Frequency and nature of complications and hemostasis indicators in patients with ishemic artery disease, who had undergone percutaneous coronary angioplasty (based on the 18-month clinical observation)
Determination of the nature, frequency and causes of restenosis/thrombosis in patients with ishemic artery disease and PKA in prospective observation is significant for the development of preventive measures depending on the clinical (comorbidity) and biochemical (state of the hemostasis system) characteristics of each patient. The goal is to study the frequency and nature of complications in patients with coronary artery disease and PKA and their hemostasis indicators. An 18-month follow-up (outpatient, inpatient and telephone mode) was performed for 91 patients, of whom 32 had a late restenosis/stent thrombosis in history (more than 6 months after stenting) and 59 – who did not have restenosis. All patients at the beginning of the study once determined the main indicators of hemostasis (soluble fibrin, D-dimer, fibrinogen and protein C). Patients followed by clinical observation did not receive anticoagulant treatment and received dual antiplatelet therapy. Statistical processing was performed using the methods of variation statistics and correlation analysis. The results of the study revealed that in the group of patients with restenosis and diabetes mellitus in the history, the risk of developing restenosis/thrombosis of the stent is twice as high as in the general group. Herewith, damage to other parts of the cardiovascular system is practically not excluded with the same frequency. The results of the study also revealed significant abnormalities in the system of hemostasis in patients with the presence of both restenosis/thrombosis and other vascular lesions. Thus, in patients with thrombotic complications, there is a sharp increase in the factor of prethrombosis – soluble fibrin, with a clear depression of the fibrinolytic linkage of hemostasis, as indicated by the low level of D-dimer. In addition, these violations of the sF/D-d ratio are associated with inhibition of the anticoagulant ability of hemostasis represented by the protein C. Consequently, the course of the disease in patients with IAD and PKA is closely related to the presence of comorbid states and hemostasis
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