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Expired CME Article

Platelet Function in Patients with Depression

Kapil Parakh, MD, MPH, Ankit Sakhuja, MBBS, Utsav Bhat, Roy C. Ziegelstein, MD
Volume: 101 Issue: 6 June, 2008

Abstract:

Depression accelerates the development and progression of cardiovascular disease and confers an increased risk of mortality. Platelets share biochemical similarity with the central nervous system, particularly in the uptake, storage, and metabolism of serotonin. Given this similarity, and considering the central role of platelets in the biology of cardiovascular disease, it is highly plausible that platelets play an important role in the increased cardiovascular risk of patients with depression. This article provides a comprehensive review of the evidence in this area and shows that the relationship between depression and platelet function is hardly straightforward. Whereas many studies have found that patients with depression have exaggerated platelet activation, quite a number of others show no such relationship or even lower levels of platelet activation in patients with depression. Larger, carefully designed, adequately powered studies with standardized methods of assessing platelet function are needed to address this issue.


Key Points


* Depression is associated with the development and progression of cardiovascular disease, and particularly after myocardial infarction, it is associated with increased mortality.


* Alteration in platelet function is one of the most plausible mechanisms to explain this, given the central role of platelets in cardiovascular disease and their biochemical similarity with the central nervous system, particularly in the uptake, storage, and metabolism of serotonin.


* Although many studies have found that patients with depression have exaggerated platelet activation, many others show no relationship or lower levels of platelet activation.


* Selective serotonin reuptake inhibitors have an effect on platelet function and are known to increase the risk of bleeding, particularly when they are used with nonsteroidal anti-inflammatory drugs.

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