CLINICAL OUTCOMES AND DYNAMICS OF PLATELET-PLASMA AND VASCULAR HEMOSTASIS IN PATIENTS WITH UNSTABLE ANGINA AND CORONARY ARTERY BYPASS GRAFTING
https://doi.org/10.38109/2225-1685-2021-1-78-86
Abstract
The aim. To evaluate the clinical outcomes and features of the state of the platelet-plasma and vascular hemostasis in patients (pts) with unstable angina and coronary artery bypass grafting (CABG) on-pump and off-pump for the correction of antithrombotic therapy and reduce the number of postoperative cardiovascular events.
Material and methods. The study included 146 pts with unstable angina (UA) with a surgical treatment strategy. CG amounted to 106 pts with CABG and a standard approach to drug maintenance. MG comprised 40 pts with CABG and a personalized approach to antithrombotic therapy.
Results. In CABG off-pump in pts with UA, an increased in platelet aggregation and activation of platelet hemostasis occurs on the 2nd day of the postoperative period, in CABG on-pump on the 5-7th day. Activation of plasma hemostasis had laboratory manifestations on the 5-7th day of the postoperative period, and is most pronounced in CABG on-pump, compared with CABG off-pump. After 1 month of control, 38,7% pts with UA and CABG were characterized by the presence of high residual platelet reactivity against the background of standard antiplatelet treatment, of which 23,6% retained activation of plasma hemostasis, which is manifested in excess of the normal level of D-dimers, as well as an increased in peak thrombin concentration and endogenous thrombin potential. Patients with UA and CABG who underwent correction of antithrombotic therapy differed from patients with a standard approach to treatment with a significantly lower number of repeated cardiovascular events over 2 years of follow-up (5% versus 22.6%).
About the Authors
E. A. Medvedeva
Republican Scientific and Practical Centre «Cardiology»
Belarus
Belarus
Cand. of Sci. (Med.), doctor of cardiology department No.2
Minsk, R. Luxemburg str., 110B
L. G. Gelis
Republican Scientific and Practical Centre «Cardiology»
Belarus
Belarus
Professor, Dr. of Sci. (Med.), Heart Surgery Laboratory
220036, Minsk, R. Luxemburg str., 110b
V. V. Shumavets
Republican Scientific and Practical Centre «Cardiology»
Belarus
Belarus
Cand. of Sci. (Med.), Chief of 2nd Cardiac Surgery Department
220036, Minsk, R. Luxemburg str., 110b
I. I. Russkikh
Republican Scientific and Practical Centre «Cardiology»
Belarus
Belarus
clinical diagnostic laboratory doctor
220036, Minsk, R. Luxemburg str., 110b
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For citations:
Medvedeva E.A., Gelis L.G., Shumavets V.V., Russkikh I.I. CLINICAL OUTCOMES AND DYNAMICS OF PLATELET-PLASMA AND VASCULAR HEMOSTASIS IN PATIENTS WITH UNSTABLE ANGINA AND CORONARY ARTERY BYPASS GRAFTING. Eurasian heart journal. 2021;(1):78-86. (In Russ.) https://doi.org/10.38109/2225-1685-2021-1-78-86
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