title: [Ukrainian break-through in the European and world strategy of individual prophylaxis of ischemic stroke in patients with arterial hypertension].
abstract: To reduce of epidemic of an ischemic stroke often developed in patients with arterial hypertension, we have developed the program of individual diagnostics of a clinical risk factor and a method to optimize the treatment directed on prophylactic of cardio-vascular complications. The main predictor of blood clot formation, hypercoagulation, had been detected by means of our laboratory technology "Coaguloscop-TC" (Ukraine patent) which allows registration 36 biomarkers of coagulation cascade and the fibrinolysys system. It can calculate coagulation module (MC) and fibrinolysis module (MF). These biomarkers corresponded to new (2009) requirements of the American Heart Association. After analysis of results of 818 patients we have defined an interval line of MC and MF disorders located within degree (from I to X) of their dysfunction. Patients with hypertension (400) of II-III stage and concomitant ischemic heart disease (44.2% of cases) without antiplatelet therapies, hypercoagulation was found in 61% of patients. Very high risk factor (MC IX-X degree) took place in all patients with acute stroke. The high risk factor (MC VI-VIII degree) testified presence of urgent situation, for its correction we administered an antiplatelet agent (acelisin) intramuscularly once a day for 4-6 days in an individual dosis which was calculated based on MC level and body weight. After the treatment MC usually decreased to 2 degrees (low risk factor). The dislipidemia negatively effects efficiency of the treatment as its biomarkers have direct correlation (P < 0.001) with density of blood clot which increase inhibits the fibrinolysis system to dissolve blood clot. The use of effective complex treatment of patients with arterial hypertension ( antihypertensive, antiplatelet and hypolipidemic (statin) medications) is supposed to decrease the development of ischemic stroke by 80% that four times higher than in the 2006-2020 program assigned by Ministry of Health of Ukraine.
authors.forename: S M
authors.initials: SM
authors.lastname: Tolstopiatov
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D001835:Body Weight; D002545:Brain Ischemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005060:Europe; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005998:Glycine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008239:Lysine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D057285:Precision Medicine / Q000379:methods*; D012041:Regional Medical Programs / Q000458:organization & administration*; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014455:Ukraine
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D004338:Drug Combinations; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C076488:acetylsalicylate, glycine, lysine drug combination; D008239:Lysine; D001241:Aspirin; D005998:Glycine