Depression, Anxiety Will Increase Platelet Activity, Weakening Clopidogrel Effect

Amis: Depression and anxiety are linked to coronary events but the mechanism(s) remainsunclear. In addition, cardiovascular disease patients especially coronary heart disease andmyocardial infarction patients are still have cardiovascular events after conventional antiplatelettherapy. We investigated the association of depresson and anxiety with platlet hyperactivity andantiplatelet drug effect in stable myocardial infarction patients in a cross-sectonal study.Methods: Stable myocardial infarction patients(three months after myocardial infarction, noangina pectoris, and cardiac function in patients≤Ⅱ) on aspirin100mg/d and clopidogrel75mg/dwere evaluated for depression (Hamilton depression rating scale-HAMD) and anxiety(Hamiltonanxiety rating scale-HAMA) and their platelet reactivity was measured by VerifyNow plateletdetection system(VerifyNow Aspirin system testing89cases and VerifyNow P2Y12systemtesting79cases).Results: We study found that stable myocardial in infarction patients with its anxietycomorbid rate was9%-10%, depression comorbid rate was5%-7%.With anxiety, depression gradescore increases, the participants’ platelet active, PRU are increasing, and platelet inhibition rate arelowing.But, in the detection of aspirin antiplatelet curative effect, did not find this phenomenon.According to the HAMD’s score divided the selected patients into tress groups: found three groupscompared between PRU value, inhibition rate and baseline,are both statistically significantdifference (P＜0.05). Similar, According to the HAMA’s score divided the selected patients intotress groups: found three groups compared between PRU value, inhibition rate and baseline,areboth statistically significant difference (P＜0.05). However, ues the same method divided89casesof asprin test subjects into three groups, found three groups of the difference between ARU valuewas not statistically significant (P＞0.05).Conclusion: Stable myocardial infarction stable patients with its anxiety comorbid rate was9%-10%, depression comorbid rate was5%-7%. Comorbid depression, anxiety will increase theactivity of platelets, and weakening the Copidogrel therapeutic efficacy, but comorbid depression,anxiety have no significant effect the Aspirin therapeutic efficacy.