N.V. Netyazhenko, T.Y. Malchevska, O.M. Plyenova, A.I. Pastushyna, A.V. Lyakhotska. Changes in blood coagulation and anticoagulation factors activity in women with different risks of cardiovascular events.

The aim – to evaluate coagulation system homeostasis in patients at risk of fatal cardiovascular events for 10 years, and identify their characteristics among females.

Material and methods. The prospective study included 92 patients, including 38 (41.3 %) men and 54 (58.7 %) women, average age 58.2±3.4 years. Using SCORE (Systematic COronary Risk Evaluation) scale, patients were divided into 4 groups of fatal cardiovascular disease risk over the next 10 years: group I of low risk < 1 %, group II – with a moderate risk ≥ 1 to 5 %, group III – patients with a high risk of > 5 to < 10 %, IV group very high risk ≥ 10 %. In all patients parameters of hemostasis were determined: activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen concentration by Claus method, amount of soluble fibrin monomer complexes (RFMK), protein C system activity, XIIa time dependent fibrinolysis, the activity of antithrombin III. Results. Among patients with high and very high risk, particularly in women, we have found the following prothrombotic violations: shortening of APTT and thrombin time, increase of fibrinogen levels, decreased anticoagulant activity of protein C and antithrombin III, RFMK increase and extended XIIa dependent fibrinolysis. Significant differences of anticoagulant blood system were established, namely, reduced activity of protein C anticoagulant system among women at moderate, high and very high risk and antithrombin III, beginning with low risk. These figures differed not only compared to neighbour risk groups, and had significant gender differences. Conclusions. Postmenopausal women, regardless of age, had increased thrombogenic potential. This is manifested by increased activity of coagulation homeostasis combined with depletion of natural anticoagulants and inhibition of fibrinolysis. The severity of these changes is directly related to the degree of cardiovascular risk.

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