Scientific works

RESEARCH SUBJECT: GENOME-ASSOCIATED PERSONALIZED ANTITHROMBOTIC THERAPY OF PATIENTS WITH HIGH RISK OF DEVELOPMENT OF THROMBOSES AND BLEEDINGS

What is an objective of this research?

The main objective of research is development and assessment of efficiency of genome-associated personalized antithrombotic therapy of patients with high risk of development of thromboses and bleedings in patients with the Left Ventricular Assist Device (LVAD) in comparison with standard anticoagulant therapy.

For the most of people with end-stage heart failure the only way for a survival is implantation of the Left Ventricular Assist Device (LVAD). Further these patients are under supervision of doctors and are delivered long drug therapy. For the purpose of prevention of various complications after surgical interventions on heart, the complex therapy of patients includes preparations of an anticoagulant line and antiplatelet drugs.

Incorrect dosage, especially at the initial stage of treatment, increases risk of development of side effects (heavy bleedings, thromboses, etc.). The important contribution to individual sensitivity to preparations is made by genetic factors: the genes involved in a metabolism of antithrombotic drugs and the genes coding various proteins of hemostasis system. Thus, the main objective of genome-associated personalized approach of antithrombotic therapy of patients with the Left Ventricular Assist Device (LVAD) is an improvement of individualization of dosage of antithrombotic medications that will promote decrease in development of bleeding and thromboses, and finally improvement of outcomes of treatment.

This research is conducted by “case-control” type. The patients who are taking part in research will be randomized in 2 groups. By means of using computer codes, the patients will be qualified in one of treatment groups. There are no special requirements or criteria for qualifying in this or that group. 80 patients with the pulsing and not pulsing LVAD devices will be selected for research.

Groups of research:
(a) Control group (n=40). These patients will get antithrombotic therapy according to the Standard Protocol of Ministry of Health and Social Development of the Republic of Kazakhstan (MHSD RK).
(b) Control group (n=40). The patients of this group will get genome-associated personalized antithrombotic therapy taking into account results of genetic tests.