CHARACTERISTICS OF THE STUDY GROUP AND DYNAMICS OF PATHOGENETIC MARKERS ON THE BACKGROUND OF DIFFERENT ANTI-COAGULATION MODES

Аннотация

Statins are a potential means of preventing venous thromboembolism (VTE), complementing traditional anticoagulants, without concomitant bleeding-related complications. The purpose of this study was to compare the prothrombotic activity of different classes of lipid-lowering drugs in an active comparative study and determine whether there is a link between the use of statins, fibrates/niacin and procoagulant factors.Currently, taking statins is associated with lower plasma FXA levels than taking fibrates/niacin. The effect on blood clotting factors may partly explain the benefits of statin therapy in theprimary and secondary prevention ofVTE. Keywords: Study group characteristics, Pathogenetic markers, Anticoagulation therapy, Anticoagulation modes, Coagulation parameters, Hemostasis markers, Thromboticrisk. Introduction. It is estimated that the incidence of venous thromboembolism (VTE) is 1-2 cases per 1000 person-years among people of European descent [1]. Inhibitors of 3- hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the so-called statins, are a class of lipid-lowering drugs that are widely used to prevent atherosclerosis [2]. There is increasing evidence that statins are a promising means of preventing VTE, complementing anticoagulants without concomitant bleeding-related complications [3,4,5,6,7,8,9]. In addition to lowering lipid levels, statins have anti-inflammatory and antioxidant properties [10,11]. Moreover, mainly in the course of in vitro studies and observations, it was found that they can have a positive effect on the walls of blood vessels and have antithrombotic properties [12, 13]. These include decreased expression of tissue factor and thrombin production, impaired thrombin-catalyzed procoagulant reactions, including fibrinogen cleavage and activation of factors (F) V and FXIII, decreased activity of FVII and FVIII, increased expression of endothelial thrombomodulin and increased fibrinolytic activity, manifested in decreased expression of plasminogen activator inhibitor (PAI)-1 and increased expression oftissueplasminogen activator (tPA)[14, 15]. In addition, it is assumed that it has an antiplatelet effect, immediately and delayed inhibiting platelet activation, adhesion, and aggregation,although previous research could not confirm theseresults in vitro[15,16]. A recent randomized trial showed that 1 month of treatment with rosuvastatin at a dosage of 20 mg/day leads to an improvement in coagulation parameters, primarily to a decrease in factor VIII levels, in patients with previous DVT compared with those who did not take statins [17]. Given that the effect of drugs is not necessarily common to all representatives of the class, the reduction of procoagulant factors under the influence of rosuvastatin may not apply to other statins currently on the market. It is known that different types of statins reduce the level of low-density lipoproteins in different ways, reduce the manifestations of atherosclerosis and inflammation. The lowest effect is observed in those page543 INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE ISSN:2692-5206,ImpactFactor:12,23 AmericanAcademicpublishers,volume05,issue05,2025 Journal: https://www.academicpublishers.org/journals/index.php/ijai taking pravastatin, followed by those taking simvastatin and atorvastatin, and the greatest in thosetaking rosuvastatin [16,18,19]. A meta-analysis of randomized clinical trials has shown that there is a dose-effect relationship in which rosuvastatin, which is most effective in stopping or slowing the development of atherosclerosis, dyslipidemia, and inflammation, also provides the most significant reduction in the risk of venous thrombosis [20]. We sought to find out whether there is a relationship between statin use and indicators of procoagulant factors in participants oftheDutch Obesity Epidemiology Study (NEO) [20]. Materials and methods. We conducted a cross-sectional analysis of the baseline indicators of the NEO study participants who took lipid-lowering drugs (statins or fibrates/niacin) and compared their prothrombotic activity in an active comparative study. The NEO study is a cohort study involving 6,671 people aged 45-65 years living in Leiden (in the west of the Netherlands). Most of the participants had a body mass index (BMI) of 27 kg/m2 or higher. During the initial examination after a night of fasting, blood samples were taken from participants in test tubes containing 0.106 M sodium citrate (Sarstedt, Numbrecht, Germany). Plasma was obtained by centrifugation at 2500 × g for 10 minutes at room temperature and stored in aliquots at -80 °C until analysis. Fibrinogen activity was measured using the Claus method. In addition, activity FVIII:C, FIX:C, FXI:C was measured by mechanical clot detection on an ACL TOP 700 analyzer (Werfen, Barcelona, Spain). All the analyses were performed by laboratory technicians who were unaware of the status of the samples. Statistical analysis. The general characteris