THROMBOSIS AND BLEEDING COMPLICATIONS AFTER IMPLANTATION OF MECHANICAL CIRCULATORY SUPPORT DEVICES: THE REASONS AND MECHANISMS OF DEVELOPMENT, GENOME-GUIDED CORRECTION. REVIEW.
Introduction. This review is devoted about the development of the thrombosis and bleeding complications after implantation of the mechanical circulatory support (MCS) device in heart failure (HF) patients which could be treated by genotyping test results.
Objective. To analyze literature and clinical investigations about cause of the complications and their prevention by genome-guided antithrombotic therapy according to the genotyping test results for genetic polymorphisms.
Research strategy. Search for scientific publications was carried out in search engines such as Web of Science, ResearchGate, PubMed, Google Academy and e-Library.ru. Criteria for inclusion of publications in the literature review are defined as publications with the full text, in Russian and English, with statistically verified conclusions.
Results. Complications develop due to the presence of the high non-physiological shear stress at the blade region of the MCS device’s rotary. The shear stress causes platelet dysfunction which affects to normal hemostatic function. On the other hand, complications development occurs due to the antithrombotic therapy which could be prescribed with incorrect dosage for HF patients after device implantation. Nowadays, complications could be reduced by genome-guided antithrombotic therapy according to the genotyping test results for genetic polymorphisms of VKORC1, CYP2C9 and UGT1A6 genes which cause variability of drug dosage approximately for 50%.
Conclusions. The genotype polymorphisms of genes encoding enzymes which influence to the mechanism and activation of the antithrombotic drugs are necessary to be determined in HF patients as it will help to identify appropriate dosage of the drugs. The identified genome-guided antithrombotic therapy will help to reduce and predict thrombosis/bleeding complications at pre and post-MCS device implantation period which will give opportunity for patients to survive and live longer life.
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Zhalbinova M.R., Rakhimova S.E., Akilzhanov K.R., Andosova S.A., Bekbosynova M.S., Akilzhanova A.R. Thrombosis and bleeding complications after implantation of mechanical circulatory support devices: the reasons and mechanisms of development, genome-guided correction. Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 2, pp. 166-174. doi 10.34689/SH.2023.25.2.023Related publications:
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