Coagulation hemostasis and thrombotic readiness in cardiac patients with chronic heart failure and a history of cancer
AbstractHypercoagulation changes in the hemostasis system in patients with chronic heart failure (CHF) and a history of cancer due to the frequency occurrence of these nosologies and their social significance. The presence of this condition in patients of this profile requires special vigilance in terms of the development of thrombotic events.
Objective – to analyze the impact of chronic heart failure stage I–II on the severity of hypercoagulable changes and the formation of a state of thrombotic readiness in cardiac patients with a burdened oncological history.
Material and methods. In total, 540 cardiac patients with a history of cancer were analyzed and examined at the prescreening stage. After the analysis for compliance with the inclusion criteria, 100 patients with coronary heart disease (CHD) (n=57) and arterial hypertension (AH) (n=43), complicated by CHF stage I–IIB, underwent the screening stage. The main group consisted of 40 patients with cardiac pathology (AG/AG + IHD) complicated by CHF I–IIB and a history of aggravated oncologic anamnesis. The comparison group included 60 people with cardiovascular pathology (CVS) (AG/AG + IHD) with a history of aggravated oncologic anamnesis without signs of CHF. The history of oncologic anamnesis was represented by breast cancer (n=64) and primary multiple cancer (n=36). The groups were comparable by age, gender, cardiac pathology and features of the aggravated oncologic anamnesis. A standard coagulation test and thrombodynamics test were used to diagnose coagulation hemostasis disorders.
All patients underwent standard clinical, laboratory and instrumental examination.
Results. When analyzing the parameters of the standard coagulation test, differences were found in prothrombin time (PT), which was higher in the CHF group (p<0.05). At the same time, the PT value did not go beyond the reference values. The presence of procoagulant shifts was indicated by the average value of soluble fibrin-monomer complexes in both groups of more than 4×10–2 g/l. In order to clarify the obtained data, a thrombodynamics test was performed. The results of the analysis the velocity and structural parameters of the test demonstrated a tendency to hypercoagulation in both groups. However, the severity of these changes was comparable both in patients with CHF and in its absence (p>0.05). At the same time, the degree of hypercoagulation in both groups was assessed as STH in almost every second patient. The difference in clot growth retardation was noteworthy, which was lower in the group without CHF, but did not go beyond the reference values.
Conclusion. The leading role in the diagnosis of STH in patients with cardiac pathology against the background of an aggravated oncologic anamnesis and CHF I–IIB stages belongs to the thrombodynamics test, and not the standard coagulation test. Hypercoagulation changes are equally pronounced in cardiac patients with an aggravated oncologic anamnesis both in the presence of CHF I–IIB stages and in its absence. A personalized approach to patient management is required regardless of the presence of CHF I–IIB. At the same time, severe CHF requires a separate analysis.
Keywords: chronic heart failure; aggravated oncologic anamnesis; hypercoagulation; thrombodynamics test
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
Authors’ contribution. Collection, analysis, interpretation of data, final approval of the manuscript – Ramazanova Z.G., Parshina S.S.; justification and writing of the manuscript – Ramazanova Z.G.; verification of critical intellectual content – Parshina S.S.
For citation: Ramazanova Z.G., Parshina S.S. Coagulation hemostasis and thrombotic readiness in cardiac patients with chronic heart failure and a history of cancer. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2025; 13 (1): 38–44. DOI: https://doi.org/10.33029/2309-1908-2025-13-1-38-44 (in Russian)
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