Evaluation of Mental Status and Its Correction Agomelatine in Patients With Acute Coronary Syndrome

Aim: to study the changes in heart rate variability (HRV) in patients with anxiety and depressive disorders who suffered acute coronary syndrome (ACS) and to determine the effects of antidepressant agomelatine on HRV and sleep quality during six-month follow up.Material and Methods. The study included 54 people with ACS, anxiety, and depressive disorders. Patients were randomly assigned to two groups. Antidepressant agomelatine 25 mg/day was administered to patients of group 1 in addition to standard therapy for ACS; group 2 received placebo. Twenty four-hour Holter ECG monitoring, HRV study, mental status monitoring, and sleep quality assessment were performed during hospitalization and at six-month follow up.Results. Patients of both groups had clinically significant anxiety, subclinical depression, and insomnia of varying severity. According to Holter monitoring data, all patients had decline in HRV parameters. After six months, anxiety and depression significantly improved in patients administered with agomelatine; these patients had sleep normalization and improved HRV. The comparison group did not have similar changes.Conclusion. Additional administration of agomelatine 25 mg/day to patients with anxiety and depressive disorders after ACS resulted in improvement of mental status, heart rate variability, and sleep quality. Due to the absence of pro-arrhythmogenic effects, administration of agomelatine allows to correct anxiety-depressive disorders in patients with ACS.

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The Effects of Agomelatine on Heart Rate Variability in Patients With Anxiety-Depressive Disorders Who Suffered Acute Coronary Syndrome

Попонина

Гундерина

Попонина

et al. 2018

Sibirskij medicinskij žurnal

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Analysis of the S100B protein level in patients with acute coronary syndrome associated with anxiety and depressive symptoms

Попонина

Гундерина

Poponina

et al. 2023

SJCEM

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Background. Acute coronary syndromes are often associated with the onset or aggravation of anxiety and depressive disorders, delirium, cerebral ischemia up to the development of a stroke.Aim: To study the level of brain-specific protein S100B in blood plasma in patients with acute coronary syndrome (ACS) associated with anxiety-depressive disorders (ADD).Material and Methods. The study included 81 patients with ACS and the presence of anxiety and depression. Patients were surveyed using the Hospital Anxiety and Depression Scale, the Beck Depression Inventory, and the Sheehan Patient-Rated Anxiety Scale. All patients underwent blood sampling to study the level of S100B protein.Results. Patients included in the study were diagnosed with clinical anxiety and subclinical depression. In 35 patients (43%), the S100B protein level varied from 0 to 90 ng/l, and in 46 patients (57%), its level was above 90 ng/l. According to correlation analysis in patients, positive correlations were found between a high level of S100B protein in the blood serum and clinical indicators (diabetes mellitus, obesity, smoking, arterial hypertension, postinfarction cardiosclerosis, a history of cerebral stroke), levels of anxiety and depression, as well as negative correlations between high level of S100B protein in blood serum and glomerular filtration rate, left ventricular ejection fraction.Conclusions. An increase in the level of S100B protein was observed in comorbid patients with clinically pronounced anxiety and depressive symptoms. It is possible that higher values of glial protein S100B in the blood at admission in patients with ACS may predict a more severe course of cardiovascular disease and a worse neurological prognosis, but it requires further study.

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Evaluation of Mental Status and Its Correction Agomelatine in Patients With Acute Coronary Syndrome

Cited by 2 publications

References 11 publications

The Effects of Agomelatine on Heart Rate Variability in Patients With Anxiety-Depressive Disorders Who Suffered Acute Coronary Syndrome

The Effects of Agomelatine on Heart Rate Variability in Patients With Anxiety-Depressive Disorders Who Suffered Acute Coronary Syndrome

Analysis of the S100B protein level in patients with acute coronary syndrome associated with anxiety and depressive symptoms

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