抗抑郁药可减少心脏病病人血栓发生的机率
By reducing the tendency of platelets to stick together, sertraline, an antidepressant marketed as Zoloft, may reduce the risk of dangerous clots in heart patients, researchers report.
The finding may help to explain why depression is linked to an increased risk of complications in patients with clogged heart arteries, according to a report presented recently at the American College of Cardiology meeting in Anaheim, California.
"We‘ve been interested for some time in the enhanced platelet function seen in depressed patients after a (heart attack) because of their 3- to 5-fold higher mortality," Dr. Paul Gurbel, director of Sinai Health System of Baltimore‘s Center for Thrombosis Research in Baltimore, Maryland, told Reuters Health.
In order to test the effects of antidepressants on platelet function, Gurbel and his colleagues collected platelets from healthy individuals and patients with coronary artery disease and mixed them with sertraline or with N-desmethylsertraline (a metabolite of sertraline without antidepressant properties). They chose doses that mimicked blood levels that might be seen in patients taking between 50 milligrams and 200 milligrams of sertraline daily.
By several measures, both sertraline and N-desmethylsertraline inhibited the normal function of platelets. Higher doses, Gurbel said, resulted in greater interference with the normal platelet function.
"In both cases," he explained, "the platelets became less sticky with increasing doses. "Both agents appear to reduce the likelihood of clots forming, suggesting they might reduce the chance of a second heart attack or subsequent stroke."
In fact, Gurbel noted, this theory has been the subject of a recent international clinical study involving nearly 400 depressed patients who had experienced a heart attack. In that study, conducted under the direction of Dr. Christopher O‘Conner at Duke University in Durham, North Carolina, half the patients were treated with sertraline, and half were treated with (an inactive) placebo. The data from this trial are being analyzed, with results expected later this year.
"We‘ve learned a great deal about the way platelets function in heart attacks, and their increased stickiness in depressed patients may account for their increased risk," Gurbel said. "By favorably affecting the platelet‘s blood-clotting function, antidepressants may help to reduce the death rates in these patients after a heart attack.", 百拇医药
The finding may help to explain why depression is linked to an increased risk of complications in patients with clogged heart arteries, according to a report presented recently at the American College of Cardiology meeting in Anaheim, California.
"We‘ve been interested for some time in the enhanced platelet function seen in depressed patients after a (heart attack) because of their 3- to 5-fold higher mortality," Dr. Paul Gurbel, director of Sinai Health System of Baltimore‘s Center for Thrombosis Research in Baltimore, Maryland, told Reuters Health.
In order to test the effects of antidepressants on platelet function, Gurbel and his colleagues collected platelets from healthy individuals and patients with coronary artery disease and mixed them with sertraline or with N-desmethylsertraline (a metabolite of sertraline without antidepressant properties). They chose doses that mimicked blood levels that might be seen in patients taking between 50 milligrams and 200 milligrams of sertraline daily.
By several measures, both sertraline and N-desmethylsertraline inhibited the normal function of platelets. Higher doses, Gurbel said, resulted in greater interference with the normal platelet function.
"In both cases," he explained, "the platelets became less sticky with increasing doses. "Both agents appear to reduce the likelihood of clots forming, suggesting they might reduce the chance of a second heart attack or subsequent stroke."
In fact, Gurbel noted, this theory has been the subject of a recent international clinical study involving nearly 400 depressed patients who had experienced a heart attack. In that study, conducted under the direction of Dr. Christopher O‘Conner at Duke University in Durham, North Carolina, half the patients were treated with sertraline, and half were treated with (an inactive) placebo. The data from this trial are being analyzed, with results expected later this year.
"We‘ve learned a great deal about the way platelets function in heart attacks, and their increased stickiness in depressed patients may account for their increased risk," Gurbel said. "By favorably affecting the platelet‘s blood-clotting function, antidepressants may help to reduce the death rates in these patients after a heart attack.", 百拇医药
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