Diagnosis of hemostatic system disorders in patients with chronic heart failure using classical and integral methods

Abstract

BACKGROUND: The state of the hemostatic system in patients with chronic heart failure (CHF) remains an insufficiently studied problem.

PURPOSE OF THE STUDY: to present the results of an original study of the coagulation system of patients with CHF using an integral technique — low-frequency piеzothromboelastography (LPTEG).

MATERIAL AND METHODS: The study involved 90 patients with CHF due to hypertension and coronary artery disease aged 50–75 years. The subjects were divided into groups with CHF I–IIa (n = 30), CHF stages IIb–III (n = 60). All patients underwent a study of the hemostasis system using classical (coagulogram) and integral (NPTEG) methods before prescribing antiplatelet and anticoagulant therapy. The comparison group consisted of healthy patients of the same age group without CHF (n = 30).

RESULTS: In patients with CHF, a general blood test revealed a statistically significant decrease in the number of platelets (group 1 — 215; group 2 — 185) compared to the control group — 241. When analyzing the coagulogram, a decrease in the levels of prothrombin (group 1 — 89; group 2 — 86; control group 105), antithrombin-III (group — 76.5; group 2 — 73; control group — 91) and increased INR (group 1 — 1.03; group 2 — 1.12; control group 1.01) in patients in groups with CHF compared to the control group (p < 0.05). When using the NPTEG method in patients with CHF, a decrease in indicators characterizing the rate of clot polymerization (intensity of clot polymerization) and clot density (maximum amplitude) was determined when compared with the control group (p < 0.05).

CONCLUSION: In patients with CHF, changes in the hemostatic system are determined, characterized by a tendency to hypocoagulation, the frequency a severity of which increases with the progression of the stage of the disease.

Keywords

bleeding / chronic heart failure / coagulogram / hemostasis system / low-frequency piezothromboelastography / thrombosis / integral methods of studying the hemostasis system

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