Batushkin V. Acute myocardial infarction in declining and senile patients: hemocoagulative, endothelial, proinflammatory violations and their correction

The work is devoted decision of actual problem of pathophysiologic mechanisms in unfavorable motion of AMI for elderly patients on the base of complex estimation of violation coagulative-platelet hemostasis, function of endothelium, activation of system inflammation. Work is based on information of observation und examination of 512 patients with AMI - 191 -in age before 65 years, 156 - in age 65-74 years and 165 - more than 74 years. The pathophysiologic features of disturbances of coagulative hemostasis and endothelial function in patients with AMI in age 65-74 and after 74 years, which are characterized by the greater increases of levels of spontaneous and inductive platelets agregation, by growth of procoagulative potential in plasma, considerable violations of vasоmotore activity of endothelium. The role of activating of local inflammatory answer is certain for formation zone necrosis in myocardium with worsening of intracardial hemodynamics and progress of pathological postinfarction remodelingfor advanced ages. The basic biochemical factors of risk prognosis for unfavorable motion of AMI were detected for elderly patients in an one-year term. The features of influencing fibrinolytic are certain anticoagulant and correctors endothelium function on the patophysiologic processes of development of AMI complications in groups patients by age 65-74 years and more than 74.