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

• Published in: Journal of psychosomatic research 2021-12, Vol.151, p.110659-110659, Article 110659
• Main Authors: Deter, Hans-Christian, Orth-Gomér, Kristina, Rauch-Kröhnert, Ursula, Albus, Christian, Ladwig, Karl-Heinz, Söllner, Wolfgang, de Zwaan, Martina, Grün, Anna-Sophia, Ronel, Joram, Hellmich, Martin, Herrmann-Lingen, Christoph, Weber, Cora
• Format: Article
• Language: English
• Subjects: Anxiety; Cardiovascular disease; Coagulation; Coronary artery; Coronary artery disease; Coronary Artery Disease - complications; Coronary vessels; Cross-Sectional Studies; Depression; Fatigue; Fibrinogen; Heart diseases; Humans; Male; Medicin och hälsovetenskap; Mental depression; Middle Aged; Myeloperoxidase; Patients; Prospective Studies; Psychological intervention; Psychotherapy; Randomised controlled trial; Tissue factor; Vein & artery diseases; Vital exhaustion
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2021.110659

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. 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, D-dimer, 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). HAM-D at baseline was correlated with TF (corr. R2 = 0.27; F = 9.31, p = 0.001). HADS anxiety was associated with fibrinogen (corr. R2.20; 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