Conditions in the coagulant and anticoagulant activity of blood in patients with coronary heart disease with concomitant diabetes mellitus type 2, depending on the his compensation
DOI:
https://doi.org/10.15587/2519-4798.2019.155751Keywords:
thrombosis, hemostasis, ischemic heart disease, the coagulant and anticoagulant system, type 2 diabetes mellitusAbstract
The aim: to evaluate and analyze the parameters of coagulant and anticoagulant activity in the blood in different groups of patients with coronary heart disease without and with associated Diabetes Mellitus (DM) type 2 depending on its compensation.
Materials: during the study of the coagulant and anticoagulant activity in the blood system, 52 patients were hospitalized in the cardiology and endocrinology department of the Kyiv Clinical Hospital on Railway Transport No. 2 of the Health Protection Center branch of the Ukrainian Railways Public Joint-Stock Company (clinical base of the Department of Internal Medicine Propedeutics No. 1 of the National OO Bogomolets Medical University) with clinical signs of coronary artery disease. Patients were divided into three groups: 27 patients with IHD and with type 2 diabetes in the subcompensation stage, 14th - compensation stage and 11th - decompensation stage.
Results: after analyzing the data, at all stages of compensation there was a decrease in all indicators of coagulation hemostasis: APTT - by 6,94 % (compensation stage (I)) (p<0,05) and 13,7 % (decompensation stage (III)) (p<0,01), PTT - by 9,14 % (І) (р<0,01), by 6,43 % (the stage of subcompensation (II) (p<0,05), by 10,3 % (ІІІ ) (p<0,001), TT - by 15,54 % (I) (p<0,001), by 19,2 % (II) (p<0,001), by 20,9 % (III) (p<0,001) and also an increase in the level of fibrinogen by 32,16 % (I) (p<0,001), by 36,04 % (II) (p<0,001), by 48,06 % (III) (p<0,001), which indicates about accelerating the processes of coagulation at once in three links: reduction of the periods of generation of active trombin by internal and external mechanisms with simultaneous activation of fibrogenesis (factor IIA and fibrin). The anticoagulant potential was reduced: AT III by 16,5 % (I) (p<0,001), by 22,7 % (II) (p<0.001) , by 23,6 % (ІІІ) (p<0,001), and PS - by 18,63 % (I and ІІ) (p<0,001). It should be noted that when comparing the groups between themselves, a significant decrease in AT III between the stages of subcompensation and decompensation on 8,5 % (p<0,05).
Conclusion: it should be noted that in patients with comorbid IHD with type 2 diabetes, hypercoagulable shifts in the hemostasis system occurred against the background of inhibition of the own anticoagulant blood potential. Changes in the coagulation potential in the combination of type 2 DM were marked by accelerating the processes of coagulation at once in all three stages of coagulation (prothrombinase, thrombin and fibrin formation)
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