Features of haemostasis in patients with coronary heart disease

Abstract

Aim. To identify the nature of changes in the hemostasis system in patients with chronic and acute ischemic heart disease. Methods. The first group was comprised of 46 patients with stable angina of the II-III functional class, the second group was comprised of 42 patients with acute coronary syndrome, the control group included 28 healthy individuals. In all of the examined individuals determined were the number of platelets, the amount of antithrombin III, activated partial thromboplastin time, international normalized ratio, fibrinogen content, soluble fibrin monomer-complexes, von Willebrand factor, protein C and S in blood plasma. Results. In patients with stable angina of the II-III functional class originally noted was an increase in the level of the von Willebrand factor in plasma by 43%, while in patients with acute coronary syndrome - by 67% compared with the control figures, the content of fibrinogen in blood plasma exceeded the control values by 18.8% and 68.8%, respectively. In patients with acute coronary syndrome the concensoluble fibrin monomer-complexes was initially increased. In the evaluation of plasma hemostasis in patients of both groups revealed was a significant decrease of the international normalized ratio and activated partial thromboplastin time values, which was more pronounced during acute coronary syndrome than in the control group. Conclusion. In patients with ischemic heart disease present was a thrombogenic shift of the hemostasis indices toward hypercoagulation, which is most evident in acute coronary syndrome, suggesting the presence of chronic intravascular blood coagulation.