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Year 2022 Vol. 30 No 3

SCIENTIFIC PUBLICATIONS

R.E. KALININ, I.A. SUCHKOV, V.O. POVAROV, N.D. MZHAVANADZE, O.N. ZHURINA

THE STATE OF PRIMARY HEMOSTASIS IN PATIENTS WITH PACEMAKERS IN THE EARLY POSTOPERATIVE PERIOD<

Ryazan State Medical University, Ryazan,
Russian Federation

Objective. To assess dynamics of primary hemostasis markers in patients with pacemakers (PM) in the early postoperative period. Methods. The study included 94 patients (49 men) with an average age of 72 (67-81) years with indications for pacemaker implantation. 43 patients (45.7%) were underwent management of antiplatelet agents (acetylsalicylic acid in a standard dosage) and 51 (54.3%) patients – anticoagulants due to the presence of atrial fibrillation. Before implantation, after 7 days and after 1 month, samples of blood were taken to determine the number of platelets, thrombocrit, platelet distribution width, mean platelet volume, von Willebrand factor (vWF) activity, and the level of soluble P-selectin (sP-selectin). Results. The number of platelets decreased 7 days after the pacemaker implantation (p<0.001), recovering to the initial values after 1 month (p=0.002). Thrombocrit significantly decreased 7 days after surgery (p=0.003). The mean platelet volume decreased after 1 month compared to baseline values (p=0.016) and 7 days values after implantation (p=0.01). The level of sP-selectin increased on the 7th day of the postoperative period (p=0.006). The mean values of the platelet distribution width, vWF, and other changes not described above were statistically hegligibl (p>0.05). The number of platelets 7 days after implantation of a pacemaker requiring puncture of the subclavian vein was lower than in the case of using the cephalic vein (p=0.02). When analyzing subgroups, these changes were noted primarily in patients underwent antiplatelet therapy. Conclusion. The changes in the investigated parameters after implantation of the pacemaker may indicate the activation of the primary hemostasis in patients underwent antiplatelet therapy, but not anticoagulant therapy. A more pronounced activation of the primary hemostasis has occurred in the case of subclavian vein puncture. The mean platelet volume decreases 1 month after pacemaker implantation, which may be associated with the relief of bradyarrhythmia and the elimination of its role in the pathogenesis of heart failure.

Keywords: cardiac implantable electronic devices, pacemaker, hemostasis system, primary hemostasis, platelets
p. 255-263 of the original issue
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Address for correspondence:
390026, Russian Federation,
Ryazan, st. Vysokovoltnaya, 9,
Ryazan State Medical
University Named by Acad. I.P. Pavlov,
Department of Cardiovascular,
X-ray Endovascular Surgery
with a Course of Radiation Diagnostics,
phone: +7-903-836-24-17,
e-mail: suchkov_med@mail.ru,
Suchkov Igor A.
Information about the authors:
Kalinin Roman E., MD, Professor, Head of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University Named by Acad. I.P. Pavlova, Ryazan, Russian Federation.
https://orcid.org/0000-0002-0817-9573
Suchkov Igor’ A., MD, Professor, Professor of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University Named by Acad. I.P. Pavlova, Ryazan, Russian Federation.
https://orcid.org/0000-0002-1292-5452.
Povarov Vladislav O., PhD., Junior Researcher of the Scientific and Educational Center, Ryazan State Medical University Named by Acad. I.P. Pavlova, Ryazan, Russian Federation.
https://orcid.org/0000-0001-8810-9518
Mzhavanadze Nina D., PhD., Assistant Professor of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University Named by Acad. I.P. Pavlova, Ryazan, Russian Federation.
https://orcid.org/0000-0001-5437-1112
Zhurina Olga N., Researcher of the Department of Clinical Laboratory Diagnostics, Ryazan State Medical University Named by Acad. I.P. Pavlova, Ryazan, Russian Federation.
https://orcid.org/0000-0002-2159-582X
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