biomarkers and their changes with mental stress according to MSIMI status in the validation cohort (MIMS2 Study).
| MSIMI
|
Unadjusted
|
Adjusted Model 1**
|
Adjusted Model 2†
|
Adjusted Model 3‡
|
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Negative (n = 191) Median (IQR) |
P value* | Positive (n = 37) Median (IQR) |
P value* | β (95 % CI) | P value* | β (95 % CI) | P value* | β (95 % CI) | P value* | |
| A) Resting inflammatory biomarkers | ||||||||||
| IL-6, pg/mL | 1.5 (1.0–2.4) |
1.7 (1.2–2.8) |
0.18 (−0.13, 0.50) |
0.25 | 0.18 (−0.12, 0.47) |
0.23 | 0.18 (−0.11, 0.47) |
0.23 | 0.14 (−0.15, 0.44) |
0.35 |
| MCP-1, pg/mL | 120.0 (101.3–139.7) |
140.6 (117.6–153.0) |
0.16 (0.02, 0.31) |
0.03 | 0.10 (−0.04, 0.25) |
0.16 | 0.09 (−0.05, 0.24) |
0.20 | 0.05 (−0.09, 0.19) |
0.48 |
| MMP-9, ng/mL | 56.3 (39.4–92.0) |
51.1 (38.9–85.3) |
−0.09 (−0.40, 0.23) |
0.59 | −0.08 (−0.39, 0.22) |
0.59 | −0.07 (−0.38, 0.23) |
0.65 | −0.05 (−0.35, 0.26) |
0.77 |
| Hs-CRP, mg/L |
3.1 (1.3–6.9) |
3.7 (0.8–5.4) |
−0.05 (−0.76, 0.67) |
0.90 | −0.09 (−0.76, 0.57) |
0.78 | −0.07 (−0.73, 0.60) |
0.84 | −0.10 (−0.78, 0.58) |
0.34 |
| B) Mental stress induced inflammatory responses§ | ||||||||||
| IL-6, pg/mL | 0.8 (0.4–1.8) |
1.2 (0.7–2.1) |
0.22 (−0.05, 0.49) |
0.11 | 0.21 (−0.06, 0.48) |
0.12 | 0.21 (−0.06, 0.48) |
0.12 | 0.19 (−0.08, 0.46) |
0.17 |
| MCP-1, pg/mL | 6.7 (−7.8 to 23.3) |
12.1 (−2.5 to 30.8) |
0.07 (−0.02, 0.17) |
0.14 | 0.08 (−0.01, 0.17) |
0.10 | 0.08 (−0.01, 0.17) |
0.10 | 0.07 (−0.02, 0.17) |
0.14 |
| MMP-9, ng/mL | 4.5 (−3.9 to 14.5) |
4.6 (−5.7 to 23.2) |
0.03 (−0.17, 0.24) |
0.75 | 0.05 (−0.16, 0.27) |
0.62 | 0.05 (−0.16, 0.26) |
0.64 | 0.09 (−0.12, 0.31) |
0.39 |
| Hs-CRP, mg/L | −0.01 (−0.3 to 0.16) |
0.003 (−0.4 to 0.3) |
0.06 (−0.12, 0.24) |
0.50 | 0.09 (−0.09, 0.27) |
0.34 | 0.09 (−0.09, 0.27) |
0.34 | 0.07 (−0.11, 0.25) |
0.46 |
Abbreviations: MSIMI, mental stress-induced myocardial ischemia; IL-6, interleukin-6; MCP-1, monocyte chemoattractant protein-1; MMP-9, matrix metallopeptidase 9; HsCRP, high-sensitivity C reactive protein.
Data was presented as median (25th and 75th percentiles). A log 2 transformation was used for biomarker values.
p values were obtained from mixed linear models.
Adjusted model 1: Adjusted for age, sex, African American race, body mass index, smoking, diabetes, hypertension, beck depression inventory score, and previous myocardial infarction.
Adjusted model 2: Adjusted model 1 + accounting for biomarker plate as a random effect.
Adjusted model 3: Adjusted model 2 + adjusting for sequence of mental/physical stress.
Responses are calculated as the differences between 90-min post mental stress values and resting values. Inflammatory response was modeled as the outcome adjusted for resting levels.