Syndrome of disseminated intravascular coagulation in patients with ischemic heart disease

Aim. To elucidate pathogenesis of the syndrome of disseminated intravascula r coagulation basing on data on blood viscosity, lipid and phospholipid spe ctra of plasma and of erythrocyte membranes as well as on activity of plate lets. Material and methods. Parameters of hemostasis including characterist ics of platelets and erythrocytes were studied in 150 patients with ischemi c heart disease (115 survivors of myocardial infarction) aged 34-65 years. Special emphasis was made on investigation of rheological properties of the blood. Spectra of lipids and phospholipids in the blood and membranes of e rythrocyte were also determined. Results. Three main elements of the system of blood coagulation were analyzed: vascular endothelium, platelets and er ythrocytes. It was shown that lowering of prostacyclin level played a cruci al role in pathogenesis of syndrome of disseminated intravascular coagulati on. Importance of antithrombin III level and its relation to elevation of a ggregatory-adhesive capacity of platelets were also stressed. It was proved that changes of structural and functional characteristics of membranes of erythrocytes characterized by increased density of their lipid packing and lowered deformability were responsible for development of disturbances of m icrocirculation. Conclusion. The following phenomena are important componen ts of pathogenesis of the syndrome of disseminated intravascular coagulatio n: damage of vessel wall endothelium, augmentation of platelet aggregation, changes of rheological properties of the blood (hyperfibrinogenemia, lower ing of antithrombin III and cAMP levels in platelets), alterations of membr anes of erythrocytes.