ANALYSIS OF THE INTERACTION OF INFLAMMATION MARKERS AND THROMBOCYTE ACTIVATION WITH POLYMORPHIC VARIANTS OF THE HEMOSTASIS SYSTEM GENES AND THROMBOCYTE RECEPTORS IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION

Abstract

In case of cardiac rhythm disturbance, factors related to the activation of the blood coagulation system and platelet aggregation have a significant contribution to the pathogenesis of thromboembolic complications, the researchers are closely focused on a joint study of congenital risk factors for the development of thrombosis and biomarkers that may be associated with the pathogenesis of thrombosis in atrial fibrillation.

Objective: to study the relationship of markers of inflammation and platelet activation with polymorphic variants of genes of the hemostasis system and platelet receptors in patients with non-valvular atrial fibrillation receiving anticoagulant therapy and having a history of thrombotic complications and patients with atrial fibrillation without thrombotic complications.

Materials and methods: the study included 60 patients diagnosed with atrial fibrillation, 21 patients developed thrombotic complications. All patients gave their written informed consent for inclusion in the study. The study of a panel of biomarkers, polymorphic variants of genes and platelet aggregation was conducted using the equipment of the Center for Collective Use "Medical Genomics" of the Tomsk National Research Medical Center.

Results: comparative analysis of polymorphic variants of plasminogen activator inhibitor PAI–1, platelet collagen receptor ITGA2, nitric oxide synthase NOS3, and beta-2 adrenergic receptor ADRB2 genes in patients with or without thrombotic complications did not reveal statistically significant differences in the studied groups. In the group of patients with thrombotic complications, compared with patients without thrombosis, there was a decrease in the levels of α-acid glycoprotein, fetuin A, L-selectin, thrombomodulin and an increase in CD40L and platelet factor 4 levels, a statistically significant difference was noted in subgroups with a high-risk genotype of thrombosis. The genotype of a high risk of thrombosis and the feasibility study of the PAI–1 and ITGA2 genes in the group with thrombotic complications is associated with increased platelet aggregation activity and increased platelet factor 4 content.

Conclusion: analysis of the relationship between markers of inflammation and platelet activation with polymorphic variants of hemostasis system genes and platelet receptors showed a link between the high-risk genotype and an increase in CD40L, platelet factor 4, and aggregation activity in patients in the group with thrombotic complications.

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