EFFECT OF FRAXIPARINE AND TICLOPIDINE ON MARKERS OF ACTIVATION OF SYSTEMS OF COAGULATION AND ANTICOAGULATION IN PATIENTS WITH MULTIFOCAL ATHEROSCLEROSIS

Effect of venous occlusion and therapy with direct anticoagulant and w ith antiaggregant on activity of systems of coagulation and anticoagul ation was studied in 25 male patients with atherosclerotic lesions in at least 2 vascular regions. Ten patients received course therapy with low molecular weight heparin (15 000 U/day) and 14 patients were give n ticlopidine (500 mg/day). Data obtained from 14 men without obvious signs of atherosclerosis were used as control. Determination of parame ters of hemostasis was performed before and after 10 min of venous occ lusion. Compared to control group patients with multifocal atheroscler osis had signs of activation of coagulation evidenced by augmented thr ombin formation (prothrombin fragment 1+2 1,2+/-0,1 and 1,6+/-0,1 (nmo l/l, p(0,05), platelet activation(platelet factor IV 48+/-7 and 15+/-3 (mu g/l, p<0,05) and fibrin formation (fibrinogen 4,1+/-0,3 and 5,2+/ -0,3 g/l, p(0,05; d-dimer 427+/-56 and 223+/-24 (ng/ml, in controls an d patients respectively, p(0,05). Venous occlusion increased levels of fibrinogen (from 5,2+/-0,3 to 6,0+/-0,4 g/l) and protein C antigen (f rom 96+/-5 to 120+/-5%) due to hemoconcentration. Ticlopidine produced antiplatelet action decreasing content of platelet factor IV (from 40 +/-7 to 23+/-7 (mu g/l) and lowering parameters of plateletaggregation (ADP-induced platelet aggregation: maximal from 39,8+/-14 to 2,1+/-0, 7%, p=0,001, first wave amplitude from 18,3+/-7,8 to 2,0+/-0,7%, p=0,0 01; serotonin induced aggregation: maximal from 16,4+/-9,5 to 1,3+/-0, 4%, p=0,021, first wave amplitude from 3,8+/-1,3 to 1,3+/-0,4%, p=0,02 1). Fraxiparine caused decrease of protein C antigen (from 113+/-6 to 97+/-5%, p<0,05).