The following is a summary of “Anxiety and depression are associated with heightened risk of incident deep vein thrombosis: Mediation through stress-related neural mechanisms,” published in the July 2024 issue of Hematology by Rosovsky et al.

The link between anxiety, depression, and increased deep vein thrombosis (DVT) risk is unclear, with the underlying mechanisms requiring further investigation.

Researchers conducted a retrospective study investigating how anxiety and depression influence DVT risk and whether heightened stress-related neural activity (SNA) plays a role in this connection.

They involved adults (N=118,871) from the Mass General Brigham Biobank. A subset (N=1,520) had clinical ¹⁸F-FDG-PET/CT imaging. The SNA was assessed using the amygdalar to cortical activity ratio (AmygAC). High-sensitivity C-reactive protein (hs-CRP) and heart rate variability (HRV) were also measured.

The results showed a median age of 58 (IQR 42–70) with 57% female. The DVT occurred in 1,781 participants (1.5%) over a median follow-up of 3.6 years [IQR 2.1–5.2]. Anxiety and depression independently predicted DVT risk after adjustments (HR [95% CI]: 1.53 [1.38–1.71], P<.001 and 1.48 [1.33–1.65], P<.001, respectively). Anxiety and depression were also linked to increased AmygAC (standardized beta [95% CI]: 0.16 [0.04–0.27], P=.007 and 0.17 [0.05–0.29], P=.006, respectively). The AmygAC was associated with incident DVT (HR [95% CI]: 1.30 [1.07–1.59], P=.009). Mediation analysis showed the connection between anxiety/depression and DVT was mediated by higher AmygAC, higher hs-CRP, and lower heart rate variability (HRV) (P<.05 for each). Anxiety and depression presented a risk of DVT comparable to traditional risk factors.

Investigators concluded that anxiety and depression likely increased DVT risk through mechanisms involving heightened SNA, autonomic system changes, and inflammation, but further studies are needed to see if treating these mental health conditions can lower DVT risk.

Source: onlinelibrary.wiley.com/doi/abs/10.1002/ajh.27427