Kireyeva M. Mechanisms of platelet dysfunction in patients with infarction of myocardium

Object of research is mechanisms of platelets dysfunction in patients with acute myocardial infarction (AMI); aim of research is to evaluate platelet reactivity in patients with coronary artery disease and establish mechanisms of their dysfunction in AMI; methods - clinico-instrumental, morphological, biochemical, biostatistical; novelty of research and results - for the first time the full analysis and comparison of clinico-instrumental data, parameters of blood reactivity and platelets functional reactivity in vitro in patients with stable angina and AMI was conducted; it was proven that platelet is a representative model for assessment of hemostasis during AMI; gender- and age-related differencies of AMI and their relation to the reactivity of the organism, course and outcome of disease were analized; for the first time proinflammatory activity of platelets and their tendency to form platelet-leukocyte aggregates in the perifery blood during AMI were verified; it was established that development of AMI is accompanied by a significant increase in platelet response to tissue, coagulation, systemic and paracrine factors; it was proven that dual antiplatelet therapy is accompanied by a decrease in platelet response to the main agonists with the exception of thrombin; it was proven that one of the factors that participates in development of the resistance to standard antiplatelet therapy is platelet hyperadrenoreactivity, which is accompanied by maintenance or recovery of the platelet response to adenosine diphosphate and collagen; it was shown that platelet reaction to adrenaline depends not only on the balance between adrenoreceptors sensitivity but also on the state of the intracellular signaling systems; it was shown that platelet hyperreactivity can be explained by increasing role of phosphodiesterase and phospholipase C; the results were imlemented into the clinical practice of "V.K. Husak Institute of Urgent and Reconstructive Surgery of NAMS of Ukraine" (Donetsk), Institute of Traumatology and Orthopedics of Donetsk national medical university, into the teaching process of pathological physiology, pathological anatomy, histology in medical universities, and into the diagnostics procedures in the departments of cardiology, cardiosurgery, laboratories and diagnostics centres.