title: [An effect of valdoxan on the hemostasis in patients with acute coronary syndrome in the combination with anxiety and depressive disorders].
abstract: OBJECTIVE
  To explore the dynamics of hemostasis in patients with acute coronary syndrome (ACS) in the combination with anxiety and depressive disorders (ADD) during therapy with valdoxan (agomelatine).
  
  
  METHODS
  We examined 196 male and female patients (mean age 64.2 ± 0.8 years) in the first 24 hours of ACS. The patients were divided into three groups: patients with ACS without ADD (n=88), patients with ACS and ADD without valdoxan therapy (n=58) and patients with ACS and ADD treated with valdoxan (n=50). Coagulation and vascular-platelet hemostasis were studied in the first 24 hours of hospitalization and in the 10th day of hospitalization.
  
  
  RESULTS
  Patients with ACS revealed high levels of fibrinogen, soluble fibrin-monomer complexes, D-dimer at all stages of the study. In patients with ADD, these parameters were significantly higher compared to patients without ADD. The levels of D-dimer in the 10th day were similar in patients with ADD treated with valdoxan and in patients with ACS without ADD. In both groups of patients with ADD, the levels of spontaneous aggregation in the first and 10th days of hospitalization were not significantly higher than in the control group and in patients with ACS without ADD. All patients with ACS had high values of platelet aggregation stimulated by adenosine diphosphate in dose 0.1 uM. In patients with ACS and ADD treated with valdoxan, a significant reduction of these parameters was noted in the 10th day of treatment compared to the first day of hospitalization.
  
  
  CONCLUSIONS
  The high procoagulant activity of the hemostatic system was observed during all stages of the study in the patients with ACS and ADD who received a combined antithrombotic therapy without valdoxan.
authors.affiliation: Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk; Karpovich Clinical Emergency Hospital, Krasnoyarsk.
authors.forename: N Yu
authors.initials: NY
authors.lastname: Shimohina
authors.affiliation: Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk.
authors.forename: M M
authors.initials: MM
authors.lastname: Petrova
authors.affiliation: Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk; The Research Institute of Medical Problems of the North, Krasnoyarsk.
authors.forename: A A
authors.initials: AA
authors.lastname: Savchenko
authors.affiliation: Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk.
authors.forename: M S
authors.initials: MS
authors.lastname: Piliugina
mesh_terms: D000081:Acetamides / Q000008:administration & dosage*; D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D002492:Central Nervous System Depressants / Q000008:administration & dosage; D003866:Depressive Disorder / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D008297:Male; D008550:Melatonin / Q000819:agonists; D008875:Middle Aged; D016896:Treatment Outcome; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D002492:Central Nervous System Depressants; D008550:Melatonin; C084711:agomelatine; D009281:Naphthalenes