Prognostic value of the psychoemotional status in patients with coronary artery disease: focus on platelet hemostatic system

Aim. To assess the effect of psychological distress on platelet morphology depending on the severity of mixed anxiety-depressive disorder (MADD) in patients with coronary artery disease (CAD).

Material and methods. The study included 112 patients (mean age — 60,9±1,46 years), 84 of whom were diagnosed with CAD, class II-III angina of effort and stage I-III hypertension. The assessment of psychoemotional status and type D personality was carried out using the Hospital Anxiety and Depression Scale (HADS) and the Type D Scale-14 (DS14), respectively. The detection of platelet phenotype was performed on a high-tech XN-1000 hematology analyzer using flow cytometry.

Results. Participants were divided into two groups: group I (n=40) — patients with MADD; group II (n=44) — patients without anxiety and depression. Assessment of the interconnected effect of MADD and psychological distress on the platelet profile in patients with CAD revealed differences between groups by the platelet morphology. The average platelet count (PLT) in patients of group I was 312,1±17,17x10⁹/L, and in patients with type D personality — 316,7±17,54x10⁹/L, which significantly prevailed the same parameter in comparison group — 220,4±1,48x109/L (p<0,001). The average platelet distribution width (PDW) was significantly higher in group I compared with group II (17,0±0,94 fL vs 13,6±0,76 fL (p<0,05)). The mean platelet volume (MPV) in patients of group I (11,3±0,42) was significantly higher than in the comparison and control groups: 9,7±0,23 and 8,7±0,28 fL, respectively (p<06001). According to logistic regression, the independent predictors of increased platelet aggregation in cardiac patients were depression

Conclusion. Increased functional activity of platelets in patients with CAD and hypertension is due to the effect of MADD associated with type D personality.

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