UDC

615.273.53.03(470.11)

Authors

Rogozina Aleksandra Sergeevna
Postgraduate Student, Northern State Medical University (Arkhangelsk, Russia)
Vorobyeva Nadezhda Aleksandrovna
Northern State Medical University; Northern Branch of the Hematology Research Centre, Russian Academy of Medical Sciences (Arkhangelsk, Russia)

Abstract

Vitamin K antagonists are used to prevent and treat thrombosis, including that in patients with artificial heart valves, atrial fibrillation and thrombosis of various localization. This paper aimed to determine the levels of thrombin–antithrombin, thrombin, and homocysteine in patients with atrial fibrillation and deep vein thrombosis, taking vitamin K antagonists. The study included 46 patients, both men and women, aged 54 years (from 21 to 76 years). The first group of patients had deep vein thrombosis (n=37), the second – atrial fibrillation (n=9). We evaluated the content of thrombin–antithrombin, thrombin, and homocysteine in the blood serum originally (on the first day) and on the 6th month of warfarin therapy. The initial values had no statistically significant differences between the groups, with the exception of thrombin–antithrombin levels, which were higher in patients with deep vein thrombosis (p < 0.05) than those in patients with atrial fibrillation. After a six month’s warfarin therapy, patients with atrial fibrillation showed a decrease in thrombin level (p < 0.05), while the level of thrombin–antithrombin stayed unchanged (p > 0.05). In patients with deep vein thrombosis, the level of thrombin remained the same (p > 0.05) while the level of thrombin-antithrombin was statistically significantly higher (p > 0.05). All patients showed high homocysteine levels, which can be explained by their diet excluding green plants and vegetables, i.e. deficient in folic acid and B vitamins.

Keywords

thrombin, thrombin–antithrombin, homocysteine, warfarin, thrombosis, atrial fibrillation

References

1. Barkagan Z.S., Mamot A.P. Diagnostika i kontroliruemaya terapiya narusheniy gemostaza [Diagnosis and Controlled Therapy of Bleeding Disorders]. Moscow, 2001, 285 p. 
2. Bokarev I.N., Kozlova T.V. Printsipy ratsional’noy terapii oral’nymi antikoagulyantami [Principles of Rational Therapy with Oral Anticoagulants]. Tromboz, gemostaz i reologiya, 2000, no. 4 (4), pp. 16–21. 
3. Kropacheva E.S. Dlitel’naya terapiya nepryamymi antikoagulyantami u bol’nykh mertsatel’noy aritmiey bez porazheniya klapanov serdtsa [Long-Term Therapy with Anticoagulants in Patients with Nonvalvular Atrial Fibrillation (Prospective Follow-Up)]. Kardiologiya, 2004, no. 6, pp. 24–30. 
4. Vavilova T.V. Gemostaziologiya v klinicheskoy praktike [The Study of Hemostasis in Clinical Practice]. St. Petersburg, 2005. 92 p. 
5. Charnaya M.A., Morozov Yu.A. Trombozy v klinicheskoy praktike [Thrombosis in Clinical Practice]. Moscow, 2009. 224 p. 
6. Odinak M.M., Yanishevskiy S.N., Voznyuk I.A. Uroven’ gomotsisteina plazmy, risk tserebrovaskulyarnykh zabolevaniy i vitaminy gruppy B [Plasma Homocysteine Levels, Risk of Cerebrovascular Disease, and B Vitamins]. Medlayn-Ekspress, 2008, no. 1, pp. 20–23. 
7. Rogozina A.S., Vorob’eva N.A. Pervyy opyt raboty antikoagulyantnoy kliniki g. Arkhangel’ska [First Experience of Anticoagulation Clinic in Arkhangelsk]. Ekologiya cheloveka, 2012, no. 12, pp. 59–64. 
8. Hirsh J. Guidelines for Antithrombotic Therapy. London, 2005, p. 122. 
9. Hirsh J. Guidelines for Prevention of Venous Thromboembolism in Major Orthopedic Surgery. Summary of the American College of Chest Physicians. London, 2005, p. 3. 
10. Granger C.B., Becker R., Tracy R.P., et al. Thrombin Generation, Inhibition and Clinical Outcomes in Patients with Acute Myocardial Infarction Treated with Thrombolytic Therapy and Heparin: Results from the GUSTO-I Trial. GUSTO-I Hemostasis Substudy Group. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. J. Am. Coll. Cardiol., 1998, no. 31 (3), pp. 497–505. 
11. Gorin L., Fauchier L., Nonin E., et al. Antithrombotic Treatment and the Risk of Death and Stroke in Patients with Atrial Fibrillation and a CHADS2 Score=1. Thromb. Haemost., 2010, vol. 103 (4), pp. 833–840. 
12. Grzhibovskiy A.M. Vybor statisticheskogo kriteriya dlya proverki gipotez [Choosing Statistical Criterion to Test Hypothesis]. Ekologiya cheloveka, 2008, no. 11, pp. 48–55. 
13. Scharfstein J.S., Abendschein D.R., Eisenberg P.R., et al. Usefulness of Fibrinogenolytic and Procoagulant Markers During Thrombolytic Therapy in Predicting Clinical Outcomes in Acute Myocardial Infarction. Am. J. Cardiol., 1996, no. 78 (5), pp. 503–510.