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Rodionova E.S.,Russian Research Cardiology Center | Mironova N.A.,Russian Research Cardiology Center | Aparina O.P.,Russian Research Cardiology Center | Rogova M.M.,Russian Research Cardiology Center | And 2 more authors.
Terapevticheskii Arkhiv | Year: 2012

Cardiac arrhythmias and conduction disturbances are an important cause of morbidity and mortality in many countries all over the world. Etiology of these disorders remains unclear in many patients. Experimental and clinical studies show that autoimmune reactions may be involved in development of arrhythmias and cardiac blocks. Precise identification of an autoanlibody-mediated mechanism opens new perspectives in the treatment and prevention of cardiac arrhythmias including use of immunosuppressive agents or removal of autoantibodies by absorption technique. The review focuses on cardiac autoantigens. autoantibodies and their interactions that may be involved in development of cardriac arrhythmias.

Vorobyeva N.M.,Russian Research Cardiology Center | Panchenko E.P.,Russian Research Cardiology Center | Dobrovolsky A.B.,Russian Research Cardiology Center | Titaeva E.V.,Russian Research Cardiology Center | And 5 more authors.
Terapevticheskii Arkhiv | Year: 2011

Aim: To study effects of thrombin-activated fibrinolysis inhibitor (TAFI) on efficacy and safety of long-term anti-coagulant treatment in patients with venous thromboembolic complications (VTEC). Material and methods. A total of 111 patients with a history of an episode of deep vein thrombosis (DVT) and/or pulmonary artery thromboembolism (PATE) entered the study. All the patients received unfractionated or low-molecular heparin for at least 5 days than switch on warfarin (target values of INR 2,0-3,0). Baseline blood levels of TAFI were measured. The patients were followed up for 18 months. Recurrent (DVT/TAFI and hemorrhagic complications (HC) were end points. Also, frequency of complete lysis of deep vein thrombi was assessed after 12 months of treatment. Results. A TAFI level varied from 50 to 217% (median 106%, interquartile rage 90-133%). TAFI concentration positively correlated with fibrinogen and thromb size. The patients were divided into two groups depending on TAFI content: group 1 patients had low TAFI (under 25 th percentile; < 90%); patients of group 2 had high TAFI (above 25 th percentile; > 90%). Group 1 patients were characterized by less stable anticoagulation. This association did not depend on genetic characteristics which determine sensitivity to warfarin (CYP2C9 and VKORCl). Low TAFI was associated with reduced risk of DVT for 18 months and higher probability of complete lysis of the thrombi after 12 months of anticoagulant therapy compared to VTEC patients with high TAFI. No differences were found by TAFI level in patients with HC and without HC, but in HC patients low TAFI was associated with spontaneous hemorrhages and bleeding in therapeutic INR values. Conclusion. The results of this pilot study evidence that a TAFI level can be one of the factors influencing efficacy and safety of long-term anticoagulant therapy in patients with VTEC on warfarin treatment.

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