Peculiarities of changes in anticoagulant and coagulant activity in patients with coronary artery disease combined with type 2 diabetes mellitus
Background. Determining the features of regulatory mechanisms of plasma hemostasis in patients with coronary artery disease (CAD) and concomitant type 2 diabetes mellitus (DM) is of theoretical and practical interest, as it gives an opportunity, on the one hand, to establish their correlation with clinical manifestations and, thus, to predict the occurrence and development of complications, and on the other — to work out the additional diagnostic, curative, preventive approaches to the management of these patients. The purpose of the work is to study and analyze the state of anticoagulant and coagulant activity in patients with CAD and CAD with concomitant type 2 DM. Materials and methods. During the study of the anticoagulant and coagulant system, 50 patients were hospitalized in the cardiology and endocrinology department of the Kyiv Railway Clinical Hospital No. 2 with clinical signs of coronary artery disease. We selected 25 patients with CAD, and 25 — with CAD and type 2 DM. Results. We found that the comorbidity of CAD and type 2 diabetes mellitus is characterized by activation of all blood coagulation units, with a predominant activation of the final stage — the formation of a blood clot, as evidenced by statistically significant shortening of prothrombin time by 17.6 % (p < 0.001), and an increase in fibrinogen level by 39.6 % (p < 0.001) compared to the control group. In this group of patients, there was a significant decrease in the anticoagulant potential. Hypercoagulation shifts in the hemostasis system occurred against the background of inhibition of its own anticoagulant blood potential. The changes of coagulant potential in case of combination with type 2 DM were characterized by the acceleration of coagulation processes in all three stages of coagulation (prothrombinase, thrombin and fibrin formation). Conclusions. Data have shown that in patients with coronary artery disease without comorbidity and in people with coronary artery disease combined with type 2 diabetes mellitus, there is an inhibition of anticoagulant activity and an increase in the coagulant potential of the blood, which, in turn, increases the risk of vascular diseases.
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