Prothrombotic changes with acute psychological stress: Combined effect of hemoconcentration and genuine coagulation activation

Känel, Roland von; Kudielka, Brigitte M.; Haeberli, André; Stutz, Monika; Fischer, Joachim E.; Patterson, Stephen

doi:10.1016/j.thromres.2008.05.014

Cited by 30 publications

(52 citation statements)

References 44 publications

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“…Acute stress triggers myocardial ischemia, promotes arrhythmogenesis, stimulates platelet aggregation, and increases blood viscosity through hemoconcentration [28,29]. SNS stimulation produced from acute stress leads to a variety of effects, ranging from heart rate and blood pressure rise to direct effects on coronary vascular endothelium [30].…”

Section: Discussionmentioning

confidence: 99%

Anxiety trait in patients with stress-induced cardiomyopathy: a case–control study

et al. 2011

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Background Stress-induced Tako-tsubo cardiomyopathy (TTC) is an acute cardiac syndrome, mimics ST elevation myocardial infarction (STEMI), largely confined to postmenopausal women, frequently precipitated by a stressful event. The pathogenesis of TTC is still unknown. Some authors hypothesized a possible connection between TTC and anxiety disease, but no previous study analyzed the relationship between anxiety trait and TTC. This study sought to assess the potential role of anxiety trait in the development and clinical course of TTC. Methods We included in the present prospective casecontrol study 50 consecutive patients admitted to our Hospital with a diagnosis of TTC according to the Mayo Clinic criteria. Fifty control patients with anterior STEMI matched for clinical characteristics such as age, gender, and hypertension were selected. During the hospitalization, all patients were asked to complete the Spielberger Trait Anxiety Inventory (STAI) scale for measuring self-reported trait anxiety (Trait-A). Outcome measures at follow-up were death, TTC recurrence, and rehospitalization. Results The mean value of STAI scale was 46 ± 12 in TTC patients and 45 ± 14 in STEMI patients (p = 0.815). High-anxiety trait (STAI scale value C 40) was documented in 30 (60%) TTC patients and in 26 (52%) STEMI patients (p = 0.387). At multivariate analysis, predictors of TTC were lower peak creatine kinase value (HR 0.999; 95% CI 0.998-0.999; p = 0.018) and an antecedent stressful trigger event (HR 45.487;; p = 0.001), but anxiety trait was not. There were no differences in outcome measures between TTC patients with or without high-anxiety trait. Conclusion In TTC patients, high-anxiety trait is a common finding but it is not significantly more frequent than in patients with STEMI. Moreover, a high-anxiety trait seems to be neither associated with a worse clinical outcome nor a predictor of TTC. Our study do not support the routine evaluation of anxiety trait in patients with TTC.

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Section: Discussionmentioning

confidence: 99%

Anxiety trait in patients with stress-induced cardiomyopathy: a case–control study

et al. 2011

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“…In addition to elevated blood viscosity, stresshemoconcentration is accompanied by hypercoagulation [18]. Moreover, hypercoagulation may be a mechanism of acute coronary syndromes initiated by acute psychological stress [10,11].…”

Section: Stress-induced Changes In Indices Of Hemoconcentrationmentioning

confidence: 99%

“…However, the results from these studies were in the expected direction, and nonsignificance likely occurred due to the low statistical power arising from small sample sizes. Additionally, some studies have not found a statistically significant increase in D-dimer during acute mental stress in men [18,142,143,150] and women [142]. Such discrepancies may be due to the use of different assays.…”

Section: Blood Coagulation and Acute Stressmentioning

confidence: 99%

“…The ensuing net hypercoagulability resulting from acute psychological stress may put an individual at a greater risk for coronary thrombosis after plaque disruption and thus contribute to acute coronary syndromes [10,11]. Other crucial factors suggested to accompany hypercoagulation are stress-induced hemoconcentration [18] and increased blood viscosity [9,19], both of which exacerbate the shear stresses imposed by atherosclerotic plaques and plaque ruptures [7]. Elucidation of how these mechanisms occur is central to understanding the relationship between stress and CHD.…”

Section: Introductionmentioning

confidence: 99%

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Hemoconcentration and Hemostasis During Acute Stress: Interacting and Independent Effects

2011

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“…This idea of "giving time back" is intriguing and does make intuitive sense. In a previous study (5), we were to our knowledge the first group to attempt to arithmetically correct for plasma volume changes when examining clotting time. We used the equation that has been used extensively to correct for plasma volume changes when examining concentrations, which incorporates a (-).…”

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confidence: 99%

Reply to Letters From Fall and Bailey, and Muldoon

Austin

Wirtz

Patterson

et al. 2013

Psychosomatic Medicine

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Two letters were recently submitted to the editor regarding our recent publication (1), both of which raised important issues. Fall and Bailey identified discrepancies between their work (2) and ours, which deserve consideration. They also used the same Dill and Costill correction technique (3) after maximal exercise, though it yielded different results to their study and one by Darlington and colleagues (4). Darlington and colleagues found that progressive dilutions from 0-90% of citrated plasma elongated coagulation times, which is in agreement with the results of Fall and Bailey's experiment (2). However, we feel that the design of the Darlington et al. study is not very useful to explain our findings. While the dilution of citrated

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Prothrombotic changes with acute psychological stress: Combined effect of hemoconcentration and genuine coagulation activation

Cited by 30 publications

References 44 publications

Anxiety trait in patients with stress-induced cardiomyopathy: a case–control study

Anxiety trait in patients with stress-induced cardiomyopathy: a case–control study

Hemoconcentration and Hemostasis During Acute Stress: Interacting and Independent Effects

Reply to Letters From Fall and Bailey, and Muldoon

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