Endothelial dysfunction, systemic inflammation, platelet aggregation properties and their relationship in patients with stable stenocardia
https://doi.org/10.24884/1682-6655-2020-19-1-22-28
Abstract
The aim of the study was to study the associations between markers of endothelial dysfunction, systemic inflammation and platelet aggregation properties in patients with stable stenocardia. Materials and methods. 100 patients with stable stenocardia were examined, mean age 59.2 ± 6.9 years, who received double antiplatelet therapy (DAPT) in the form of acetylsalicylic acid (ASA) 75 mg and clopidogrel 75 mg. The obtained data (general clinical, aggregometry, level of C-reactive protein (CRP), soluble CD40 ligand, sP-selectin, von Willebrand factor (VF), endothelin-1 (ET-1), forearm blood flow (FBF studies)) were analyzed using STATISTICA 10.0 programs. Results. 45 % of patients with an insufficient response to DAPT (SG2) and 55 % with a normal response (SG1) were identified. The level of ET-1, PV, and CRP was higher in SG2, compared to SG1. FBF in SG1 – 2.4 [–8.9; 25.0] %, in SG2 – –8.4 [–19.2; 14.1] %, p <0.05. In SG2, patients with pronounced endothelial dysfunction (p = 0.024 according to Fisher’s exact test) predominated. Conclusions. DAPT with ASA and clopidogrel is effective in 55 % of patients with stable stenocardia. 45 % of patients have an insufficient response to DAPT. Laboratory resistance to DAPT in patients with stable stenocardia is multifactorial and is associated with high levels of CRP, ET-1, PV and a pronounced endothelial dysfunction. The presence of a pronounced decrease of FBF (OR 3.4; 95 % CI 1.2–9.3, p <0.05), elevated CRP values (OR 2.9; 95 % CI 1.2–6.8, p <0.05), can be used as a criterions for selecting patients to aggregometry.
About the Authors
T. P. Pronko
Grodno State Medical University
Belarus
Belarus
Pronko Tatyana P. – MD, PhD, associated professor, head of the department of Propaedeutics of Internal Diseases
80 Gorkogo str., Grodno, 230009
V. A. Snezhitskiy
Grodno State Medical University
Belarus
Belarus
Snezhitskiy Victor A. – corresponding member of the National Academyof Csiences of Belarus, doctor of Medicine, professor, rector
80 Gorkogo str., Grodno, 230009
V. R. Shulika
Grodno State Medical University
Belarus
Belarus
Shulika Valentina R. – researcher of the scientific department
80 Gorkogo str., Grodno, 230009
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For citations:
Pronko T.P., Snezhitskiy V.A., Shulika V.R. Endothelial dysfunction, systemic inflammation, platelet aggregation properties and their relationship in patients with stable stenocardia. Regional blood circulation and microcirculation. 2020;19(1):22-28. (In Russ.) https://doi.org/10.24884/1682-6655-2020-19-1-22-28
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