Abstract
Introduction. Ischemic cerebrovascular diseases (ICD) are one of the main causes of death and disability in today’s world. One of the significant ethiological factors for ischemic stroke (IS) in relatively young patients are Ph-negative myeloprolifera- tive diseases (MPD) — clonal diseases occurring at the level of hematopoietic stem cell. Aim: evaluation of hemostasiological and hemorheological disorders in patients with cerebrovascular pathology and Ph-neg- ative MPD. Material and methods. We examined 104 patients (men — 32.7%, women — 67.3%) 20–58 years old with Ph-negative MPD. The main group consisted of 21 patients with IS. Clinical and neuroimaging examinations were performed in all patients. Lab- oratory methods included determination of hemorheological, hemostasiological, fibrinolytic parameters and identification of V617F mutation in JAK2 gene. Results. All patients had alterations of the majority of hematological parameters beyond the normal range irrespectively from association with IS. Hemoglobin values and color index were higher, and platelet count was lower in patients with IS than in comparison group. A high prevalence of JAK2 mutation (V617F) was noted in IS patients (86%). The influence of this mutation on some hemorheological and hemostatic parameters was also determined. Conclusion. Ph-negative MPDs are the important etiological factor of IS development. The mechanisms of thrombus forma- tion in IS patients with MPD are apparently different from thromboses of other localizations. The study underlines the neces- sity of identifying a uniform marker of cerebral thrombotic complications in MPD which may lead to personified prophylaxis and target correction of MPD. REFERENCES 1. Benjamin E.J., Virani S.S., Callaway C.W. et al. Heart disease and stroke statistics-2018 update: a report from the American Heart Association. Circulation. 2018; 137: 1–442. DOI: 10.1161/ CIR.0000000000000554. 2. Suslina Z.A., Tanashyan M.M., Ionova V.G. Ischemic stroke: blood, vascular wall, antithrombotic therapy [Ishemicheskij insul’t: krov’, sosudistaya stenka, antitromboticheskaya terapiya]. Moskva: Medi- cinskaya kniga. 2005: 248 s (in Russ.). 3. Arber D.A., Orazi A., Hasserjian R. et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016; 127: 2391–405. DOI: 10.1182/ blood-2016–03–643544. 4. Moulard O., Mehta J., Fryzek J. et al. Epidemiology of myelofibrosis, essential thrombocythemia, and polycythemia vera in the European Union. Eur J Haematol. 2014; 92: 289–97. DOI: 10.1111/ejh.12256. 5. Tanashyan M.M., Kuznetsova P.I., Shabalina A.A. et al. Clinical characteristics of cerebrovascular pathology with patients suffer- ing from Ph-negative myeloproliferative disease. Cerebrovasc Dis Extra. 2016; 6 (3): 66–70. DOI: 10.1159/000448597. 6. Levine R.L., Pardanani A., Tefferi A., Gilliland D.G. Role of JAK2 in the pathogenesis and therapy of myeloproliferative disorders. Nat Rev Cancer. 2007; 7 (9): 673–83. DOI: 10.1038/nrc2210. 7. Kalala F., Mamara A., Ioannou M., Speletas M. Transient ischemic attacks as the first presentation of JAK2-V617F positive chronic myeloproliferative neoplasm. Hematol Rep. 2012; 4: e12. 8. Posfai E., Marton I., Szoke A. et al. Stroke in essential throm- bocythemia. J Neurol Sci. 2014; 336 (1): 260–2. DOI: 10.1016/j. jns.2013.10.016. 9. Kuznetsova P.I. Cerebrovascular pathology in Ph-negative myelo- proliferative diseases [Cerebrovaskulyarnaya patologiya pri Ph-neg- ativnyh mieloproliferativnyh zabolevaniyah]. Avtoref. dis. kand. med. nauk. Moskva. 2017: 29 s (in Russ.). 10. Tanashyan M.M. Hemostasis, hemorheology and atrombogenic activity of the vascular wall in angioneurology [Gemostaz, gemore- ologiya i atrombogennaya aktivnost’ sosudistoj stenki v angionev- rologii]. Annaly klinicheskoj i eksperimental’noj nevrologii. 2007; 1 (2): 29–33 (in Russ.).
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call