Endocrine factors and patient centered outcomes in coronary artery disease

Psychosocial factors affect the occurrence of coronary artery disease (CAD) disease and development of complications. People with depression or anxiety symptoms have the activate hypothalamic-pituitary-adrenal axis. Thyroid hormone changes are also found in patients with CAD. Fatigue and health-related quality of life (HRQoL) depends not only on good physical health, but also on psychoemotional state, especially on the presence of depression and anxiety disorders. Therefore, it is important to evaluate complex of hormonal markers and behavioral factors (depression, anxiety and fatigue) interaction on patients with CAD for quality of life, disease course and outcome. The aim of this study was examine relationship of cortisol and thyroid axis hormones concentrations with NT-pro B type natriuretic peptide (NT-proBNP) concentrations and with patient oriented outcomes such as depressive symptoms, fatigue and HRQoL in CAD patients. Study demonstrates relationship between thyroid axis hormones and cortisol concentrations with depression, anxiety symptoms, fatigue and HRQoL in CAD patients. Low T3, free T4 and higher RT3 concentrations are associated with higher NT-proBNP levels, depression symptoms, higher fatigue and worse HRQoL. Higher morning cortisol concentrations are associated with depression symptoms in women. The data obtained can be used in patients with coronary artery disease and depressive anxiety disorder, disease progression, and prognosis and quality of life evaluation