Depression, anxiety, and vital exhaustion are associated with pro-coagulant markers in depressed patients with coronary artery disease - A cross sectional and prospective secondary analysis of the SPIRR-CAD trial.

Autor: Deter HC; Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany. Electronic address: deter@charite.de., Orth-Gomér K; Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Rauch-Kröhnert U; Medical Clinic, Cardiology and Pulmonology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany., Albus C; Department of Psychosomatics and Psychotherapy, University of Cologne, Germany., Ladwig KH; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München (TUM), German Center for Cardiovascular Research, Partner Site Munich, Germany., Söllner W; Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Germany., de Zwaan M; Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Germany., Grün AS; Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany., Ronel J; Klinik Barmelweid, Switzerland; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Germany., Hellmich M; Clinical Trials Center Cologne, Institute for Medical Statistics, Informatic und Epidemiology (IMSIE), University of Cologne, Germany., Herrmann-Lingen C; Dept. of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, German Center for Cardiovascular Research, Partner Site Göttingen, Germany., Weber C; Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany.
Jazyk: angličtina
Zdroj: Journal of psychosomatic research [J Psychosom Res] 2021 Dec; Vol. 151, pp. 110659. Date of Electronic Publication: 2021 Oct 28.
DOI: 10.1016/j.jpsychores.2021.110659
Abstrakt: Introduction: A hyper-coagulant state is a biological mechanism that triggers cardiac events in patients with coronary artery disease (CAD). Depressive symptoms and anxiety predict an unfavourable course of CAD. The SPIRR-CAD-RCT examined the effects of a psychological intervention and provided the opportunity to explore cross-sectional associations between indices of psychological strain and coagulation parameters, as well as prospective changes in depression scores and coagulation parameters.
Methods: In this secondary analysis, we investigated 253 CAD patients (194 male; age m 58.9, SD 8.3 yrs.) with mild to moderate depression (≥8 on the HADS-D) at baseline and at follow-up 18 months later: TF, fibrinogen, D-dimer, VWF, FVII and PAI-1 and the course of depression (HAM-D), vital exhaustion (VE) and anxiety scores (HADS-A) were examined by ANOVA in the total and younger age groups (≤ 60).
Results: HAM-D at baseline was correlated with TF (corr. R 2  = 0.27; F = 9.31, p = 0.001). HADS anxiety was associated with fibrinogen (corr. R 2 .20; F = 7.27, p = 0.001). There was no detectable therapeutic effect on coagulation. Fibrinogen and VWF decreased within 18 months (time effect; p = 0.02; p = 0.04), as did HADS-D in both treatment groups (p < 0.001). Fibrinogen decreased more in patients ≤60 years with high VE compared to low VE (interaction time x group, p = 0.01).
Conclusions: This is the first study to show an association between TF and depression. Coagulation parameters as potential mediators of CAD progression correlated cross-sectionally with depression and anxiety and prospectively with VE. Further studies should replicate these correlations in depressed and non-depressed CAD patients.
Isrctn: 76240576; clinicaltrials.gov.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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