Hemostasis disorders in patients with NSTEMI and diagnostic markers.
DOI:
https://doi.org/10.52692/1857-0011.2022.1-72.15Keywords:
NSTEMI, haemostasis disorder, procoagulant markers, anticoagulant system markers, fibrinolysis markersAbstract
Actualitate. Tulburarea hemostazei este un mecanism important al afecțiunilor cardiovasculare, iar aportul patogenetic al acestuia în evoluția NSTEMI este îndeosebi notabil în contextul semnificației paternului fiziopatologic determinat de dereglarea microcirculației coronariene. Evidențierea markerilor iminenți va facilita diagnosticul și prognosticul NSTEMI. Scopul. Relatarea datelor de sinteză a literaturii privind markerii circulanți ai tulburării hemostazei la pacienții cu NSTEMI. Rezultate. Markerii principali ai dereglării hemostazei în NSTEMI și cu valoare predictivă asupra diagnosticului și evoluției post-infarct sunt:vizavi de sistemul procoagulant: elevarea microparticulelor derivate de endoteliocite și plachete ce expresează fosfotidilserină, activarea complexului factorilor de coagulare II, VII și X, formarea agregatelor dintre plachete și leucocite;vizavi de sistemul anticoagulant: creșterea trombomodulinei solubile în asociere cu micșorarea plasmatică a antitrombinei și a proteinelor C și S;vizavi de sistemul fibrinolitic: elevarea nivelului plasmatic al monomerilor și D-dimerilor ai fibrinei, al inhibitorului activatorului plasminogenului în asociere cu deprecierea cantitativă a activatorului plasminogenului.
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