PP.18.05] EVALUATION OF PLATELET-PLASMA HEMOSTASIS IN PATIENTS WITH UNSTABLE ANGINA AND ARTERIAL HYPERTENSION

Abstract

Objective: To assess the activity of platelet and plasma hemostasis in patients with unstable angina and arterial hypertension (AH). Design and method: The study involved 126 patients with unstable angina (UA):1 group −48 patients (38%) - without AH (mean age 59.2 + − 7.2 years), 2 group- 78 patients (mean age 57.4 +− 6.4 years) (62%) with hypertension. All patients underwent a complete blood count, determination of cardiac enzymes (troponin I, CKMB, biochemical blood tests, a marker of inflammation CRP, levels of myeloperoxidase (MPO), von Willebrand factor (VWFr), thrombin levels, determining the activity of platelets, D-dimers (DD), Xa factor, aggregatogram with analyzer Multiplate and determination of platelet activation by flow cytometry, determining the activity of platelets, ECG, EchoCG, ABPM,coronary angiography. Results: Patients (pts) in both groups detected the activation of platelet-plasma hemostasis at admission. However, in patients with UA and AH were significantly higher than the following values: platelet volume (MPV) 9,7fl vs 8,9fl; VWF 147% vs 132%; level of MPO 330 pmol/l vs 284 pmol/l; the level of spontaneous aggregation with method of Multiplate (TRAP-test) with an estimate of area under the curve (AUC) 122U vs 106U. The activity of receptors of platelets IIb/IIIa and expression of p-selectin on the platelet surface was confirmed by the number of CD62P positive cells by flow cytometry and was in the 2 group of patients with UA and AH 56% vs 49% in the 1 group (UA without AH). All values in groups 1 and 2 was significantly different. Conclusions: The presence of arterial hypertension in patients with unstable angina increases hyperaggregation of platelets and activates plasma hemostasis. This fact should be considered when the antithrombotic therapy in pts with UA is assign and in the control of hemostasis during treatment.