Thrombodynamics as a tool for monitoring the effectiveness of anticoagulant therapy in patients with pulmonary embolism

Abstract

Background . Monitoring of hemostasis in patients with pulmonary embolism (PE) to assess the efficacy and safety of anticoagulant therapy is one of the most emerging needs in clinical practice. Aim. To determine the factors associated with an insufficient decrease in the rate of fibrin clot formation in patients after pulmonary embolism receiving anticoagulation therapy. Methods. 33 patients were recruited in the study. To control plasma hemostasis, we measured coagulogram indices and performed dynamic thrombophotometry (T-2 Thrombodynamics Registrar, GemaCore, Russia). Results. The median rate of fibrin clot formation in the general sample of patients was within the normal range. However, 13 patients (39.4%) had these values higher than 29 pm/min. Patients with an insufficient decrease in the rate of fibrin clot formation were significantly younger (p = 0.045), more often had massive PE of the main branches of the pulmonary artery (p = 0.015), and high systolic pulmonary artery pressure (p = 0.043). Conclusion. Thrombodynamics allows identifying patients with PE and an increased thrombogenic potential under anticoagulation therapy by the end of the hospital stage. A high rate of fibrin clot formation by the end of the hospital period is observed in younger patients with thrombosis of the main branches of the pulmonary artery and high pulmonary hypertension.