Vol. 2, Issue 11 (2014)

Author(s):
Mariya A. Orynchak, Maryana M. Vasylechko

Abstract:
To study peculiarities of the coagulation and platelet hemostasis parameters in hypertensives with permanent form of atrial fibrillation (AF) background of metabolic syndrome (MS).
Materials and Methods: The study included 70 hypertensives (25 male, 45 female), mean age: 70±9 years with permanent form of AF and MS by ATP III (2001). Blood pressure (BP) monitoring, electrocardiography (ECG) and coagulation hemostasis parameters for prothrombin index (PtI), fibrinogen, soluble fibrin-monomer complexes (SFMC), D-dimers and platelet aggregative activity (PAA) such as the beginning of aggregation, the degree of aggregation rate and speed aggregation and platelet von Willebrandt factor (vWF) accordingly to body mass index (BMI) by standard biochemical and immunoassay procedures were measured. The control group consisted of 20 healthy individuals.
Results and Discussion: Basal BP levels were ranged 140/90 ± 10/7 mm Hg. By clinic and ECG symptoms AF permanent form was diagnosed in all cases. Abdominal obesity (AO) with increasing BMI over 30 kg/m2 in 57 (81.00%) and overweight with BMI 27.50±2.05 kg/m2 in 13 (19.00%) cases were found. Among them in 32 (56.00%) cases II degree obesity with BMI equal to 34.90 ± 3.92 kg/m2 and in 25 (44.00%) cases III degree obesity with BMI equal to 43.41 ± 2.25 kg/m2 were diagnosed. In all patients MS was diagnosed that’s why low risk of thromboembolism by CHADS2 and CHA2DS2-VASc indicators panel was not found. Basal blood activation of aggregative function and fibrinolysis levels with increasing PtI; fibrinogen and SFMC parameters by11.85%; 78.28% and 91.05% vs. 98.11±3.68%; 3.04±0.52 g/L and 3.80±0.8 mg/ml accordingly in the control group (p<0.05) in all patients were revealed. In patients with AO hypercoagulable status with plasma positive D-dimers in 20 (35.00%) and increased PAA levels in 37 (65.00%) cases in patients with overweight in 3 (25.00%) and 10 (75.00%) cases accordingly were found. In all patients the platelets number ranged 280.14±11.52×109/l vs. 284.21±8.32×109/l in the control group (p>0.05).Conclusions: Atrial fibrillation complicated by increased levels aggregation and coagulation disorders of hemostasis under MS. Assessment of hemostasis disorders severity solely on the basis of PtI and fibrinogen is insufficient because it does not take into account other parameters of coagulation and platelet hemostasis, in particular, the level of circulating SFMC, D-dimers and PAA parameters according to the aggregation start parameters, the degree and rate of aggregation and vWF that are predictors of acute cardio-vascular events and the definition of a high risk of thromboembolism by CHADS2 and CHA2DS2-VASc scales.