Anxiety-depressive disorders (ADD) have a negative impact on the course and prognosis of patients with ischemic heart disease, but the mechanisms of their correlation are not studied enough. The purpose of this study was to elucidate special characteristics of hemostasis and immune system in patients with acute coronary syndrome (ACS) combined with ADD. We included into the study 60 patients during first 24 hours of ACS. ADD was identified in 27 patients (45%). Parameters of plasma and vascular-platelet hemostasis and phenotype of lymphocytes were determined in samples of blood taken during first 24 hours and on day 10 of hospitalization. We found that patients with ACS combined with ADD had procoagulant state of hemostasis, increased platelet aggregation, decreased content of lymphocytes and augmented immunoregulatory induction of inflammatory processes.