Kozachyshyn N. Optimization of diagnosis and prediction of disorders of platelet hemostasis in patients with acute and chronic coronary syndromes and comorbid conditions after stenting of coronary arteries.

The dissertation provides a detailed analysis of platelet aggregation in patients with acute and chronic coronary syndrome who underwent percutaneous coronary intervention (PCI) and had concomitant type 2 diabetes and a history of coronavirus infection. Despite the successes in interventional cardiology and in the development of new drugs, morbidity and mortality from cardiovascular diseases (CVD) are steadily increasing. It is essential to improve and evolve a conceptual approach to avoid adverse events in the future. In addition, many patients have comorbidities that are difficult to control. The combination of comorbid disorders, such as arterial hypertension (AH), atrial fibrillation (AF), type 2 diabetes mellitus (DM), and a previous COVID-19 infection against the background of acute (ACS) or chronic (CCS) coronary syndrome is a frequent cause of the development of thrombotic complications (pulmonary artery thromboembolism (PE), deep vein thrombosis (DVT), strokes, repeated heart attacks and other cardiovascular occasions). Therefore, the study of changes of the hemostasis system, as well as a violation of the platelet link, will allow optimizing a personalized approach to patients and selecting the optimal therapy before and after PCI. Our work aimed to increase the efficiency of diagnostics of disorders in the hemocoagulation system and timely prediction of probable thrombotic complications based on the study of platelet hemostasis indicators in patients with acute and chronic coronary syndromes and comorbid conditions after stenting. Objectives of the study: 1. To investigate the state of platelet hemostasis in patients with acute coronary syndrome before and after stenting. 2. To study the state of functional activity of platelets in patients with chronic coronary syndrome before and after stenting. 3. To assess the effect of double antiplatelet therapy (clopidogrel/ticagrelor) in patients with coronary heart disease on the state of platelet hemostasis. 4. To study the influence of comorbid type 2 diabetes and transferred COVID-19 infection on the state of the platelet link of hemostasis in patients with coronary artery disease. 5. Analyze the risk of the development of repeated cardiovascular events based on the assessment of the state of platelet hemostasis during the one-year observation period in patients with coronary artery disease who underwent PCI. We conducted a prospective study of 128 patients who were undergoing inpatient treatment at the Amosov National Institute of Cardiovascular Surgery (by the agreement on scientific cooperation with the O.O. Bogomolets National Medical University). Two main groups were distinguished: Group I patients with ACS (n=61, average age was 61.6±9.8), and Group II – patients with ACS (n=67, average age was 65.2±8.6). Among the examined, the vast majority were men, 93 (72.7%), while women – 35 (27.3%).