Issue: 2017, Vol. 22, No. 2
HEMOSTASIS SYSTEM INDICES IN PATIENTS WHO HAD ACUTE CORONARY SYNDROME IN COMBINATION WITH ANXIETY DEPRESSIVE DISORDERS ON THE BACKGROUND OF AGOMELATINE ADMINISTRATION
- Keywords
- anxiety, depression, hemostasis, acute coronary syndrome, valdoksan, agomelatine
- Abstarct
- Objective - to study the dynamics of hemostasis system in patients who had acute coronary syndrome in combination with anxiety depressive disorders on the background of agomelatine therapy. Material and methods . 196 patients (average age 64,2 ± 0,8 years) within first 24 hours after acute coronary syndrome manifestation who did not take antiaggregation agents before hospitalization. Patients filled in questionnaires within first 24 hours after transference from critical care unit in order to reveal anxiety depressive disorders. Several groups of patients were formed as follows: first group - patients with acute coronary syndrome without anxiety depressive syndrome (n = 88), second group - patients with acute coronary syndrome with anxiety depressive syndrome who were not administered agomelatine (n = 58) and third group - patients with acute coronary syndrome with anxiety depressive syndrome who were administered agomelatine (n = 50). Coagulation and vascular thrombocyte hemostasis were studied within first 24 hours after the hospitalization of the patients and on the 10th day from the disease onset. Results . High levels of fibrinogen, soluble fibrin-monomer complexes, D-dimer were revealed at all stages of the examination in patients who had acute coronary syndrome but the meanings of these parameters were significantly higher in the group of patients with anxiety depressive disorders than in patients without them. In the group of patients who had acute coronary syndrome with anxiety depressive disorders on the background of agomelatine therapy D-dimer level on the 10th day of the examination came nearer to the parameters of the patients who had acute coronary syndrome without anxiety depressive disorders. In the both groups of patients who had acute coronary syndrome with concomitant anxiety depressive syndrome the indices of spontaneous aggregation on the first day of hospitalization and on the 10th day significantly prevailed both control parameters and indices in the group of patients who had acute coronary syndrome without anxiety depressive disorders. The indices of thrombocyte aggregation which was stimulated by adenosine diphosphate in the dose of 0,1 mcM were rather high in all examined patients. Patients with had acute coronary syndrome and anxiety depressive disorders who took agomelatine demonstrated significant decrease of trombocyte aggregation and it was stimulated by adenosine diphosphate in the dose of 0.1 mcM, adrenaline and adenosine diphosphate in the dose of 5 mcM in comparison with first days of hospitalization. Conclusions . At all stages of the examination in patients with acute coronary syndrome with concomitant anxiety depressive disorders on the background of combined antithrombotic therapy without agomelatine high procoagulative activity of hemostasis system was maintained. Marked decrease of thrombocyte aggregation activity was revealed on the background of agomelatine therapy till the moment of the discharge from the hospital in comparison with first days of hospitalization.
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