RESUMO
OBJECTIVE: To explore the dynamics of hemostasis in patients with acute coronary syndrome (ACS) in the combination with anxiety and depressive disorders (ADD) during therapy with valdoxan (agomelatine). MATERIAL AND METHODS: We examined 196 male and female patients (mean age 64.2 ± 0.8 years) in the first 24 hours of ACS. The patients were divided into three groups: patients with ACS without ADD (n=88), patients with ACS and ADD without valdoxan therapy (n=58) and patients with ACS and ADD treated with valdoxan (n=50). Coagulation and vascular-platelet hemostasis were studied in the first 24 hours of hospitalization and in the 10th day of hospitalization. RESULTS: Patients with ACS revealed high levels of fibrinogen, soluble fibrin-monomer complexes, D-dimer at all stages of the study. In patients with ADD, these parameters were significantly higher compared to patients without ADD. The levels of D-dimer in the 10th day were similar in patients with ADD treated with valdoxan and in patients with ACS without ADD. In both groups of patients with ADD, the levels of spontaneous aggregation in the first and 10th days of hospitalization were not significantly higher than in the control group and in patients with ACS without ADD. All patients with ACS had high values of platelet aggregation stimulated by adenosine diphosphate in dose 0.1 uM. In patients with ACS and ADD treated with valdoxan, a significant reduction of these parameters was noted in the 10th day of treatment compared to the first day of hospitalization. CONCLUSION: The high procoagulant activity of the hemostatic system was observed during all stages of the study in the patients with ACS and ADD who received a combined antithrombotic therapy without valdoxan.
Assuntos
Acetamidas/administração & dosagem , Síndrome Coronariana Aguda/sangue , Ansiedade/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Hemostasia/efeitos dos fármacos , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/tratamento farmacológico , Adulto , Idoso , Ansiedade/sangue , Ansiedade/complicações , Depressores do Sistema Nervoso Central/administração & dosagem , Transtorno Depressivo/sangue , Transtorno Depressivo/complicações , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Melatonina/agonistas , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Anxiety-depressive disorders (ADD) have a negative impact on the course and prognosis of patients with ischemic heart disease, but the mechanisms of their correlation are not studied enough. The purpose of this study was to elucidate special characteristics of hemostasis and immune system in patients with acute coronary syndrome (ACS) combined with ADD. We included into the study 60 patients during first 24 hours of ACS. ADD was identified in 27 patients (45%). Parameters of plasma and vascular-platelet hemostasis and phenotype of lymphocytes were determined in samples of blood taken during first 24 hours and on day 10 of hospitalization. We found that patients with ACS combined with ADD had procoagulant state of hemostasis, increased platelet aggregation, decreased content of lymphocytes and augmented immunoregulatory induction of inflammatory processes.
Assuntos
Síndrome Coronariana Aguda/imunologia , Ansiedade/imunologia , Depressão/imunologia , Hemostasia/fisiologia , Imunidade Inata , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/complicações , Ansiedade/sangue , Ansiedade/complicações , Depressão/sangue , Depressão/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Anxiety-depressive disorders (DD) have a negative impact on the course and prognosis of patients with ischemic heart disease, but the mechanisms of their correlation are not studied enough. The purpose of this study was to elucidate special characteristics of hemostasis and immune system in patients with acute coronary syndrome (ACS) combined with ADD. We included into the study 60 patients during first 24 hours of ACS. ADD was identified in 27 patients (45%). Parameters of plasma and vascular-platelet hemostasis and phenotype.
RESUMO
In patients with complicated essential hypertension (ischemic stroke) and coronary heart disease, inductors of platelet aggregation in various doses induced "paradoxical" changes in platelet aggregation activity reflecting the degree of decompensation under conditions of persistent endothelial dysfunction. Aggregation inductors in low doses were shown to have a greater diagnostic significance. The content of endothelial dysfunction markers in the blood was persistently elevated under these conditions.
