Detection And Analysis Of Hyper Coagulable State In Patients With Chronic Heart Failure

Purpose:To investigate the incidence and severity of HCS in CHF patients via detecting TEQ sTM,PAI-1 and other indicators.Methods:CHF patients who were hospitalized with cardiovascular disease were enrolled in the Department of Cardiology at the Hunan Provincial People's Hospital from January 2016 to September 2016.Patients were grouped according to the New York Heart Association(NYHA)cardiac function classification criteria which are divided into three subgroups ?????,and selected patients without HF as the control group.The expression levels of Copeptin?sTM and PAI-1 were detected by enzyme-linked immunosorbent assay(ELISA).TEG(R?K?Angel?MA?CI)was detected by CFMS(Sphinx)Thrombus Elasticity.DDI?Fbg?APTT?TT?PT?AT-? were detected by Coagulation method and immunoturbidimetric.TEG?conventional coagulation function?sTM?PAI-1 were used to determine the blood hypercoagulable state and the judgment criteria were derived from the eighth edition of?diagnostics?(People's Health Publishing House).Statistical analysis of the four groups were performed.Results:1.the values of sTM in control?classification ??? and ? were(3.45±0.60)?(3.71±0.48)?(5.46±2.20)?(7.73±4.32),the values of PAI-1 were(212.77±48.89)?(287.77±116.21)?(644.99±211.10)?(805.62±437.35)respectively.With the Increasing of cardiac function,the values of sTM and PAI-1 were increased(P<0.05)in all other comparisons between the groups showing significant differences;except of the comparison between control and group ?(P>0.05).sTM(r=0.791 P<0.001)?PAI-1(r=0.769 P<0.001)was positively correlated with NT-proBNP.2.The values of R in control?classification ??? and IV were(7.28±1.17)?(7.61±1.26)?(6.06±2.02)?(4.66±1.38),the values of K were(1.58±0.40)?(1.96±0.32)?(1.05±0.27)?(0.82±0.27),the values of MA were(61.50±4.57)?(59.64±3.05)?(67.50±4.64)?(73.49±5.07),the values of CI were(0.68±1.65)?(1.35±1.22)?(2.17±1.66)?(3.16±1.38),the values of Angel were(68.53±5.70)?(70.32±6.15)?(75.10±8.12)?(78.64±9.16)respectively.With the exception of the comparison between control and group ?(P>0.05),the values of R and K were decreased but MA and CI were increased(P<0.05)in all other comparisons between the groups showing significant differences;The values of Angel was increased,the level of Angel in groups ? and ? was higher than that in the control and classification ?,but there was no significant difference between the comparison of groups ? and ?(P>0.05)and control and group ?(P>0.05).R(r=-0.490 P<0.001)?K(r=-0.662 P<0.001)were negatively correlated with NT-proBNP.Angel(r=0.565 P<0.001)?MA(r=0.734 P<0.001)?CI(r=0.640 P<0.001)were positively correlated with NT-proBNP.3.The values of Fbg in control?classification ??? and IV were(2.73±0.60)?(2.50±0.37)?(2.70±0.77)?(3.04±0.61),the values of APTT were(31.35±5.29)?(33.11±3.99)?(32.11±3.60)?(33.21±3.66),the values of TT were(19.71±2.59)?(18.19±1.77)?(18.30±2.44)?(17.63±2.30),the values of PT were(10.98±0.83)?(11.35±1.06)?(11.39±1.45)?(11.66±1.25),thevaluesof AT-? were(92.83±10.45)?(91.32±9.37)?(84.21±12.79)?(83.59±20.57),the values of DDI were(0.23±0.14)?(0.24±0.14)?(0.70±0.59)?(2.69±1.79).There was no significant difference between conventional coagulation parameters Fbg,APTT,TT,PT,AT-? among the four groups(P>0.05).With the exception of the comparison between control and group ?(P>0.05),the values of DDI were increased(P<0.05)in all other comparisons between the groups showing significant differences;Fbg(r=0.502 P<0.001)?DDI(r=0.439 P<0.001)were positively correlated with NT-proBNP(r=0.502 P<0.001,r=0.439 P<0.001),APTT(r=-0.308 P=0.002)?TT(r=-0.437 P<0.001)?PT(r=-0.230 P=0.035)?AT-?(r=-0.252 P=0.014)was negatively correlated with NT-proBNP.4.In 105 cases,the results detected by TEG showed that there was no HCS in the control group.6 cases(35.29%)had HCS in the group ?,21 cases(80.77%)had HCS in the group III,28 cases had HCS in group IV(96.55%).A total of 55 CHF patients had HCS in 72 cases of patients(76.39%).When we detected by routine coagulation,the results showed that there were no HCS in the control group,6 cases(23.08%)had HCS in group ?,10 cases(34.48%)had HCS in group IV,making a total of 16 cases of HCS patients out of 72 cases of patients with CHF(22.22%).Conclusions:1.Detection of sTM?PAI-1 and TEG are beneficial to judge HCS in patients with CHF.2.The identification of HCS in CHF patients via TEG may be more accurate than conventional coagulation function index.3.This proves that the CHF patients are likely to have HCS and the severity of CHF increases with the incidence of HCS.