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Anxiety is a better predictor of platelet reactivity in coronary artery disease patients than depression

M Urooj Zafar1, Manuel Paz-Yepes, Daichi Shimbo

  • 1Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA.

European Heart Journal
|January 26, 2010
PubMed

Insights

Anxiety, not depression, is linked to increased serotonin-mediated platelet hyperactivity in coronary artery disease patients. This finding highlights anxiety as a key factor in cardiovascular events.

Area of Science:

  • Cardiology
  • Psychiatry
  • Hematology

Background:

  • Depression and anxiety are known risk factors for coronary events.
  • The underlying mechanisms linking these psychological states to cardiovascular disease remain incompletely understood.

Purpose of the Study:

  • To investigate the association between depression, anxiety, and serotonin-mediated platelet hyperactivity in patients with coronary artery disease (CAD).

Main Methods:

  • A cross-sectional study evaluated 83 stable CAD patients three months post-acute coronary event.
  • Assessments included depression (Beck Depression Inventory) and anxiety (Hospital Anxiety and Depression Scale).
  • Platelet reactivity was measured using optical aggregometry and flow cytometry in response to adenosine diphosphate (ADP) and serotonin + epinephrine (5HT:E).

Main Results:

  • Platelet reactivity to serotonin + epinephrine was significantly higher in patients with both depression and anxiety compared to those with only depression or neither.
  • Anxiety symptoms independently predicted all serotonin + epinephrine-mediated platelet reactivity measures in a multivariate regression model.
  • No significant association was found between depression and platelet reactivity, possibly due to clopidogrel therapy affecting ADP-induced aggregation.

Conclusions:

  • Anxiety is significantly associated with elevated serotonin-mediated platelet reactivity in stable coronary artery disease patients.
  • Symptoms of anxiety demonstrate strong, independent correlations with platelet function in this population.
  • These findings suggest anxiety plays a crucial role in the pathophysiology of cardiovascular events via platelet activation.
Abstract

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