Hemostatic Gene Polymorphisms in Acute Coronary Syndrome with Nonobstructive Coronary Atherosclerosis

Fedorova, Sofya S.; Кулагина, И. В.; Ryabov, V. V.

doi:10.18087/cardio.2019.10.2680

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Screening for the presence of hereditary thrombophilia in MINOCA patients showed an incidence of about 14–33% [ 12 , 14 , 15 ], including factor V Leiden (− 12%), protein C and S deficiency, and factor XII deficiency (− 3%). A number of studies report the prevalence of other hereditary thrombophilia, such as hyperhomocysteinemia (HHC), increased levels of von Willebrand factor (VWF), and plasminogen deficiency, and their role in the development of thrombosis in patients with MINOCA [ 16 , 17 ]. The prevalence of the acquired thrombotic disorders (antiphospholipid syndrome, myeloproliferative diseases) is about 20% [ 12 , 14 ].…”

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confidence: 99%

Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with myocardial infarction with obstructive and non-obstructive coronary artery disease

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Ryabov

Lugacheva

et al. 2022

BMC Cardiovasc Disord

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The relationship between prothrombotic activity and coronary microvascular dysfunction (MVD) is limited. This study aimed to perform a comparative analysis of the relationship between prothrombotic activity and MVD in patients with myocardial infarction without obstructive coronary artery disease (MINOCA) and myocardial infarction with obstructive coronary artery disease (MI-CAD). Material and methods A total of 37 patients were enrolled in the study; the main group included 16 MINOCA patients, and 21 MI-CAD patients were included in the control group. Blood samples for protein C, antithrombin, WF, plasminogen, and homocysteine were performed on the 4th ± 1 day of admission. CZT-SPECT data were used to determine the standard indices of myocardial perfusion dis-orders (SSS, SRS, and SDS), as well as stress and rest myocardial blood flow (MBF), myocardial flow reserve (MFR), and difference flows (DF). MVD was defined as MFR (≤ 1.91 ml/min); coronary slow flow (CSF) was defined as corrected TIMI frame count (21 ± 3). Results We performed a step-by-step analysis of prothrombotic activity of the hemostasis system in binary logistic regression for MINOCA patients to identify factors associated with MVD (MFR ≤ 1.91 ml/min). A predictive model was developed to estimate the probability of reduced MFR. A low MFR is related to only plasminogen in MINOCA patients, whereas only wall motion score index (WMSI) in MI-CAD group was associated with a low MFR. Conclusion This small-scale study revealed the relationship between indicators of prothrombotic activity and MVD. The key factors that affect MVD in MINOCA patients was plasminogen, whereas, in patients with MI-CAD, WMSI was the key factor. Measurements of MVD may enhance the risk stratification and facilitate future targeting of adjunctive antithrombotic therapies in MINOCA and MI-CAD patients.

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Section: Introductionmentioning

confidence: 99%

Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with myocardial infarction with obstructive and non-obstructive coronary artery disease

Воробьева

Ryabov

Lugacheva

et al. 2022

BMC Cardiovasc Disord

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Comparative analysis of prothrombotic activity in patients with myocardial infarction with and without obstructive coronary artery disease

et al. 2021

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Aim. To compare parameters of prothrombotic activity in patients with myocardial infarction (MI) with obstructive (MICAD) and non-obstructive coronary artery disease (MINOCA).Material and methods. The study included 40 patients with MI, which were divided into experimental (n=19) and control group (n=21). Three patients (15,7%) with acute myocarditis were excluded from the analysis. Hemostasiological and hematological blood tests were studied upon admission, on the 2nd, 4th, 7th days from hospitalization. Blood samples for protein C, antithrombin, von Willebrand factor (VWF), plasminogen, homocysteine were performed on 4th±1 day from hospitalization. To determine the IgG/IgM anticardiolipin (aCL) and anti-beta 2 glycoprotein I (β2-GPI) antibodies in order to diagnose antiphospholipid syndrome (APS), the ORGENTEC Anti- β2-Glycoprotein I IgG/IgM ELISA enzyme immunoassay was used. Blood tests for lupus anticoagulant were performed using an ACL-Top 700 analyzer (Werfen) with HemosIL SynthASil dRVVT screen/dRVVT confirm and with a SCT screen/SCT confirm quartz activator.Results. According to the data obtained, it was found that patients with MINOCA had a significantly lower level of plasminogen (p=0,007), as well as a higher level of homocysteine (p=0,03). For such indicators as protein C, antithrombin, ejection fraction, differences between the groups were not revealed (p<0,05). At the same time, protein C deficiency was detected in 2 (12,5%) patients with MINOCA and in 1 (5,3%) patient in the control group. Antithrombin deficiency was detected in 2 (12,5%) patients with MINOCA and in 2 (9,5%) patients with MICAD. An increase in the level of ejection fraction was found in 6 (37,5%) patients in the study group and in 7 (33,3%) patients in the control group. There were no differences in levels of lupus anticoagulant, aCL and β2-GPI antibodies (p>0,05). There was a higher platelet count in patients with MINOCA on the 2nd and 4th days of acute MI (p=0,46 and p=0,01, respectively). However, the hemoglobin level in patients with MINOCA was significantly lower on admission, 4th and 7th day of MI (p=0,02, p=0,03 and p=0,04, respectively).Conclusion. According to the study results, in patients with MINOCA and MICAD, differences in blood thrombotic activity were revealed. A higher level of homocysteine and a lower level of plasminogen were determined in patients with MINOCA. For such parameters as protein C, antithrombin, VWF, aCL and β2-GPI antibodies, differences between the groups were not determined. According to laboratory data, patients with MINOCA showed higher platelet count, but lower levels of hemoglobin and hematocrit in the early postinfarction period.

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Hemostatic Gene Polymorphisms in Acute Coronary Syndrome with Nonobstructive Coronary Atherosclerosis

Cited by 2 publications

References 29 publications

Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with myocardial infarction with obstructive and non-obstructive coronary artery disease

Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with myocardial infarction with obstructive and non-obstructive coronary artery disease

Comparative analysis of prothrombotic activity in patients with myocardial infarction with and without obstructive coronary artery disease

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