THROMBOSIS AND BLEEDING COMPLICATIONS AFTER IMPLANTATION OF MECHANICAL CIRCULATORY SUPPORT DEVICES: THE REASONS AND MECHANISMS OF DEVELOPMENT, GENOME-GUIDED CORRECTION. REVIEW.
DOI:
https://doi.org/10.34689/btezcc62Keywords:
heart failure , antithrombotic therapy , warfarin , aspirin , gene polymorphismAbstract
Introduction. This review is devoted about the development of the thrombosis and bleeding complications after
implantation of the mechanical circulatory support (MCS) device in heart failure (HF) patients which could be treated by
genotyping test results.
Objective. To analyze literature and clinical investigations about cause of the complications and their prevention by
genome-guided antithrombotic therapy according to the genotyping test results for genetic polymorphisms.
Research strategy. Search for scientific publications was carried out in search engines such as Web of Science,
ResearchGate, PubMed, Google Academy and e-Library.ru. Criteria for inclusion of publications in the literature review are
defined as publications with the full text, in Russian and English, with statistically verified conclusions.
Results. Complications develop due to the presence of the high non-physiological shear stress at the blade region of the
MCS device’s rotary. The shear stress causes platelet dysfunction which affects to normal hemostatic function. On the other
hand, complications development occurs due to the antithrombotic therapy which could be prescribed with incorrect dosage
for HF patients after device implantation. Nowadays, complications could be reduced by genome-guided antithrombotic
therapy according to the genotyping test results for genetic polymorphisms of VKORC1, CYP2C9 and UGT1A6 genes which
cause variability of drug dosage approximately for 50%.
Conclusions. The genotype polymorphisms of genes encoding enzymes which influence to the mechanism and
activation of the antithrombotic drugs are necessary to be determined in HF patients as it will help to identify appropriate
dosage of the drugs. The identified genome-guided antithrombotic therapy will help to reduce and predict
thrombosis/bleeding complications at pre and post-MCS device implantation period which will give opportunity for patients to
survive and live longer life.
References
Zhalbinova M.R., Rakhimova S.E., Akilzhanov K.R., Andosova S.A., Bekbosynova M.S., Akilzhanova A.R. Thrombosis
and bleeding complications after implantation of mechanical circulatory support devices: the reasons and mechanisms of
development, genome-guided correction. Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 2, pp.
166-174. doi 10.34689/SH.2023.25.2.023
Жалбинова М.Р., Рахимова С.Е., Акильжанов К.Р., Андосова С.А., Бекбосынова М.С., Акильжанова А.Р.
Осложнения тромбообразования и кровотечения после имплантации устройств механической поддержки
кровообращения: причины и механизмы развития, геном – ассоциированная коррекция. Обзор литературы // Наука и
Здравоохранение. 2023. 2(Т.25). С. 166-174. doi 10.34689/SH.2023.25.2.023
Жалбинова М.Р., Рахимова С.Е., Акильжанов К.Р., Андосова С.А., Бекбосынова М.С., Акильжанова А.Р.
Механикалық қан айналымын қолдайтын құрылғысынның имплантациялаудан кейінгі тромбтың түзілу және қан
кетудің асқынулары: даму себептері мен механизмдері, геном – негізделген ем. Әдебиетке шолу // Ғылым және
Денсаулық сақтау. 2023. 2 (Т.25). Б. 166-174. doi 10.34689/SH.2023.25.2.023
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Copyright (c) 2026 Мадина Жалбинова, Сауле Рахимова, Кенес Акильжанов, Салтанат Андосова, Махаббат Бекбосынова, Айнур Акильжанова (Автор)
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