Assessing endothelium resistance to thrombus formation as a potential risk factor causing recurrent cardiovascular events in young patients after cardiac infarction

Abstract

Cardiac infarction is considered a disease more common for elderly people; despite that, up to 10% of all cardiac infarctions occur at a young age. Cardiac infarction has grave consequences both for mental health and future working capability of patients who had it. Approximately 15% patients who have had cardiac infarction have to face a recurrent cardiovascular event based on thrombus formation in spite of therapy. Our research goal was to assess endothelium homeostasis in patients after cardiac infarction being treated with double anti-thrombocyte therapy during out-patient rehabilitation and to reveal potential risks that could cause recurrent cardiovascular diseases. Overall, we examined 25 people aged from 18 to 45 who had cardiac infarction and were treated with invasive therapy aimed at eliminating ischemic heart disease. The therapy was emergency percutaneous coronary intervention and coronary artery stenting performed at Perm Clinical Cardiologic Clinic during a period from September 2018 to March 2019. Endothelial homeostasis was examined in 12 months after cardiac infarction. We detected that, together with conventional risk factors, young patients after cardiac infarction had apparent changes in coagulation homeostasis (shorter activated partial thromboplastin time, shorter prothrombin time, an increase in fibrinogen concentration; greater aggregative activity of thrombocytes with adenosine-diphosphate; depressed Hageman-factor-dependent fibrinolysis. Nevertheless, there was no significant difference in aggregative activity of thrombosytes with ristocetin between the test and control groups. Therefore, in 12 months after cardiac infarction, young patients still ran high risks of recurrent cardiovascular events; those risks were caused both by significant prevalence of conventional risk factors and by high thrombogenic risk that persisted in spite of relevant anti-thrombus therapy.

Keywords

• cardiac infarction
• young patients
• recurrent cardiovascular events
• risk factors
• endothelial homeostasis
• hyper-coagulation
• thrombosis