Features of Blood Coagulation System in Patients at High and Very High Cardiovascular Risk According to the SCORE Charts in the Presence of Heart Rate Turbulence

  • A. I. Vytryhovskyy Ivano-Frankivsk National Medical University
Keywords: cardiovascular risk, coronary heart disease, arrhythmia, sudden cardiac death, ventricular fibrillation

Abstract

The objective of the research was to determine the features of the blood coagulation system in patients at high and very high cardiovascular risk according to the SCORE charts in the presence of heart rate turbulence.

Materials and methods.  603 patients were examined to determine the role of heart rate variability in the cardiovascular continuum; 319 patients were examined to study the role of heart rate turbulence in the formation and progression of sudden death in the cardiovascular continuum based on the Holter monitoring. All patients were divided into 4 groups: Group 1 included patients with coronary heart disease without concomitant risk factors such as smoking, obesity, metabolic syndrome; Group 2 consisted of patients smoking tobacco for more than 2 years; Group 3 included patients with metabolic syndrome without existing coronary heart disease or arterial hypertension; Group 4 consisted of patients with metabolic syndrome and arterial hypertension. The control group included 149 people. In patients with ventricular extrasystoles of different degrees according to V. Lown’s and M. Wolf’s scale the phenomenon of heart rate turbulence was observed and the parameters of the blood coagulation system were determined.

Results. There was no significant difference between indices of coagulation among studied groups and the control group. In patients with post-infarction cardiosclerosis hematocrit was lower due to regular intake of antiplatelet drugs to prevent the progression of coronary heart disease. It can be stated that the phenomenon of heart rate turbulence itself does not affect the change in the coagulation system of the human body. When determining the advisability of administering anticoagulants to patients with heart rate turbulence, we should be guided by not only the presence of ventricular ectopy the total cardiovascular risk should be considered as well.

Conclusions. The presence of isolated heart rate turbulence phenomenon in a patient does not require a special approach to anticoagulant therapy.

Author Biography

A. I. Vytryhovskyy, Ivano-Frankivsk National Medical University

Ivano-Frankivsk National Medical University, Ivano-Frankivsk

Ivano-Frankivsk Regional Clinical Cardiology Dispensary, Ivano-Frankivsk

References

Bardy GY, Lee RL, Mark DB. Sudden Cardia Death in Heart Failure Trial (SCD-HeFT). N. Engl. J. Med. 2005;352:225-237.

Barthel P, Schneider R, Malik M, Schmidt G. EMIAT substudy: Impact of age on heart rate turbulence indices. Eur. Heart J. 2001;22(Suppl 436):2315.

Barthel P, Schneider R, Bauer A, et al. Risk stratification after acute myocardial infarction by heart rate turbulence. Circulation. 2003;108:1221-1226.

Bauer A, Barthel P, Schneider R, et al. Dynamics of heart rate turbulence as independent risk predictor after dynamic myocardial infarction. PACE. 2002;25(Pt II):608.

Brune S. Prevalence of late potentials ventricular in hypertensive patients. J Cardiovasc. Pharmacol. 1991;17(Suppl 2):146-147.

Davies LC, Francis DP, Ponikowski P, et al. Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure. Am. J. Cardiol. 2001;87:737-742.

Laragh John H, Barry MD, Brenner M.D. Hypertension Pathophysiology, Diagnosis and Management. 2nd ed. Raven Press New York. 2015;1:1720.

Published
2016-06-19
Section
Original Research