Ischemic Heart Disease and Liver Cirrhosis: Adding Insult to Injury

Role of Coagulation Factors in Hepatocellular Carcinoma: A Literature Review

Hepatocyte carcinoma (HCC) is a globally prevalent neoplasm with profound effects on morbidity and mortality rates. This review summarizes the complex interactions between coagulation abnormalities and the pathophysiological mechanisms underlying HCC. Essential coagulation biomarkers, such as P-selectin, thrombomodulin, d-dimer, prothrombin, and von Willebrand factor, are reviewed for their diagnostic, prognostic, and therapeutic significance. The contribution of these biomarkers to tumor progression, metastatic spread, and patient prognosis is highlighted through a synthesis of contemporary research findings. In addition, this review highlights the underlying mechanisms linking coagulation pathways to HCC pathogenesis and explores potential therapeutic targets. An integrative perspective on the role of coagulation markers in HCC may improve clinical management strategies for patients affected by this malignancy.

Transjugular intrahepatic portosystemic shunting in patients over 60 years with cirrhosis and comorbidities when liver transplantation is reasonably denied

Aim. To determine the potential of TIPS that provides effective portal decompression for longevity and quality of life of patients over 60 years with cirrhosis and concomitant pathology when liver transplantation is reasonably denied.

Materials and methods. The study included 27 patients aged over 60 with comorbidities, who underwent TIPS in 2016–2023 due to life-threatening manifestations of complicated portal hypertension of cirrhotic origin.

Results. TIPS provided effective portal decompression in all 27 patients, confirmed by a 55.4 ± 5.2% reduction in portal pressure gradient. No hospital and 6-week mortality was recorded. 2 deaths (7.4%) were registered within one year after shunt surgery.

Conclusion. In addition to lessening the risk of life-threatening complications, reduction of portal hypertension in liver cirrhosis provides favorable conditions for therapy of concomitant diseases, limited by concerns regarding hepatic decompensation. Due to the achieved stabilization of comorbidities, the denial to include the patient in the waiting list for liver transplantation can be reconsidered.

THE DEPENDENCE OF CHANGES IN LABORATORY INDICATORS ON ACCOMPANYING PATHOLOGY IN PATIENTS WITH VIRAL HEPATITIS C

Objective: to determine the dependence of changes in hematological, biochemical indicators and indexes of nonspecific reactivity, inflammation, endogenous intoxication on accompanying pathology in patients with chronic viral hepatitis C (HCV). Materials and methods: hematological, biochemical, non-specific immunological changes were analyzed in 20 chronic HCV patients without cardiovascular system pathologies, in 20 chronic HCV patients with concomitant coronary heart disease (CHD), in 20 people with coronary heart disease and arterial hypertension, and in 40 healthy people. Statistical analysis was carried out using IBM SPSS Statistics and Microsoft Office Excel 2016 programs with the calculation of non-parametric criteria. Results: men with minimal hepatitis C virus (HCV) activity predominated among the patients. The majority of patients without accompanying pathologies were young, and those with arterial hypertension and coronary heart disease were elderly. In patients with viral hepatitis C, persons with concomitant cardiovascular pathology (ischemic heart disease and arterial hypertension), the following was observed: a decrease in the content of platelets, erythrocytes; increase in the number of rod neutrophils, ESR, de Ritis coefficient; an increase in the integral index of severity, indices of non-specific immunoreactivity (RC, IRI, IRLM, Ilymph) and endogenous intoxication (HII and II). Also, in these patients, the levels of platelets and lymphocytes were reduced against the background of an increased level of II compared to patients who had viral hepatitis C with only hypertension. Conclusions: in patients with chronic viral hepatitis C, who have arterial hypertension and coronary heart disease, there is a decrease in the content of platelets, erythrocytes and an increase in rod-shaped neutrophils, ESR, de Ritis coefficient, integral indicators of severity, indices of non-specific immunoreactivity and endogenous intoxication in comparison with patients without coronary heart disease and patients with chronic HCV only.

Ischemic Heart Disease in the Context of Different Comorbidities

Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide [...].