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[Changes in the hemostatic system and the progression of arteriosclerosis in ischemic heart disease patients]
Insights
Mental stress significantly impacts the hemostatic system in coronary heart disease patients. Stress-induced hypercoagulation worsens with greater coronary artery damage, affecting blood clotting and fibrinolysis.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Psychosomatic Medicine
Background:
- Coronary heart disease (CHD) patients often exhibit pre-existing hemostatic abnormalities.
- Mental stress is a known trigger for cardiovascular events.
- The interplay between mental stress and the hemostatic system in CHD requires further elucidation.
Purpose of the Study:
- To investigate the impact of standardized mental stress on the hemostatic system in patients with documented coronary atherosclerosis.
- To differentiate patient responses based on the activation status of their anti-clotting mechanisms.
Main Methods:
- 160 patients with confirmed coronary atherosclerosis underwent a standardized mental stress protocol.
- Stress was induced via time deficit, sensory overload, and performance criticism.
- Patients were categorized into two groups based on their blood heparin activity and fibrinolysis response.
Main Results:
- All patients exhibited hypercoagulation compared to controls, with the second group (depressed fibrinolysis) showing the highest degree.
- Mental stress exacerbated hypercoagulative changes in both groups.
- The severity of hypercoagulation, both at rest and under stress, correlated positively with the extent of coronary artery damage.
Conclusions:
- Mental stress significantly affects the hemostatic system in CHD patients, leading to increased hypercoagulation.
- Individual differences in anti-clotting system activation influence the response to stress.
- The degree of coronary artery disease directly impacts the susceptibility to stress-induced hemostatic alterations.
Abstract:
The effect of standardized mental stress on the hemostatic system was studied in 160 patients with coronary heart disease. The diagnosis of coronary atherosclerosis was documented by selective coronary angiographic findings. Emotional tension was modelled using the method of counting with interswitching in conditions of time deficit, irritating light and sound signals, as well as critical remarks about the work performed. According to the protective-adaptive activation of the anti-clotting system, the patients were divided into two groups: 1 with activation of heparin activity of the blood and fibrinolysis, 2 with depressed fibrinolysis and lowered blood heparin. Prior to the onset of the study the patients of both groups exhibited hypercoagulation as compared with the control group. The maximum degree of hypercoagulation was observed in the second group patients. Hypercoagulative changes both at rest and under stress were shown to depend on the degree of coronary artery damage.