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Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge
Background: The procoagulant stress response reflects part of a beneficial adaptation of the organism to environmental threats, but a protracted procoagulant state generates a thrombotic risk. Atrial fibrillation (AF) is the most common arrhythmia in the general population. Patients with AF have a h...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146033/ https://www.ncbi.nlm.nih.gov/pubmed/30271365 http://dx.doi.org/10.3389/fpsyg.2018.01709 |
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author | Galli, Federica Borghi, Lidia Faioni, Elena Cavicchioli, Marco Ferrari Losi, Jessica Vegni, Elena |
author_facet | Galli, Federica Borghi, Lidia Faioni, Elena Cavicchioli, Marco Ferrari Losi, Jessica Vegni, Elena |
author_sort | Galli, Federica |
collection | PubMed |
description | Background: The procoagulant stress response reflects part of a beneficial adaptation of the organism to environmental threats, but a protracted procoagulant state generates a thrombotic risk. Atrial fibrillation (AF) is the most common arrhythmia in the general population. Patients with AF have a higher risk of thromboembolic events and stroke, therefore they are treated with long-term oral anticoagulant (OAC) therapy. The aim of this study is to evaluate if there is any association between psychological distress and clinically unexplained variations of the International Normalized Ratio (INR), that is the index used to monitor both thromboembolic and bleeding risk in the case of patients under OAC therapy. Methods: Fifty-eight patients (men = 27; women = 31; mean age = 74.98) were recruited. The sample was divided according to the recognition (or not) of the reason why the INR was subtherapeutic (<2) and classified as “Known Reasons” (KR = 32.8%) and “Unknown Reasons” (UR = 67.2%). Psychological assessment included the following dimensions: symptoms of anxiety and depression, perceived stress, emotional regulation strategies, and alexithymia. Results: Considering Mann–Whitney test results, no significant difference was found in the scores of anxiety, depression, stress, and emotional regulation strategies. With regard to alexithymia, UR patients are characterized by a moderate tendency to an outward-oriented thinking (r = 0.25). Conclusion: A clear role for the detected psychological factors in determining abnormal INR range in patients under OAC therapy could not be found. Further studies are needed to support our findings, if possible exploring factors other than psychological distress and the related emotion regulation strategies. |
format | Online Article Text |
id | pubmed-6146033 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-61460332018-09-28 Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge Galli, Federica Borghi, Lidia Faioni, Elena Cavicchioli, Marco Ferrari Losi, Jessica Vegni, Elena Front Psychol Psychology Background: The procoagulant stress response reflects part of a beneficial adaptation of the organism to environmental threats, but a protracted procoagulant state generates a thrombotic risk. Atrial fibrillation (AF) is the most common arrhythmia in the general population. Patients with AF have a higher risk of thromboembolic events and stroke, therefore they are treated with long-term oral anticoagulant (OAC) therapy. The aim of this study is to evaluate if there is any association between psychological distress and clinically unexplained variations of the International Normalized Ratio (INR), that is the index used to monitor both thromboembolic and bleeding risk in the case of patients under OAC therapy. Methods: Fifty-eight patients (men = 27; women = 31; mean age = 74.98) were recruited. The sample was divided according to the recognition (or not) of the reason why the INR was subtherapeutic (<2) and classified as “Known Reasons” (KR = 32.8%) and “Unknown Reasons” (UR = 67.2%). Psychological assessment included the following dimensions: symptoms of anxiety and depression, perceived stress, emotional regulation strategies, and alexithymia. Results: Considering Mann–Whitney test results, no significant difference was found in the scores of anxiety, depression, stress, and emotional regulation strategies. With regard to alexithymia, UR patients are characterized by a moderate tendency to an outward-oriented thinking (r = 0.25). Conclusion: A clear role for the detected psychological factors in determining abnormal INR range in patients under OAC therapy could not be found. Further studies are needed to support our findings, if possible exploring factors other than psychological distress and the related emotion regulation strategies. Frontiers Media S.A. 2018-09-13 /pmc/articles/PMC6146033/ /pubmed/30271365 http://dx.doi.org/10.3389/fpsyg.2018.01709 Text en Copyright © 2018 Galli, Borghi, Faioni, Cavicchioli, Ferrari Losi and Vegni. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychology Galli, Federica Borghi, Lidia Faioni, Elena Cavicchioli, Marco Ferrari Losi, Jessica Vegni, Elena Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title | Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title_full | Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title_fullStr | Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title_full_unstemmed | Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title_short | Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge |
title_sort | failure of the anticoagulant therapy and psychological distress: still far from a bridge |
topic | Psychology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146033/ https://www.ncbi.nlm.nih.gov/pubmed/30271365 http://dx.doi.org/10.3389/fpsyg.2018.01709 |
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