Predicting suicidal ideation using multiple serum biomarkers in patients with acute coronary syndrome

Background: Biomarkers for suicidal behavior in patients with acute coronary syndrome (ACS) have yet to be elucidated. This study aimed to identify a panel of serum biomarkers associated with suicidal ideation (SI) in patients with ACS. Methods: The study evaluated 969 patients within 2 weeks of ACS (acute phase) and 711 patients 12 months later (chronic phase). The evaluation included 14 serum biomarkers covering 7 functional systems, sociodemographic/clinical characteristics, and SI assessed by the "suicidal thoughts" item of the Montgomery-& Aring;s- berg Depression Rating Scale. Logistic regression models were used to analyze the data. The results showed that 195 patients (20.1 %) had SI in the acute phase, and 87 patients (12.2 %) had SI in the chronic phase. Results: A combination of five serum biomarkers (tumor necrosis factor-alpha, interleukin-18, folate, troponin I, and creatine kinase-MB) was significantly associated with SI in the acute phase, and a combination of three serum biomarkers (tumor necrosis factor-alpha, interleukin-18, and folate) was significantly associated with SI in the chronic phase in a clear dose -dependent manner (all P -values < 0.001) after adjustment for relevant covariates. Discussion: These findings suggest that the application of a combination of multiple serum biomarkers could improve the predictability of SI in patients with ACS at both acute and chronic phases.