Peculiarities of Platelet Metabolism in Patients with Acute Coronary Syndrome with Anxiety–Depressive Disorders and Informativity of Enzymes in the Forecast of Development of Cardiovascular Complications

Abstract

Anxiety–depressive disorders (ADD) are a risk factor of cardiovascular mortality in patients with coronary artery disease (CAD). Acute coronary syndrome (ACS) is the main clinical manifestation of a progressing CAD. Metabolic processes disorder in platelets can be one of the causes of cardiovascular complications in patients with ACS and concomitant ADD. We studied platelets metabolism and prognostic informativity of NAD(P)-dependent dehydrogenases of platelets in ACS patients with ADD in terms of forecasting cardiovascular complications development over a year of observation. The levels of NAD- and NADP-dependent dehydrogenases of platelets were determined by means of a bioluminescent method during the first 24 h after admission to hospital and in dynamics in 10 days. Among 315 examined patients, ADD was found in 161 (51.1%). ACS patients with concomitant ADD had both cytoplasmic and mitochondrial processes impairment in platelets that consisted in a decrease of energy metabolism intensity, inhibition of anaerobic glycolysis reactions and lipid catabolism. After 12 months of follow-up, 41 (25.5%) cardiovascular complications were detected in the group of ACS patients with ADD and 20 (13.0%) in the group of ACS patients without ADD. According to the results of the analysis of the neural network based on NAD(P)-dependent dehydrogenases of platelets activity in ACS patients with ADD, indicators were obtained that are informative for predicting the development of recurrent cardiovascular complications.

Beyond Haemostasis and Thrombosis: Platelets in Depression and Its Co-Morbidities

“…In general, both PF4 and β-TG were higher in depressed compared to non-depressed CAD patients [ 218 , 219 , 220 ], as well as in depressed CAD patients compared to CAD- and depression-free controls [ 221 ]. In a recent study [ 269 ], the activity of platelet-dependent NAD and NADP dehydrogenases has been measured as read-out of platelet metabolism in patients with acute coronary syndrome (ACS) with or without concomitant anxiety-depressive disorder (ADD) followed up for one year for recurrent cardiovascular complications. Among the patients that developed cardiovascular complications over the follow-up period, the ones with the concomitant ACS and ADD had lower NADP–MDH activity compared to controls and to ACS patients without ADD [ 269 ].…”

The prevalence of anxiety syndrome in people with chronic non-communicable diseases in real clinical practice

“…В ряде работ продемонстрирована распространённость тревожно-депрессивных расстройств в период стационарного лечения пациентов, при этом полученные данные существенно разнятся. Например, при хронической обструктивной болезни лёгких (ХОБЛ) умеренно-тяжёлая тревога выявляется у 18,5% пациентов, а депрессивные симптомы -у 30,7% [19], в то время как при остром коронарном синдроме (ОКС) распространённость аффективных расстройств достигает 50% [20]. Вместе с тем немногие исследования характеризуют особенности распространения тревожных расстройств у пациентов с ХНИЗ в амбулаторной терапевтической практике.…”