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This dissertation, Post-myocardial Infarction Depression, Inflammatory Markers and Cardiac Prognosis in Chinese Patients by 王雪萊, Xuelai, Shelley, Wang, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract of the thesis entitled Post-myocardial infarction depression, inflammatory markers and cardiac prognosis in Chinese patients submitted by Shelley X. L. Wang for the degree of Doctor of Philosophy at the University of Hong Kong in September, 2007 Background Post-myocardial infarction depression has been identified as a significant risk factor for poor outcome of MI. However, the precise nature of the relationship between post-MI depression and cardiac prognosis has been the subject of much great debate and the underlying mechanisms of how and why post-MI depression is associated with a negative outcome remain obscure. Given that depressive disorders may confer increased risk of further cardiac events and death after Acute MI, speculation that cytokine activity is the key mechanism connecting the two has lead to attempts to clarify this relationship. This thesis describes work that examined the associations between inflammatory markers and depression following Acute MI and cardiac outcomes, in particular to clarify if cytokines and C-reactive protein (CRP) do link clinical depression and acute MI to explain the increased cardiac risks faced by depressed MI patients. Method The thesis has two stages. First, a meta analysis was performed using data from the electronic databases MEDCINE, EMBASE, and PSYCINFO (1988-2007) to identify studies that prospectively compared all-cause mortality, cardiac mortality and cardiovascular events in depressed and non-depressed post-MI patients to synthesize pooled odds ratios for these three sets of outcomes respectively. The second part of this thesis describes a multi-center prospective study that examined the associations iibetween baseline depression, inflammatory marker (C-reactive protein, interleukin-6 and sICAM-1) levels, and combined cardiac mortality and events after 12 months in 312 Mainland Chinese patients confirmed to have acute myocardial infarction (MI). Results The Meta-analysis identified 19 studies for all-cause mortality, 6 for cardiac mortality and 12 for cardiovascular events searched across 981 papers, that met inclusion criteria. Meta-analysis indicated that the pooled odds ratios of risk associated with post-MI depression for each end-point were 2.07 (95% CI, 1.77-2.41, P

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