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IMPACT OF ANTICOAGULANT THERAPY ON THE INDICATORS OF ARTERIAL STIFFNESS AND ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ATRIAL FIBRILLATION AFTER CARDIOEMBOLIC STROKE

https://doi.org/10.14412/2074-2711-2016-4-25-31

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Abstract

Objective: to investigate the impact of anticoagulant therapy on the indicators of arterial stiffness and endothelial dysfunction (ED) in patients with atrial fibrillation (AF) after cardioembolic stroke (CES).

Patients and methods. The investigation enrolled 93 patients with AF after CES. The patients were divided into two groups: a study group in which all patients (n=48) received anticoagulants and a comparison group (n=45) in which the patients did not take anticoagulants, although the latter had been prescribed. The follow-up duration was 180.5±5.5 days. During this time the patients visited their doctors twice: the first visit was at baseline, the second one was after 24 weeks.

All the patients underwent three-dimensional sphygmography. The levels of glucose, creatinine, total cholesterol, high-density lipoproteins, and triglycerides were determined. The markers of endothelial function, such as von Willebrand factor, plasminogen, antithrombin III,  and tissue plasminogen activator inhibitor-1, were estimated.

Results. All the patients in the study and comparison groups had a higher comorbidity index of obvious somatic pathology. The patients from both groups showed changes in all cardiac morphometric and functional parameters. It was noted that after 6 months of a follow-up, there was a statistically significant positive trend in the indicators of arterial stiffness in the patients taking anticoagulants. The study group showed a significant correlation of blood pressure with the argumentation index. The 6-month follow-up revealed a strong correlation between the cardioankle vascular index and all the indicators of ED in the study group. After 24 weeks, in both groups there were 12 (12.9%) deaths: 3 (6.25%) and 8 (17.8%) in the study and comparison groups, respectively.

Conclusion. The findings suggest that in patients with AF after CES, the indicators of arterial stiffness and endothelial function tend to improve during anticoagulant therapy.

About the Authors

I. A. Zolotovskaya
Samara State Medical University
Russian Federation

Aleksandrovna Zolotovskaya - Department of Hospital Therapy with Courses of Outpatient Therapy and Transfusiology.

89, Chapaevskaya St., Samara 443099, zolotovskay@list.ru



I. L. Davydkin
Samara State Medical University
Russian Federation

Department of Hospital Therapy with Courses of Outpatient Therapy and Transfusiology.

89, Chapaevskaya St., Samara 443099



I. E. Poverennova
Samara State Medical University
Russian Federation

Department of Neurology and Neurosurgery.

89, Chapaevskaya St., Samara 443099



N. P. Romanchuk
Samara State Medical University
Russian Federation

Department of Normal Physiology.

89, Chapaevskaya St., Samara 443099



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For citation:


Zolotovskaya I.A., Davydkin I.L., Poverennova I.E., Romanchuk N.P. IMPACT OF ANTICOAGULANT THERAPY ON THE INDICATORS OF ARTERIAL STIFFNESS AND ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ATRIAL FIBRILLATION AFTER CARDIOEMBOLIC STROKE. Neurology, Neuropsychiatry, Psychosomatics. 2016;8(4):25-31. (In Russ.) https://doi.org/10.14412/2074-2711-2016-4-25-31

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ISSN 2074-2711 (Print)
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