The changes of hemostasis parameters in female patients with miocardium infraction with elevation of ST segment at postmenopause paying attention to the sex hormones levels

Authors

  • Нонна Василівна Нетяженко Bohomolets National Medical University 9 Povitryanoflotskyy ave., Kiev, Ukraine, 02012, Ukraine

DOI:

https://doi.org/10.15587/2313-8416.2015.57342

Keywords:

myocardium infraction, female sex, thrombosis, hemostasis, postmenopause, ischemic heart disease

Abstract

Aim To assess the changes of homeostasis parameters in female patients with myocardium infraction with elevation of ST segment in postmenopausal period paying attention to the sex hormones levels.

Materials and methods There were examined 48 female patients with diagnosed acute myocardium infraction with elevation of ST segment in the period of early postmenopause (MP). In his group there were assessed the levels of sex hormones and its interrelations with homeostasis parameters.

Results: The decrease of estradiol less than 45,14 ng/ml was attended with shortening of duration of activated partially thromboplastin time APTT) and thrombi of the new time (TT) in 61,3 % and 44,7 % of cases respectively, increase of fibrinogene concentration in 51,7 % of cases, decrease of antithrombin activity (AT)III in 62,4 % and porotein С in 42,1 %, growth of concentration of the soluble fibrinmonomeric complexes (SFMC) in 37,5 % and suppression of ХІІа dependent fibrinolysis (DF) in 41,0 % of cases. In patients with content of general progesterone >5 ng/ml in 56,5 % were noticed hyperfibrinogenemia and in 68,2 % – the decrease of ATIII concentration. An importance of estradiol\progesterone ratio (EPR) lower than 12,117 ng/ng was associated with the decrease of protein C activity in 47,4 %, increase of SFMC concentration in 49,2 % and ХІІа DF suppression in 54,3 % of patients.

Conclusions: The period of early PM in women with MI with decrease of the sex hormone levels namely estradiol <45,14 ng/ml, progesterone >5 ng/ml and estradiol\progesterone ratio <12,117 hg/ng was associated with thrombophilic and procoagulative changes of the plasma hemostasis system

Author Biography

Нонна Василівна Нетяженко, Bohomolets National Medical University 9 Povitryanoflotskyy ave., Kiev, Ukraine, 02012

Candidate of Medical Sciences, Assistant Professor

Department propaedeutics Internal Medicine №2

References

Berkovskaia, M. A., Butrova, S. A. (2010). Rasprostranennost narushenyi svertivaiushchei i protyvosvertivaiushchei system krovy u zhenshchyn s metabolycheskym syndromom v postmenopauze.Ozhyrenye y metabolyzm, 3, 21–27.

Chazova, Y. E., Smetnyk, V. P., Balan, V. E., Zaidyeva, Ya. Z., Maichuk, E. Iu., Michka, V. B., Yureneva, S. V. (2009). Vedenye zhenshchyn s serdechno-sosudystim ryskom v pery i postmenopauze: konsensus rossyiskykh kardyolohov y hynekolohov. Praktycheskaia medytsyna, 34, 5–18.

Goodman, N., Cobin, R., Ginzburg, S., Katz, I., Woode, D. (2011). American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocrine Practice, 17 (6), 1–25.

Shufelt, C., Waldman, T., Wang, E., Merz, C. N. B. (2015). Female-Specific Factors for IHD: Across the Reproductive Lifespan. Current atherosclerosis reports, 17 (2), 1–9. doi: 10.1007/s11883-014-0481-6

Sipilä, S., Finni, T., Kovanen, V. (2015). Estrogen influences on neuromuscular function in postmenopausal women. Calcified tissue international, 96 (3), 222–233. doi: 10.1007/s00223-014-9924-x

Purohit, A., Reed, M. J. (2002). Regulation of estrogen synthesis in postmenopausal women. Steroids, 67 (12), 979–983. doi: 10.1016/s0039-128x(02)00046-6

Tantry, U. S., Bonello, L., Aradi, D., Price, M. J., Jeong, Y.-H., Angiolillo, D. J. et. al. (2013). Consensus and Update on the Definition of On-Treatment Platelet Reactivity to Adenosine Diphosphate Associated With Ischemia and Bleeding. Journal of the American College of Cardiology, 62 (24), 2261–2273. doi: 10.1016/j.jacc.2013.07.101

Steg, P. G., James, S. K., Atar, D., Badano, L. P., Lundqvist, C. B., Borger, M. A. et. al. (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal, 33 (20), 2569–2619. doi: 10.1093/eurheartj/ehs215

Barkahan, Z. S., Momot, A. P. (2008). Dyahnostykaia y kontrolyruemaia terapyia narushenyi hemostaza. Moscow: "Niudyamed-AO", 292.

Prior, J. C., Elliott, T. G., Norman, E., Stajic, V., Hitchcock, C. L. (2014). Progesterone therapy, endothelial function and cardiovascular risk factors: a 3-month randomized, placebo-controlled trial in healthy early postmenopausal women. PLoS One, 9 (1), 1–9. doi: 10.1371/journal.pone.0084698

Published

2015-12-29

Issue

Section

Medical