Additional risk factors for in-hospital ischemic stroke. Hypercoagulation syndrome
- Authors: Kolomentsev S.V.1, Shermatyuk E.I.1, Tsygan N.V.1, Voznyuk I.A.1,2, Yanishevsky S.N.1,3, Odinak M.M.1, Litvinenko I.V.1
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Affiliations:
- S.M. Kirov Military Medical Academy
- I.I. Dzhanelidze Research Institute of Emergency Medicine
- V.A. Almazov National Medical Research Center
- Issue: Vol 40, No 4 (2021)
- Pages: 87-94
- Section: Reviews
- URL: https://journal-vniispk.ru/RMMArep/article/view/83627
- DOI: https://doi.org/10.17816/rmmar83627
- ID: 83627
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Abstract
The risk of ischemic stroke in inpatients is higher than in the general population. This is due to both the greater comorbidity of inpatients and the presence of additional risk factors, the most studied of which are iatrogenic interventions. At the same time, the higher the probability of developing an ischemic stroke, the more risk factors the patient has. An important link in the pathogenesis of in-hospital ischemic stroke is the activation of the hemostasis system, which is an obligate consequence of a typical pathological process underlying diseases and injuries that led to hospitalization: blood loss, inflammation, mechanical tissue damage, dehydration, etc. In foreign literature, this condition is attributed to the group of acquired thrombophilia, in domestic literature the term hypercoagulation syndrome has become more widespread. Iatrogenic effects can also play an important role in the pathogenesis of hypercoagulation syndrome. It is characterized by increased readiness for thrombosis, clinical and laboratory signs of hypercoagulation, activation of various factors and components of coagulation, decreased fibrinolysis, but without the development of acute thrombosis. Hypercoagulation syndrome is rarely assessed in routine practice as a risk factor for ischemic stroke, however, it can act as an additional and main risk factor for the development of all subtypes of ischemic stroke (according to the TOAST classification), including the ESUS concept. In this regard, it is advisable to distinguish in its structure: chronic (existing before hospitalization: hereditary and/or acquired) and acute (situational, developed as a result of the underlying disease, its complications or iatrogenic effects) hypercoagulation syndromes. To designate a group of acute pathological conditions predisposing to the development of hypercoagulation syndrome, systemic and/or local thrombotic complications, including in-hospital ischemic stroke, and requiring increased preventive measures, it seems pathogenetically justified, understandable and convenient to use the term situational hypercoagulation conditions (1 table, bibliography: 19 refs)
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##article.viewOnOriginalSite##About the authors
Sergey V. Kolomentsev
S.M. Kirov Military Medical Academy
Email: skolomencev@yandex.ru
ORCID iD: 0000-0002-3756-6214
SPIN-code: 6439-6701
Ph.D. (Medicine)
Russian Federation, Saint PetersburgEvgeniy I. Shermatyuk
S.M. Kirov Military Medical Academy
Email: sherma1@mail.ru
SPIN-code: 9915-4960
Russian Federation, Saint Petersburg
Nikolay V. Tsygan
S.M. Kirov Military Medical Academy
Email: 77tn77@gmail.com
ORCID iD: 0000-0002-5881-2242
SPIN-code: 1006-2845
Scopus Author ID: 37066611200
ResearcherId: H-9132-2016
D.Sc. (Medicine), Associate Professor
Russian Federation, Saint PetersburgIgor A. Voznyuk
S.M. Kirov Military Medical Academy;I.I. Dzhanelidze Research Institute of Emergency Medicine
Email: voznjouk@yandex.ru
ORCID iD: 0000-0002-0340-4110
SPIN-code: 3340-2897
Scopus Author ID: 56604172800
ResearcherId: D-4121-2018
D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgStanislav N. Yanishevsky
S.M. Kirov Military Medical Academy;V.A. Almazov National Medical Research Center
Email: stasya71@yandex.ru
SPIN-code: 7379-4564
Scopus Author ID: 57200699871
ResearcherId: ABA-5695-2020
D.Sc. (Medicine)
Russian Federation, Saint PetersburgMiroslav M. Odinak
S.M. Kirov Military Medical Academy
Email: odinak@rambler.ru
ORCID iD: 0000-0002-7314-7711
SPIN-code: 1155-9732
Scopus Author ID: 7003327776
ResearcherId: I-6024-2016
Corresponding Member of the Academy of Sciences, M.D., D.Sc. (Medicine)
Russian Federation, Saint PetersburgIgor V. Litvinenko
S.M. Kirov Military Medical Academy
Author for correspondence.
Email: litvinenkoiv@rambler.ru
ORCID iD: 0000-0001-8988-3011
SPIN-code: 6112-2792
Scopus Author ID: 57202361039
ResearcherId: F-9120-2013
D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgReferences
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