Email this article Hemostasiological, lipidemic, and hemodynamic indicators associated with the risk of cardiovascular death in high- and very high-risk patients according to the SCORE scale
- Authors: Kachkovskiĭ MA1, Simerzin VV1, Rubanenko OA1, Kirichenko NA1
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Affiliations:
- ГБОУ ВПО "Самарский государственный медицинский университет" Минздрава России
- Issue: Vol 86, No 3 (2014)
- Pages: 59-64
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/31463
- ID: 31463
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Abstract
AIM: To identify lipidemic, hemostasiological, and hemodynamic indicators associated with the risk of cardiovascular death in high- and very high-risk patients/MATERIAL AND METHODS: One hundred and forty-eight patients whose mean age was 50.8±4.4 years were examined. All the patients were divided into high (1 group) and very high (2 group) cardiovascular death risk groups according to the SCORE scale. Lipid metabolism, hemostatic system parameters (fibrinogen, time of ADP-induced platelet aggregation initiation, D-dimer), endothelial dysfunction markers (von Willebrand factor), and echocardiographic findings were studied/RESULTS: Multivariate regression analysis showed that the odds ratio for a cardiovascular death risk was 1.8 (95% confidence interval (CI), 1.1 to 4.2; p=0.04) in patients with a D-dimer level of greater than 1 mg/ml, 0.77 (95% CI, 0.6 to 0.97; p=0.03) in those with an ADP-induced platelet aggregation initiation time of 13.5 sec, 1.04 (95% CI, 1.01 to 1.07; p=0.02) in those with an end-diastolic volume of more than 123 ml, 1.1 (95% CI, 1.04 to 1.2; p=0.003) in those with an end-diastolic dimension of more than 51 mm, 1.5 (95% CI, 1.1 to 2.0; p=0.009) in those with a ventricular septal thickness of more than 11.5 mm, and 2.1 (95% CI, 1.03 to 3.2; p=0.0032) in those with a von Willebrand factor level of more than 140%/CONCLUSION: The high levels of von Willebrand factor, D-dimer, ADP-induced platelet aggregation, triglycerides, end-diastolic volume, end-diastolic dimension, and ventricular septal thickness are independent predictors of cardiovascular death in very high-risk patients. These indicators bear out a close relationship between lipid metabolic and hemostatic disturbances and between endothelial dysfunction and intracardiac hemodynamic worsening in these patients.
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##article.viewOnOriginalSite##About the authors
M A Kachkovskiĭ
ГБОУ ВПО "Самарский государственный медицинский университет" Минздрава России
V V Simerzin
ГБОУ ВПО "Самарский государственный медицинский университет" Минздрава России
O A Rubanenko
ГБОУ ВПО "Самарский государственный медицинский университет" Минздрава России
Email: neron@samtel.ru
N A Kirichenko
ГБОУ ВПО "Самарский государственный медицинский университет" Минздрава России
References
- Тот П.П., Мэки К.К. Нарушения липидного обмена. Пер. с англ. под ред. В.В. Кухарчука. М: ГЭОТАР-Медиа; 2010.
- Conroy R.M., Pyorala K., Fitzgerald A.P. et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987-1003.
- Панченко Е.П. Атеротромбоз: механизмы развития и реально проводимая терапия. Атеротромбоз 2008; 1: 22-27.
- Folsom A.R., Delaney J.A., Lutsey P.L. et al. Associations of factor VIIIc, D-dimer, and plasmin-antiplasmin with incident cardiovascular disease and all-cause mortality. Am J Hematol 2009; 84 (6): 349-353.
- Шальнова С.А., Деев А.Д., Оганов Р.Г. Факторы, влияющие на смертность от сердечно-сосудистых заболеваний в российской популяции. Кардиоваск тер и проф 2005; 1: 4-9.
- Smith А., Patterson С., Yarnell J. et al. Which Hemostatic Markers Add to the Predictive Value of Conventional Risk Factors for Coronary Heart Disease and Ischemic Stroke? The Caerphilly Study. Circulation 2005; 112: 3080-3087.
- Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации (V пересмотр). Рос кардиол журн. 2012; 4: Приложение 1.
- Smith F.B., Lee A.J., Fowkes F.G.R. et al. Hemostatic factors as predictors of ischaemic heart disease and stroke in the Edinburg Artery Study. Artherioscler Thromb Vasc Biol 1997; 17: 3321-3325.
- Quinn M., Fitzgerald D., Totowa N.J. Platelet function: assessment, diagnosis, and treatment. Humana Press 2005.
- Paulinska P., Spiel A., Jilma B. Role of von Willebrand factor in vascular disease. Hamostaseologie 2009; 29 (1): 32-38.
- Плотникова И.В., Соколов А.А., Ковалев И.А. Особенности структурно-геометрической перестройки миокарда левого желудочка на ранних этапах формирования эссенциальной артериальной гипертензии в подростковом возрасте. Кардиология 2012; 12: 28-33.
- Mandry D., Eschalier R., Kearney-Schwartz A. et al. Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominalobesity. J Hypertens 2012; 30 (3): 567-573.
- Di Bella G., Siciliano V., Aquaro G.D. et al. Scar extent, left ventricular end-diastolic volume and wall motion abnormalities identify high-risk patients with previous myocardial infarction: a multiparametric approach for prognostic stratification. Eur Heart J 2013; 34 (2): 104-111.
- Беленков Ю.Н. Дисфункция левого желудочка у больных ИБС: современные методы диагностики, медикаментозной и немедикаментозной коррекции. Рус мед журн 2000; 17: 685-693.
- Sarwar N., Danesh J., Eiriksdottir G. et al. Triglycerides and the Risk of Coronary Heart Disease. Circulation 2007; 115: 450-458.
- Graham I., Cooney M.T., Bradley D. et al. Dyslipidemias in the prevention of cardiovascular disease: risks and causality. Curr Cardiol Rep 2012; 14 (6): 709-720.
- Jeppesen J., Hein H.O., Suadicani P. et al. Triglyceride concentration and ischemic heart disease. An eight-year follow-up in the Copenhagen Male Study. Circulation 1998; 97: 1029-1036.
- Kasai T., Miyauchi K., Yanagisawa N. et al. Mortality risk of triglyceride levels in patients with coronary artery disease. Heart 2013; 99 (1): 22-29.
