Peculiarities of Hemostasis and Proteomics in Patients With Acute Myocardial Infarction and Healthy Volunteers After SARS-CоV-2 Infection.

IF 0.5 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-09-30 DOI:10.18087/cardio.2024.9.n2752
A I Kalinskaya, A K Elizarova, A S Anisimova, D A Vorobyeva, G I Rusakovich, E V Maryukhnich, O A Dukhin, O I Ivanova, A E Bugrova, A G Brzhozovskiy, M I Indeykina, A S Kononikhin, E N Nikolaev, E Yu Vasilieva
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Abstract

Aim: To identify the features of plasma, platelet hemostasis, and proteomic composition of the blood plasma in patients with acute myocardial infarction (AMI) and healthy volunteers after COVID-19.

Material and methods: The study included patients with AMI who have recently had COVID-19 (AMI-post-COVID, n=56) and patients with AMI who have not recently had COVID-19 (AMI-control, n=141). Healthy volunteers constituted the control groups and were also divided into control-post-COVID (n=32) and control-control (n=71) groups. Previous SARS-CoV-2 infection was determined by anti-N IgG in the blood serum, the level of which persists for 6-10 months after the disease. Hemostasis was evaluated by thromboelastometry (on whole blood), thrombodynamics (on platelet-poor plasma), fibrinolysis, impedance aggregometry, and proteomic analysis.

Results: The AMI-post-COVID and AMI-control groups had higher values of thrombus growth rate, size and density based on the data of thromboelastometry and thrombodynamics, as well as increased concentrations of the complement system components, proteins regulating the state of the endothelium, and a number of acute-phase and procoagulant proteins compared to the control groups. Furthermore, in the AMI-post-COVID group, compared to the AMI-control group, the thrombus density was lower, and its lysis rates were higher when measured by the thrombodynamics method on platelet-poor plasma, while the platelet aggregation induced by ADP and thrombin was higher. Also, in the control-post-COVID group, compared to the control-control group, the thrombus formation rate was lower, whereas, in contrast, the thrombus size as measured by the thrombodynamics method and the platelet aggregation induced by arachidonic acid and thrombin were higher. In addition, in the AMI-post-COVID group, compared to the AMI-control group, the concentrations of proteins involved in inflammation and hemostasis were lower.

Conclusion: Patients with AMI who have recently had COVID-19 are characterized by a less pronounced activation of the immune response compared to patients with AMI who have not had COVID-19. This may be due to long-term chronic inflammation and depletion of components of the immune activation system after SARS-CoV-2 infection. Long-term activation of the hemostasis system in both patients with AMI and healthy volunteers after COVID-19 is primarily due to the platelet component of hemostasis.

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SARS-CоV-2 感染后急性心肌梗死患者和健康志愿者的止血和蛋白质组学特征
目的:确定急性心肌梗死(AMI)患者和健康志愿者在接受COVID-19治疗后血浆、血小板止血和蛋白质组组成的特征:研究对象包括近期接受过COVID-19治疗的急性心肌梗死患者(AMI-后COVID,n=56)和近期未接受过COVID-19治疗的急性心肌梗死患者(AMI-对照组,n=141)。对照组由健康志愿者组成,也分为对照-COVID 后组(32 人)和对照-对照组(71 人)。通过血清中的抗 N IgG 来确定是否曾感染过 SARS-CoV-2,抗 N IgG 的水平在病后 6-10 个月内持续存在。通过血栓弹性测定(全血)、血栓动力学(贫血小板血浆)、纤溶、阻抗聚集测定和蛋白质组分析对止血情况进行了评估:结果:根据血栓弹力仪和血栓动力学的数据,AMI 后 COVID 组和 AMI 对照组的血栓生长速度、大小和密度均高于对照组,补体系统成分、调节内皮状态的蛋白质以及一些急性期和促凝血蛋白的浓度也高于对照组。此外,与 AMI 对照组相比,AMI 后 COVID 组的血栓密度较低,通过血栓动力学方法测量贫血小板血浆,血栓溶解率较高,而 ADP 和凝血酶诱导的血小板聚集率较高。同时,与对照-对照组相比,对照-COVID 后组的血栓形成率较低,而血栓动力学法测定的血栓大小以及花生四烯酸和凝血酶诱导的血小板聚集率则较高。此外,与急性心肌梗死对照组相比,急性心肌梗死后COVID组参与炎症和止血的蛋白质浓度较低:结论:与未接受过 COVID-19 治疗的 AMI 患者相比,近期接受过 COVID-19 治疗的 AMI 患者的免疫反应激活程度较低。这可能是由于感染 SARS-CoV-2 后长期慢性炎症和免疫激活系统成分耗竭所致。COVID-19对AMI患者和健康志愿者止血系统的长期激活主要是由于血小板的止血作用。
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来源期刊
Kardiologiya
Kardiologiya 医学-心血管系统
CiteScore
1.70
自引率
20.00%
发文量
94
审稿时长
3-8 weeks
期刊介绍: “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.
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