Prevention of Cerebrovascular Disease in Patients with Myeloproliferatie Disorders

Resumo

Introduction. Hemorheological abnormalities in patients with Ph-negative myeloproliferative disorders (MPD) may lead to the development and/or progression of cerebrovascular pathology. Adequate preventive therapy in such cases lowers the risk of cerebral thrombotic complications. Objective. Evaluation of the effect of dipyridamole and acetylsalicylic acid (ASA) on platelet and erythrocyte aggregation, as well as on morphofunctional properties of erythrocytes in patients with cerebrovascular disease (CVD) due to MPD. Materials and methods. The study comprised 40 patients with various forms of CVD and Рh-negative MPD: 20 patients received dipyridamole, and 20 received ASA for prevention of cerebral thrombotic complications. Mean patient’s age was 44.6 years [35; 58.5]. A thorough clinical and neurological examination was performed, as well as neuroimaging studies, coagulation tests, analysis of platelet aggregation and rheological properties of erythrocytes. Results. Within the observation period (median—6.3 months) no acute cerebrovascular events in both groups were registered. Platelet aggregation (induced by ADP or adrenaline) was similar in both groups. Dipyridamole and ASA were also similar in their effect on functional properties of erythrocytes. Conclusion. Our findings suggest that the therapeutic effect of dipyridamole concerning CVD is similar to that of ASA. Dipyridamole can be recommended for use in patients with Рh-negative MPD if other antiplatelet agents are contraindicated.