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TITLE:

APROSPECTIVE OBSERVATION OF PATIENTS WITH ANGINA PECTORIS AND HEMOSTASIS DISORDERS

AUTHORS:

Yu.E. Malchevsky, A.A. Rahimov, E.V. Kasparov

ABSTRACT:

Purpose. The purpose of the study was to evaluate the effect of hardware plasmapheresis on clinical manifestations and the system of hemostasis in patients with angina pectoris (AP). Materials. 658 men aged 53-72 (64.8 ± 8.9) with stable angina of functional class II with manifestations of cardiac insufficiency of the first stage were examined within the period from 2000 to 2017. Duration of the disease was from 7 to 20 years. 269 patients with thrombinemia were identified in the total surveyed sample. The patients were divided into 2 groups. In group I (177 people), the patients underwent hardware plasmapheresis for the management of thrombinemia. In group II (92 people), plasmapheresis was not performed. Control of hemostasis in both groups was performed annually. Results. The use of plasmapheresis as a part of the treatment plan for patients with AP resulted in the improvement of the clinical picture, which was manifested by a decrease in the rate of complaints, including pains in the heart area by 25-40%, and a decrease in their duration by 32-43%. Before the treatment, the following changes in the hemostatic system were revealed in the examined patients: soluble fibrin-monomeric complexes (SFMC) level – 13.1х10-2 g/l, D-dimers (DD) - 552 ng/ml, fibrinogen (FG) - 4.8 g/l. After the course of hardware plasmapheresis for 30 days, the levels of these parameters were SFMC-: 5.7x10-2 g/l, DD - 197 ng/ml, FG - 3.4 g/l. Conclusion. Significant changes in patients’ hemostasis improved the microcirculation in various tissues and organs, including the heart muscle. It is feasible to include hardware plasmapheresis in the complex treatment of patients with AP, accompanied by hemostasis disorders. The use of this method is pathogenetically justified, due to its favorable effect on the hemostatic system and the rheological properties of the blood. Key words: hardware plasmapheresis, angina pectoris, ischemic heart disease, hemostasis disorders.

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