Peculiarities of changes in the coagulation and fibrinolytic activity in patients with coronary heart disease and concomitant type 2 diabetes mellitus, depending on the presence of diabetic vascular complications
Background. The purpose of this work was to study endogenous coagulation/fibrinolysis markers in patients with coronary heart disease (CHD) and concomitant type 2 diabetes mellitus (DM) and to compare these indices with respect to microvascular complications. Materials and methods. We have examined fifty four patients with CHD and concomitant type 2 DM (divided into 2 groups, with and without complications), who were hospitalized in the cardiology and endocrinology unit of the Kyiv Clinical Railway Hospital. Results. Prolonged prothrombin time in the coagulation system was detected in two groups (CHD + type 2 DM and CHD + type 2 DM + diabetic complications): by 7.64 % — in patients without microvascular complications and by 7.49 % — with complications, as well as and a significant increase in fibrinogen (by 36 and 42 %, respectively), but no significant changes were observed between the groups. The study of the anticoagulant blood system indexes revealed that the activity of antithrombin III and protein C in patients with CHD and concomitant type 2 DM with diabetic complications was lower (by 26 and 19.4 %, respectively) compared to the control group. A significant inhibition of the fibrinolytic activity of the blood plasma was detected. Conclusions. The obtained data indicate an inhibition of fibrinolytic and anticoagulant plasma activity, which was most pronounced in patients with CHD and concomitant type 2 DM with microvascular complications. The correlation between fibrinolysis and vascular diseases may depend on the condition of the vascular bed, which significantly increases with the development of macro and microvascular lesions in patients with CHD and concomitant type 2 DM.
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