Relation of depression to various markers of coagulation and fibrinolysis in patients with and without coronary artery disease.
BACKGROUND
It has been suggested that changes in blood coagulation and fibrinolysis might explain the observed association between depression and coronary artery disease (CAD). So far, only a few coagulation factors have been investigated in this regard, and the results were not consistent.


METHODS
The aim of our study was to analyse a broad range of coagulation and fibrinolytic factors, with emphasis on factors directly involved in clot formation and degradation or reflecting coagulation activation, in patients with CAD and controls without CAD, as assessed by coronary angiography, who also underwent a diagnostic procedure for depression.


METHODS
We screened 306 patients with CAD and controls without CAD for depression using the Hospital Anxiety and Depression Scale and Allgemeine Depressions Skala-L questionnaires. In participants with positive screening result, diagnosis of major depression was confirmed or excluded by a structured interview. We analysed the following coagulation and fibrinolytic factors: fibrinogen, prothrombin fragment F1+2, factor XIII A-subunit, factor XIII B-subunit, tissue plasminogen activator, plasminogen activator inhibitor-1, thrombin-activable fibrinolysis inhibitor, and D-dimer.


RESULTS
We did not observe significant associations between depression and CAD, nor between depression and cardiovascular risk factors. Coagulation and fibrinolytic factors showed no differences between patients with CAD and controls, but they were associated with several cardiovascular risk factors. Depression was not associated with coagulation and fibrinolytic factors. No associations were found either when both CAD and depression were taken into account.


CONCLUSIONS
Our study gives no evidence that there is a significant relation among depression, CAD, and blood coagulation and fibrinolysis.
Laboratory for Thrombosis Research, Department of Clinical Research, University of Bern, Bern, Switzerland. verena.schroeder@dkf.unibe.ch
Verena
V
Schroeder
Urs
U
Borner
Stefan
S
Gutknecht
Jean-Paul
JP
Schmid
Hugo
H
Saner
Hans P
HP
Kohler
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001779:Blood Coagulation Factors / Q000378:metabolism*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology
D015415:Biomarkers; D001779:Blood Coagulation Factors