[Changes in parameters of coagulation system after treatment of chronic heart failure with β-adrenoblockers, angiotensin-converting enzyme inhibitors, calcium antagonists, diuretics, anticoagulants, antiagregants, cardiac glycosides, and physical exercise]

Abstract

Scientific research has proved that coagulation system is more active in patients with chronic heart failure than in healthy people. Therefore, the aim of this article was to review the data in literature about changes in coagulation system after treatment of chronic heart failure with β-adrenoblockers, angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, cardiac glycosides, diuretics, anticoagulants, and antiagregants. It is known that β-adrenoblockers used separately decrease platelet aggregation and angiotensin-converting enzyme inhibitors reduce P-selectin expression as well. Low-molecular-weight heparin decreases the concentrations of prothrombin fragments, D-dimers; orally administered anticoagulants reduce the concentrations of interleukin 6, von Willebrand factor, intercellular adhesion molecules, fibrinogen 1+2 and increases the concentration of plasminogen activator inhibitor-1. Both anticoagulants reduce the levels of VII:C factors and thrombin-antithrombin III complex. The use of aspirin together with clopidogrel reduces the concentration of intercellular adhesion and platelet-endothelial cell adhesion molecules and expression of P-selectins; however, these concentrations do not vary while using aspirin alone. The treatment with ACE inhibitors together with calcium antagonists and β-adrenoblockers decreases activated partial thromboplastin time, concentrations of D-dimers, plasminogen activator inhibitor-1, vascular cell adhesion molecules, CD63 and expression of L- and P-selectins. While analyzing the effect of abovementioned agents, it is necessary to mention that data reported by different authors are not consistent. Therefore, the effect of particular drugs on the particular parameters of coagulation system has not been completely elucidated.