Peculiarities of Platelet Metabolism in Patients with Acute Coronary Syndrome with Anxiety-Depressive Disorders and Informativity of Enzymes in the Forecast of Development of Cardiovascular Complications.

Natalya Yu Shimokhina,Andrey A Savchenko,Marina M Petrova

doi:10.3390/ph13080169

Natalya Yu Shimokhina, Andrey A Savchenko + Show 1 more

Open Access

https://doi.org/10.3390/ph13080169

Copy DOI

Abstract

Anxiety–depressive disorders (ADD) are a risk factor of cardiovascular mortality in patients with coronary artery disease (CAD). Acute coronary syndrome (ACS) is the main clinical manifestation of a progressing CAD. Metabolic processes disorder in platelets can be one of the causes of cardiovascular complications in patients with ACS and concomitant ADD. We studied platelets metabolism and prognostic informativity of NAD(P)-dependent dehydrogenases of platelets in ACS patients with ADD in terms of forecasting cardiovascular complications development over a year of observation. The levels of NAD- and NADP-dependent dehydrogenases of platelets were determined by means of a bioluminescent method during the first 24 h after admission to hospital and in dynamics in 10 days. Among 315 examined patients, ADD was found in 161 (51.1%). ACS patients with concomitant ADD had both cytoplasmic and mitochondrial processes impairment in platelets that consisted in a decrease of energy metabolism intensity, inhibition of anaerobic glycolysis reactions and lipid catabolism. After 12 months of follow-up, 41 (25.5%) cardiovascular complications were detected in the group of ACS patients with ADD and 20 (13.0%) in the group of ACS patients without ADD. According to the results of the analysis of the neural network based on NAD(P)-dependent dehydrogenases of platelets activity in ACS patients with ADD, indicators were obtained that are informative for predicting the development of recurrent cardiovascular complications.

Highlights

According to data found in literature, the prevalence of anxiety–depressive disorders (ADD) in patients with cardiovascular diseases ranges from 20% to 45%, which is 3–4 times higher than among the general population [1,2,3,4]
According to the results of the analysis of the neural network based on NAD(P)-dependent dehydrogenases of platelets activity in Acute coronary syndrome (ACS) patients with Anxiety–depressive disorders (ADD), indicators were obtained that are informative for predicting the development of recurrent cardiovascular complications
Progressing cardiac deficiency was observed in 5 ACS patients with ADD (3.1%) and in 3 ACS patients without ADD (1.9%)

Summary

Introduction

According to data found in literature, the prevalence of anxiety–depressive disorders (ADD) in patients with cardiovascular diseases ranges from 20% to 45%, which is 3–4 times higher than among the general population [1,2,3,4]. It is important to note that a risk of cardiovascular mortality in patients with an acute coronary syndrome (ACS) and an ADD was 2–2.6 times higher than for patients without affective disorders [5]. Despite the optimal medical help during the first 30 days of hospitalization after ACS, the risk of unfavorable cardiovascular occurrences is at its highest. Later on the patients who have had ACS are still subject to a continuous higher risk of recurrent cardiovascular incidents [11,12]

Methods

Results

Discussion

Conclusion