Key result
Remitted MDD is linked to a higher procoagulant index compared to healthy controls.
Why the study?
Hypercoagulability may explain the increased atherothrombotic disease risk in major depressive disorder, but whether patients with remitted depression show an enhanced procoagulant state remained unexamined.
Does remitted major depressive disorder increase the procoagulant state compared to healthy controls?
Case-Control (n=63)
Does remitted major depressive disorder increase the procoagulant state compared to healthy controls?
Standardized Mean Difference: 0.69
p-value: p=0.013
Remitted major depressive disorder is associated with an enhanced procoagulant state, suggesting that hypercoagulability is a trait characteristic of depression that may contribute to increased atherothrombotic risk.
Should not yet change practice; leaves open whether procoagulant abnormalities persist as residual thrombotic risk in remitted depression.
Objectives Hypercoagulability is one mechanism to explain the increased risk of incident atherothrombotic disease in patients with major depressive disorder (MDD). We examined whether patients with remitted MDD show an enhanced procoagulant state.Methods 63 individuals (median age 35 years, 59% women), 40 with a DSM-IV diagnosis of remitted MDD, made by a clinical interview, and 23 healthy controls provided blood samples for the measurement of fibrinogen, D-dimer, von Willebrand factor, and plasminogen activator inhibitor-1. Standardised z-scores of plasma levels of these haemostatic factors were added to form a procoagulant index (PCI) as the primary outcome variable. Self-ratings of residual depressive symptoms and trait anxiety were also obtained.Results Compared with controls, remitted MDD patients had higher PCI (p = 0.013, Cohen’s d = 0.69) and fibrinogen (p = 0.001, d = 0.91), controlling for age, sex, body mass index, smoking and C-reactive protein. There were no significant associations of the PCI and individual haemostatic molecules with age of MDD onset, time since the last MDD episode, the number of previous MDD episodes and residual depressive symptoms. Additional adjustment for anxiety symptoms did not change these results.Conclusions Remitted MDD is associated with an enhanced procoagulant state. Hypercoagulability seems more a trait than a state characteristic of depression.
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Känel et al. (2019) conducted a case-control in Remitted major depressive disorder (n=63). Remitted major depressive disorder vs. Healthy controls was evaluated on Procoagulant index (PCI) (Cohen's d 0.69, p=0.013). Remitted major depressive disorder was associated with a significantly higher procoagulant index compared to healthy controls (Cohen's d 0.69; p=0.013).
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