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Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials.

Publication ,  Journal Article
Serebruany, VL; Glassman, AH; Malinin, AI; Sane, DC; Finkel, MS; Krishnan, RR; Atar, D; Lekht, V; O'Connor, CM
Published in: Blood Coagul Fibrinolysis
September 2003

Platelets play a key role in the progression of acute coronary syndromes (ACS). Clinical depression alone is also associated with enhanced platelet activation. The purpose of this study was to compare concentrations of established biomarkers of enhanced platelet/endothelial activation in clinically depressed versus non-depressed patients enrolled in recent clinical trials for ACS. Two hundred and eighty-one baseline plasma samples from patients with acute myocardial infarction (ASSENT-2; n = 41), with ACS (PRONTO; n = 126) and with clinical depression plus previous acute coronary syndrome within 6 months (SADHART; n = 64), and from normal healthy controls (n = 50) were analyzed. Blood was drawn before applying any therapeutic strategies including interventions, thrombolytics, infusions, and selective serotonin re-uptake inhibitors. Platelet factor 4, beta-thromboglobulin, platelet/endothelial cell adhesion molecule-1, P-selectin, thromboxane, prostacyclin, vascular cell adhesion molecule-1, and E-selectin were measured by enzyme-linked immunosorbent assay by a single core laboratory. Patients with ACS exhibited a higher degree of platelet activation than controls independently of the presence of depression. Plasma levels of P-selectin, thromboxane, prostacyclin, and vascular cell adhesion molecule-1 were the highest in the acute myocardial infarction group when compared with ACS despite the presence or absence of clinical depression. Surprisingly, patients with ACS and depression exhibited the highest levels of platelet factor 4, beta-thromboglobulin, and platelet/endothelial cell adhesion molecule-1 when compared with myocardial infarction or angina patients without clinical depression. E-selectin plasma level was constantly elevated compared with controls but did not differ among the groups dependent on the incidence of depression. The depressed plus ACS group had higher plasma levels of all biomarkers compared with the non-depressed patients. Retrospective analysis of the data from several clinical trials reveals that clinical depression is associated with enhanced activation of platelet/endothelial biomarkers even above the level expected in ACS. These findings may contribute to the unfavorable outcome associated with clinical depression in patients with ACS.

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Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

September 2003

Volume

14

Issue

6

Start / End Page

563 / 567

Location

England

Related Subject Headings

  • Platelet Activation
  • Myocardial Infarction
  • Male
  • Humans
  • Female
  • Enzyme-Linked Immunosorbent Assay
  • Endothelium, Vascular
  • Depression
  • Coronary Disease
  • Case-Control Studies
 

Citation

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Chicago
ICMJE
MLA
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Serebruany, V. L., Glassman, A. H., Malinin, A. I., Sane, D. C., Finkel, M. S., Krishnan, R. R., … O’Connor, C. M. (2003). Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis, 14(6), 563–567. https://doi.org/10.1097/00001721-200309000-00008
Serebruany, Victor L., Alexander H. Glassman, Alex I. Malinin, David C. Sane, Mitchell S. Finkel, Ranga R. Krishnan, Dan Atar, Vladimir Lekht, and Christopher M. O’Connor. “Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials.Blood Coagul Fibrinolysis 14, no. 6 (September 2003): 563–67. https://doi.org/10.1097/00001721-200309000-00008.
Serebruany VL, Glassman AH, Malinin AI, Sane DC, Finkel MS, Krishnan RR, et al. Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis. 2003 Sep;14(6):563–7.
Serebruany, Victor L., et al. “Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials.Blood Coagul Fibrinolysis, vol. 14, no. 6, Sept. 2003, pp. 563–67. Pubmed, doi:10.1097/00001721-200309000-00008.
Serebruany VL, Glassman AH, Malinin AI, Sane DC, Finkel MS, Krishnan RR, Atar D, Lekht V, O’Connor CM. Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis. 2003 Sep;14(6):563–567.

Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

September 2003

Volume

14

Issue

6

Start / End Page

563 / 567

Location

England

Related Subject Headings

  • Platelet Activation
  • Myocardial Infarction
  • Male
  • Humans
  • Female
  • Enzyme-Linked Immunosorbent Assay
  • Endothelium, Vascular
  • Depression
  • Coronary Disease
  • Case-Control Studies