Роль вихідних порушень коагуляції в розвитку кровотеч у пацієнтів з ішемічною хворобою серця після проведення черезшкірного коронарного втручання високого ризику із застосуванням механічної підтримки кровообігу

The aim – to assess the impact of baseline coagulation disorders on the incidence and severity of in-hospital bleeding in patients with coronary artery disease (CAD) undergoing high-risk percutaneous coronary intervention (PCI) supported by veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Materials and methods. This prospective observational study included 26 patients who underwent high-risk PCI with mechanical circulatory support via V-A ECMO. Primary endpoints included baseline coagulation parameters; secondary endpoints were bleeding frequency and severity (assessed using the BARC scale), and the need for blood transfusion. Results. Clinically significant bleeding was observed in 17 patients (65.4 %), including BARC type 3 in 38.5 %. Blood transfusions were required in 65.5 % of cases. More severe bleeding was significantly associated with lower platelet count (p=0.038), higher INR (p=0.044), and prolonged aPTT (p=0.023). Other coagulation parameters did not show statistically significant associations. Conclusions. High-risk PCI supported by V-A ECMO is associated with a high incidence of major bleeding. Baseline coagulation parameters – especially platelet count, INR, and aPTT – may serve as potential predictors of hemorrhagic complications.