The specifics of clotting and endogenic fibrinolysis in acute coronary syndrome patients

Калинская, А. И.; Savvinova, Polina; Васильева, Е. Ю.; Shpektor, A.

doi:10.15829/1560-4071-2018-9-12-16

Cited by 3 publications

(1 citation statement)

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“…Earlier, we demonstrated that the functional state of endothelium as assessed with flow-mediated dilation test (FMD test) correlates with the patency of IRA (11). The higher activity of endogenous fibrinolysis, which is closely interconnected with the functional state of endothelium, is the most probable cause of SR (12)(13)(14)(15). Also, several small studies demonstrated higher platelet reactivity in patients without SR of the IRA (16,17).…”

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confidence: 96%

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

et al. 2022

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BackgroundThe level of systemic inflammation correlates with the severity of the clinical course of acute myocardial infarction (AMI). It has been shown that circulating cytokines and endothelial dysfunction play an important role in the process of clot formation. The aim of our study was to assess the concentration of various circulating cytokines, endothelial function and blood clotting in AMI patients depending on the blood flow through the infarction-related artery (IRA).MethodsWe included 75 patients with AMI. 58 presented with ST-elevation myocardial infarction (STEMI) and 17 had non-ST-elevation myocardial infarction (non-STEMI). A flow-mediated dilation test (FMD test), thrombodynamics and rotational thromboelastometry as well as assessment of 14 serum cytokines using xMAP technology were performed.FindingsNon-STEMI-patients were characterized by higher levels of MDC, MIP-1β, TNF-α. Moreover, we observed that patients with impaired blood flow through the IRA (TIMI flow 0-1) had higher average and initial clot growth rates, earlier onset of spontaneous clots, C-reactive protein (CRP) and IL-10 compared to patients with preserved blood flow through the IRA (TIMI flow 2-3). Patients with TIMI 2-3 blood flow had higher level of IP-10. IL-10 correlated with CRP and pro-inflammatory cytokines levels, initial clot growth rate and clot lysis time in TIMI 0-1 patients. All these differences were statistically significant.InterpretationWe demonstrated that concentrations of the inflammatory cytokines correlate not only with the form of myocardial infarction (STEMI or non-STEMI), but also with the blood flow through the infarct-related artery. Inflammatory response, functional state of endothelium, and clot formation are closely linked with each other. A combination of these parameters affects the patency of the infarct-related artery.

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Section: Introductionmentioning

confidence: 96%

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

et al. 2022

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The state of platelet and plasma hemostasis as a predictor of coronary blood flow in patients with acute myocardial infarction

et al. 2022

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Aim To study the relationship of the platelet function and plasma homeostasis with the blood flow in the infarct-related artery (IRA) and with the course of acute myocardial infarction (AMI).Material and methods This study included 93 patients with AMI (75 patients with ST-elevation AMI and 18 patients without ST segment elevation). 63 patients had TIMI 0-1 blood flow in the IRA and 30 patients had TIMI 2–3. Rotational thromboelastometry, impedance aggregometry, the endothelium-dependent vasodilation (EDVD) test, and the thrombodynamics test were performed for all patients. The primary clinical endpoint included the totality of in-hospital complications of AMI, and the secondary endpoint included the totality of out-of-hospital complications of AMI. Major bleedings (BARC 3-5) and minor bleedings (BARC 1-2) were evaluated separately.Results Patients with IRA TIMI 0–1 flow were characterized by a shorter blood clotting time (BCT), larger thrombus size and density, more intense platelet aggregation induced by arachidonic acid and ADP, and lower values of the EDVD test. It was found that the parameters of platelet aggregation induced by arachidonic acid (AUC Asa) in combination with BCT allowed assessment of the severity of IRA blood flow disorder (sensitivity 76 %, specificity 71 %) in patients with AMI, regardless of the presence of ST segment elevation on the ECG. In addition, the incidence of the primary endpoint was greater in patients with IRA TIMI 0–1 flow (41.3% and 16.7%, respectively; p=0.015). In patients with TIMI 2–3 flow in the long-term period of the disease, the incidence of minor bleedings was significantly higher (8.5% and 30.4 %, respectively; p=0.045).Conclusion Compared to patients with preserved blood flow, patients with AMI and IRA TIMI 0–1 flow are characterized by endothelial dysfunction and more intense processes of thrombogenesis and platelet aggregation. It has been shown for the first time that the combination of two simple criteria for assessing hemostasis (AUC Asa; BCT) allows assessment of the degree of IRA blood flow disorder in patients with AMI.

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Peculiarities of hemostasis in patients with COVID-19

Kalinskaya

Dukhin

Molodtsov

et al. 2022

Terapevticheskii arkhiv

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Aim. Analysis of the dynamics of different stages of clot formation and its lysis in patients with different COVID-19 severity. Materials and methods. We prospectively included 58 patients with COVID-19 (39 patients with moderate disease severity and 18 patients with severe disease) and 47 healthy volunteers as a control group. All participants underwent the assessment of flow-mediated dilation (FMD) of brachial artery, impedance aggregometry, rotational thromboelastometry and thrombodynamics. Von Willebrand factor antigen (vWF:Ag) quantification was also performed in patients with COVID-19. Measurements were repeated on the 3rd and 9th day of hospitalization. Results. Compared to the control group, patients with COVID-19 showed reduced values of platelet aggregation and greater values of the clot growth rate, as well as its size and density. On the first day of hospitalization, we found no differences in the activity of plasma hemostasis and endogenous fibrinolysis between subgroups of patients. With the progression of the disease, the growth rate and size of the clot were higher in the severe subgroup, even despite higher doses of anticoagulants in this subgroup. An increase in platelet aggregation was noted during the progression of the disease, especially in the severe subgroup. There were no differences in the results of the FMD test by subgroups of patients. The vWF:Ag level was significantly higher in the severe subgroup. Conclusion. Thus, plasma hemostasis followed by secondary platelet activation correlates with the severity of COVID-19. Patients with moderate to severe coronavirus infection have predominantly local rather than generalized endothelial dysfunction.

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The specifics of clotting and endogenic fibrinolysis in acute coronary syndrome patients

Cited by 3 publications

References 8 publications

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

The state of platelet and plasma hemostasis as a predictor of coronary blood flow in patients with acute myocardial infarction

Peculiarities of hemostasis in patients with COVID-19

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The specifics of clotting and endogenic fibrinolysis in acute coronary syndrome patients

Cited by 3 publications

References 8 publications

​Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

​Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

The state of platelet and plasma hemostasis as a predictor of coronary blood flow in patients with acute myocardial infarction

Peculiarities of hemostasis in patients with COVID-19

Contact Info

Product

Resources

About

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow

Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow