STUDY OF THE EFFECT OF MODERN ANTIPLATELET AGENTS ON HEMOSTASIS IN THE TREATMENT OF ACUTE CORONARY SYNDROME
Keywords:
acute coronary syndrome, hemostasis, antiplatelet agentsAbstract
Relevance. In the pathogenesis of acute coronary syndrome (ACS), the leading role belongs to the activation of platelets. Inhibition of platelet aggregation is of fundamental importance for the treatment of acute coronary syndrome. Objective of the study — to compare the effectiveness of various drugs for dual antiplatelet therapy for acute myocardial infarction with ST-segment elevation, a combination thereof with enoxaparin. Materials and methods. The study involved 40 patients admitted to the Odessa regional clinical hospital with a diagnosis of acute myocardial infarction with STsegment elevation, which was confirmed by an electrocardiogram, echocardiogram, laboratory findings. Patients were divided into 2 groups: group 1 (20) as a therapy received 325 mg of acetylsalicylic acid 180 mg of ticagrelor + enoxaparin 0.5 mg/ kg/bolus on admission to the intensive care unit; Group 2 (20) 325 mg of aspirin + +clopidogrel 300 mg plus enoxaparin 0.5 mg/kg/bolus. In conducting the study, patients did not receive other drugs that affect the system of regulation of blood aggregation state (RBAS). Hemostasis system research was studied with the help of low-frequency piezoelectric thromboelastography (LFPTEG) immediately after diagnosis, and on the 5th day of treatment. Results. NPTEG indicators characterizing the state of the system RBAS in ACS patients from the start of treatment had significant differences from normal values. According to the data NPTEG in patients there is statistically significant enhancement and acceleration of platelet aggregation and activation of fibrinolysis, hypercoagulation that by 5th day treatment had a tendency to to decrease. On the 5th day of treatment ACS in patients of group 1 dynamics of the system RBAS, according to NPTEG was positive, with a trend towards normalization of aggregation, coagulation and fibrinolysis. Conclusions. Patients with ACS have an initial change at all levels of coagulation system. During treatment in both groups was observed positive dynamics of system RBAS, but at the first group is more important.
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