COAGULATION AND FIBRINOLYTIC ACTIVITY INDICES IN PATIENTS WITH IHD AFTER PERCUTANEOUS CORONARY ANGIOPLASTY (PART I)

Abstract

It is well known that restenosis/thrombosis in stent placement site is one of the commonest complications in patients with ischemic heart disease (IHD) and percutaneous coronary angioplasty (PCA), and activation of intravascular thrombogenesis can be one of pathogenetic factors of this process. Hence, determination of early and reliable biochemical markers in diagnosis of that complication is aimed at timely correction of hemostasis disturbances. Blood plasma overall hemostatic potential (OHP) is considered to be one of the informative biochemical markers of hemostasis. It is helpful in determining the balance between links of blood coagulation and fibrinolysis and is based on the study of light absorption– time curve, being an index of formation and destruction of blood clot in the presence of thromboplastin and plasminogen tissue activator (t-PA). The aim of research work was to study coagulation and fibrinolytic activity indices in patients with IHD and PCA, and to determine probable markers of intravascular thrombogenesis. 91 patients (77 males and 14 females) with IHD and PCA were studied, 32 had late restenosis/thrombosis development after 6 months of stenting. Among those with no history of stent occlusion (59 individuals), 20 patients had FC ²²-²²² angina pectoris. Blood plasma hemostatic potential was determined by spectrophotometry, registering light absorption at 405 nm by fibrin clot, using microreader Multiscan (Finland). Statistical analysis was performed using variation methods and correlation analysis. Quantitative analysis of the curves of OHP and fibrinolytic potential (FP) as well as their components, obtained during the study, demonstrated all the patients of general group to have significant (ð 0.1). Determination of correlation relationships between the main components of OHP and FP in patient groups showed their one-direction positive character from moderate to strong (r=0.56?0.83). The strongest correlations between the parameters were observed in patients with angina, while the weakest ones – in those with history of restenosis. Significant increase in OHP and FP indices can be indicative of disturbed balance between the processes of blood coagulation and fibrinolysis in that category of patients. The data received indicate also that activity of hemostasis components is higher in females than in males, and coagulation system potential tends to increase in the group of patients with history of restenosis and in those with angina because of decreased FP value.

Keywords

• restenosis
• general haemostatic potential
• fibrinolytic potential
• thrombogenesis