O.V. GRUZDEVA¹, E.V. FANASKOVA¹, O.E. AKBASHEVA², E.G. UCHASOVA¹, T.Yu. PENSKAYA¹, A.A. KUZMINA¹, Yu.A. DYLEVA¹, K.P. KRIVOSHAPOVA¹, L.A. EGOROVA¹

¹Scientific-Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnoviy boulevard, Kemerovo, Russian Federation, 650002

²Siberian State Medical University, 2 Moskovskiy Trakt, Tomsk, Russian Federation, 650029

Gruzdeva O.V. ― D. Med. Sc., Head of Homeostasis Research Laboratory, tel. (3842) 64-05-53, e-mail: o_gruzdeva@mail.ru

Fanaskova E.V. ― Head of Transfusion Therapy Unit, Junior Researcher of Homeostasis Research Laboratory, tel. (3842) 64-46-14, e-mail: fanaskova70@mail.ru

Akbasheva O.E. ― D. Med. Sc., Professor of the Department of Biochemistry and Molecular Biology, tel. (3822) 901-101, e-mail: akbashoe@yandex.ru

Uchasova E.G. ― Cand. Med. Sc., Senior Researcher of Homeostasis Research Laboratory, tel. (3842) 64-05-53, e-mail: evg.uchasova@yandex.ru

Penskaya T.Yu. ― Junior Researcher of Homeostasis Research Laboratory, tel. (3842) 64-05-53, e-mail: t_penskaja@mail.ru

Kuzmina A.A. ― Junior Researcher of Homeostasis Research Laboratory, tel. (3842) 64-05-53, e-mail: gruzov@kemcardio.ru

Dyleva Yu.A. ― Cand. Med. Sc., Researcher of Homeostasis Research Laboratory, tel. (3842) 64-05-53, e-mail: dyleva87@yandex.ru

Krivoshapova K.E. ― Junior Researcher of the Laboratory of Blood Circulation Pathology, tel. (3842) 64-05-53, e-mail: ya.kristi89@yandex.ru

Egorova L.A. ― nurse-anesthetist of the Intensive Care Unit, tel. (3842) 64-05-53, e-mail: gruzov@kemcardio.ru

 The article analyzes the basic parameters of perioperative coagulation and thrombin generation test in 200 patients who underwent coronary artery bypass grafting with cardiopulmonary bypass. In the pre- and intraoperative periods, coagulation parameters showed a coagulation imbalance development: indicators of INR and prothrombin indicate anticoagulation, while the deficit of anticoagulants indicates the procoagulation shift. Thrombin generation test results reflect the state of activation of the endogenous thrombin potential. In the early postoperative period, hemostatic potential of blood, according to the parameters of thrombin generation test decreased, reach the control level. Thrombin generation test is the most informative method of confirming the presence of coagulation hypocoagulation shifts detected as a result of coagulogram and assessing the thrombin-forming function of the coagulation homeostasis due to lower activity of physiological anticoagulants.

Key words: coronary artery bypass surgery, homeostasis, thrombin generation test, coagulogram.

REFERENCES

1. Charnaya M.A. Patogenez narusheniy sistemy gemostaza pri kardiokhirurgicheskikh operatsiyakh: dis. … dok. med. nauk [Pathogenesis of hemostasis system disorders during cardiosurgery operations. Dis. Dr med. sciences]. Moscow, 2007.
2. Charnaya M.A., Dement’eva I.I. Use of aprotinin in surgical interventions associated with a high risk of hemorrhagic complications. Khirurgiya. Zhurnal im. N.I. Pirogova, 2005, no. 11, pp. 71-76 (in Russ.).
3. Shitikova A.S. Trombotsitopatii, vrozhdennye i priobretennye, pod red. L.P. Papayan, O.G. Golovinoy [Thrombocytopathy, congenital and acquired. Ed. by L.P. Papayan, O.G. Golovina]. Saint Petersburg: IITs VMA, 2008. P. 384.
4. Dolgov V.V., Svirin P.V. Laboratornaya diagnostika narusheniy gemostaza [Laboratory diagnostics of hemostasis disorders]. Moscow: Tver: OOO “Izdatel’stvo “Triada”, 2005.
5. Namestnikov Yu.A. The thrombin generation test is an integral indicator of the state of the blood coagulation system. Gematologiya i transfuziologiya, 2010, no. 2, pp. 35-39 (in Russ.).
6. Namestnikov Yu.A., Golovina O.G., Papayan L.P. The value of the thrombin generation test in clinical practice. Tromboz, gemostaz i reologiya, 2011, no. 48, pp. 47-49 (in Russ.).
7. van Veen J.J., Gatt A., Makris M. Thrombin generation testing in routine clinical practice: are we there yet? Blackwell Publishing Ltd, British Journal of Haematology, 2008, no. 142, pp. 889-903.
8. Barbarash O.L., Kashtalap V.V., Karetnikova V.N. et al. Clinical significance of indices of endothelial dysfunction, oxidative stress and hemostasis in patients with myocardial infarction. Patologiya krovoobrashcheniya i kardiokhirurgiya, 2007, no. 2, pp. 28-33 (in Russ.).
9. Samama C.M., Rosencher N., Lecoules N., et al. Comparison of fondaparinux with low molecular weight heparin for venous thromboembolism prevention in patients requiring rigid or semi-rigid immobilization for isolated non-surgical below-knee injury. Journal of Thrombosis and Haemostasis, 2013, vol. 11, no. 10, pp. 1833-1843.
10. Solov’ev O.N., Petrenko T.I. Global test for assessing the state of the hemostasis system — the endogenous potential of thrombin. Meditsinskiy alfavit. Sovremennaya laboratoriya, 2013, no. 4, pp. 41-44 (in Russ.).