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Abstract
Aim: to study frequency of protein C system abnormalities in patients with high and very high cardiovascular risk and to reveal the relationship of these disorders with severity of atherosclerosis of peripheral arteries.
Materials and methods. The study included 165 patients with high and very high cardiovascular risk. Screening of abnormalities in the protein C system was carried out using «Parus-test» (OOO «Technology-Standard», Russia). Resistance factor Va to activated protein C (APC) was determined using «Factor V-PC-test» (OOO «Technology-Standard», Russia). The obtained data were used to calculate the normalized ratio (NO). All patients underwent ultrasound duplex scanning of carotid arteries and lower limb arteries.
Results. The median NO of protein C was 1.20 [0.80–1.60]. A decrease in NO less than 0.7 was diagnosed in 16 (9.69%) patients. Re- sistance to APC was established in 1 (0.61%) patient. A decrease in the NO of protein C was associated with an increase in the de- gree of stenosis of carotid arteries and lower limb arteries. According to the results of the polynomial logistic regression analysis, the decrease in the NO protein C less than 0.7, adjusted for factors such as sex, age, smoking, hypertension, type 2 diabetes mel- litus, glomerular filtration rate and low density lipoprotein content was associated with an increase in the relative risk of identi- fying severe combined atherosclerosis of peripheral arteries in 10.8 times (95% CI=1.83–63.8; p=0.009).
Conclusion. In patients with high and very high cardiovascular risk abnormalities of the protein C system were detected in 9.69% of cases. Reduction of the normalized ratio of protein C was associated with an increase in the severity of peripheral arteries atherosclerosis. The presence of abnormalities in the protein C system was associated with a 10.8-fold increase in the relative risk of detecting a severe combined atherosclerosis of peripheral arteries.
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