Authors
Kalinin R.E., Suchkov I.A., Mzhavanadze N.D., Klimentova E.A., Zhurina O.N.
Ryazan State Medical University, Ryazan, Russia
Abstract
Objective. Assessment of intrinsic coagulation pathway factors activity and hemostatic markers of endothelial dysfunction in patients with atherosclerotic peripheral arterial disease (PAD).
Methods. The study included 120 patients with PAD. All patients had stage IIB-III of the disease according to Fontaine classification. 40 patients with PAD underwent open and endovascular interventions for aorto-femoral-popliteal segment (groups A and B) and 40 patients underwent conservative treatment (group C). Patients underwent physical examination, ankle-brachial index measurement (ABI), duplex ultrasound (DUS) and digital substraction angiography. After 3, 6, 12 months after treatment patients underwent underwent the same procedures. At inclusion in the study and 3 months after surgery peripheral venous blood samples were collected to assess the activity of VIII, IX, XI, von Willebrand factor (VWF), protein С (PrC) and metabolites of nitric oxide II (NO).
Results. In patients groups А and B mean values of activity VIII, IX, XI factors and VWF was increased in comparison with the norm before surgery. After 3 months results shown a greater increase in activity VIII, IX, XI factors, VWF in the reduction of NO metabolites. In patients group C was increased mean activity values IX, XI factors, with normal levels of NO metabolites, FVIII and PrC. Predictors of restenosis development in the reconstruction area (6 months) and the progression of atherosclerosis (12 months) in groups А and B were increased VWF and decreased NO.
Conclusions. Increased activity of VIII, IX, XI, VWF, prior to open and endovascular interventions reflect protrombogenicstate of the hemostatic system in patients with PAD.
Keywords: atherosclerosis, intrinsic coagulation pathway, hemostatic markers of endothelial dysfunction.
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