Universität zu Köln

Deter, Hans-Christian, Orth-Gomer, Kristina, Rauch-Kroehnert, Ursula, Albus, Christian, Ladwig, Karl-Heinz, Soellner, Wolfgang, de Zwaan, Martina, Gruen, Anna-Sophia, Ronel, Joram, Hellmich, Martin, Herrmann-Lingen, Christoph and Weber, Cora (2021). 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. J. Psychosomat. Res., 151. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 1879-1360

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Abstract

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, Ddimer, 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Deter, Hans-Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Orth-Gomer, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Rauch-Kroehnert, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Soellner, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED de Zwaan, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruen, Anna-Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-599479
DOI:	10.1016/j.jpsychores.2021.110659
Journal or Publication Title:	J. Psychosomat. Res.
Volume:	151
Date:	2021
Publisher:	PERGAMON-ELSEVIER SCIENCE LTD
Place of Publication:	OXFORD
ISSN:	1879-1360
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MYOCARDIAL-INFARCTION ASSOCIATION; C-REACTIVE PROTEIN; TISSUE FACTOR; HEART-DISEASE; CARDIOVASCULAR-DISEASES; PROGNOSTIC ASSOCIATION; PROTHROMBOTIC ACTIVITY; COAGULATION-FACTORS; BLOOD-COAGULATION; RISK-FACTOR Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59947