Email this article Evaluation of Inflammation and Platelet Apoptosis Parameters in Obese Patients in Various Types of Anticoagulant Prophylaxis of Venous Thromboembolic Complications in Context of COVID-19
- Authors: Agapov A.B.1,2, Kalinin R.E.1, Mzhavanadze N.D.1, Povarov V.O.1, Nikiforov A.A.1, Maksaev D.A.1,3, Chobanyan A.A.3, Suchkov I.A.1
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Affiliations:
- Ryazan State Medical University
- Ryazan Regional Clinical Hospital
- City Clinical Emergency Hospital
- Issue: Vol 32, No 3 (2024)
- Pages: 413-424
- Section: Original study
- URL: https://bakhtiniada.ru/pavlovj/article/view/265924
- DOI: https://doi.org/10.17816/PAVLOVJ631743
- ID: 265924
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Abstract
INTRODUCTION: The physical inactivity, hypoventilation, as well as chronic inflammation in obese patients aggravates their condition in various diseases. These features have become important with the advent of the COVID-19 pandemic, in which inflammation and platelet-activated coagulopathy are closely linked.
AIM: To study laboratory parameters of inflammation and platelet apoptosis in obese patients using various types of anticoagulant prophylaxis of venous thromboembolic complications with the underlying COVID-19.
MATERIALS AND METHODS: The study included 370 patients with COVID-19. Depending on the presence or absence of obesity and the type of parenteral anticoagulant, patients in our study were divided into groups: group 1 — non-obese + low molecular weight heparin (LMWH) (n = 114), group 2 — non-obese + unfractionated heparin (UFH) (n = 58), group 3 — obesity + LMWH (n = 76), group 4 — obesity + UFH (n = 66). The incidence of venous thromboembolic complications (VTEC), bleeding, general markers of the acute phase of inflammation, and specific markers of platelet apoptosis (phosphatidylserine and calreticulin) have been analyzed.
RESULTS: At the end of hospital treatment, a decrease in ferritin levels was noted in patients both with and without obesity receiving LMWH. The concentration of calreticulin was higher in patients taking LMWH (groups 1 and 3). Phosphatidylserine levels were high in patients receiving LMWH only if they were obese. In patients taking UFH compared to LMWH, a high incidence of pulmonary embolism (PE) without a source (13.6% of cases versus 2.6%, respectively, p = 0.029) and PE with a source in the lower extremities (9.1% of cases versus 0%, respectively, p = 0.018) was found. When using LMWH, a lower incidence of bleeding was observed compared to using UFH (5.3% of cases versus 16.7%, respectively, p = 0.056).
CONCLUSION: The levels of phosphatidylserine and calreticulin are higher in obese patients receiving LMWH. At the same time, patients in this group have a low incidence of VTEC and hemorrhagic complications compared to the group of patients taking UFH.
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##article.viewOnOriginalSite##About the authors
Andrey B. Agapov
Ryazan State Medical University; Ryazan Regional Clinical Hospital
Author for correspondence.
Email: agapchik2008@yandex.ru
ORCID iD: 0000-0003-0178-1649
SPIN-code: 2344-5966
MD, Cand. Sci. (Med.)
Russian Federation, Ryazan; RyazanRoman E. Kalinin
Ryazan State Medical University
Email: kalinin-re@yandex.ru
ORCID iD: 0000-0002-0817-9573
SPIN-code: 5009-2318
MD, Dr. Sci. (Med.), Professor
Russian Federation, RyazanNina D. Mzhavanadze
Ryazan State Medical University
Email: nina_mzhavanadze@mail.ru
ORCID iD: 0000-0001-5437-1112
SPIN-code: 7757-8854
MD, Dr. Sci. (Med.), Associate Professor
Russian Federation, RyazanVladislav O. Povarov
Ryazan State Medical University
Email: ecko65@mail.ru
ORCID iD: 0000-0001-8810-9518
SPIN-code: 2873-1391
MD, Cand. Sci. (Med.)
Russian Federation, RyazanAlexander A. Nikiforov
Ryazan State Medical University
Email: alnik003@yandex.ru
ORCID iD: 0000-0003-0866-9705
SPIN-code: 8366-5282
MD, Cand. Sci. (Med.), Associate Professor
Russian Federation, RyazanDenis A. Maksaev
Ryazan State Medical University; City Clinical Emergency Hospital
Email: denma1804@yandex.ru
ORCID iD: 0000-0003-3299-8832
SPIN-code: 9962-2923
MD, Cand. Sci. (Med.)
Russian Federation, Ryazan; RyazanArtyom A. Chobanyan
City Clinical Emergency Hospital
Email: artaleksandrovich@gmail.com
ORCID iD: 0000-0002-8129-5976
SPIN-code: 4639-9650
MD, Cand. Sci. (Med.)
Russian Federation, RyazanIgor A. Suchkov
Ryazan State Medical University
Email: suchkov_med@mail.ru
ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662
MD, Dr. Sci. (Med.), Professor
Russian Federation, RyazanReferences
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