rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2023-2981KAAWKPrpcardio-2981Research ArticleASSOCIATED PROBLEMS OF CARDIOLOGYСМЕЖНЫЕ ВОПРОСЫ КАРДИОЛОГИИPlatelet phenotypes and practical aspects of platelet function testing in cardiologyФенотипы тромбоцитов и практические аспекты методов тестирования функции тромбоцитов в кардиологииhttps://orcid.org/0000-0002-5873-1768КобалаваЖ. Д.KobalavaZh. D.

Кобалава Жанна Давидовна

Москва

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Zhanna D. Kobalava

Moscow

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zkobalava@mail.ruhttps://orcid.org/0000-0003-4103-4322ПисарюкА. С.PisaryukA. S.

Писарюк Александра Сергеевна, к.м.н. , доцент кафедры внутренних болезней с курсом кардиологии и функциональной диагностики РУДН

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Alexandra S. Pisaryuk

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pisaryuk_as@pfur.ruhttps://orcid.org/0000-0002-0448-3981ФильковаА. А.FilkovaA. A.

Филькова Александра Андреевна

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Alexandra A. Filkova

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aleksa0771@gmail.comhttps://orcid.org/0009-0001-2409-7797ТухсанбоевЁ. С.TukhsanboevE. S.

Тухсанбоев Ёкубджон Сулаймонович

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Ekubdzhon S. Tukhsanboev

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yokubjon.2404@mail.ruhttps://orcid.org/0009-0003-0008-9113БолдыреваА. А.BoldyrevaA. A.

Болдырева Антонина Артёмовна

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Antonina A. Boldureva

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aleksa0771@gmail.comhttps://orcid.org/0009-0004-4125-7977ЛазутоваД. П.LazutovaD. P.

Лазутова Дарья Петровна

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Daria P. Lazutova

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aleksa0771@gmail.comhttps://orcid.org/0000-0001-6818-8845МерайИ. А.MerayI. A.

Мерай Имад Ахмадович

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Imad A. Merai

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imadmerai@yahoo.comhttps://orcid.org/0000-0002-8128-7757ПантелеевМ. А.PanteleevM. A.

Пантелеев Михаил Александрович

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Mikhail A. Panteleev

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mapanteleev@yandex.ruРоссийский университет дружбы народов имени Патриса Лумумбы, Медицинский институт; ГКБ им. В. В. Виноградова ДЗМРоссияPeoples’ Friendship University of Russia; V. V. Vinogradov Moscow City HospitalRussian FederationЦентр теоретических проблем физико-химической фармакологии Российской академии наук; Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия РогачеваРоссияCenter for Theoretical Problems of Physicochemical Pharmacology; Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and ImmunologyRussian Federation202328122023196614628Copyright © Kobalava Z.D., Pisaryuk A.S., Filkova A.A., Tukhsanboev E.S., Boldyreva A.A., Lazutova D.P., Meray I.A., Panteleev M.A., 20232023Кобалава Ж.Д., Писарюк А.С., Филькова А.А., Тухсанбоев Ё.С., Болдырева А.А., Лазутова Д.П., Мерай И.А., Пантелеев М.А.Kobalava Z.D., Pisaryuk A.S., Filkova A.A., Tukhsanboev E.S., Boldyreva A.A., Lazutova D.P., Meray I.A., Panteleev M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2981

The assessment of platelet dysfunction is usually used by hematologists to diagnose inherited (such as Bernard-Soulier syndrome, platelet-type-von Willebrand disease, Glanzmann thrombasthenia, etc.), and acquired (symptomatic) platelet disorders (in hemoblastoses, uremia, liver cirrhosis, etc.), as well as to predict the risk of intraoperative bleeding in these groups of patients. Later, laboratory platelet function tests began to be used by cardiologists, first in experimental and clinical studies. In further years, attempts were made to introduce them into clinical practice. Current data show association between platelet hyperreactivity and pathogenesis of cardiovascular events. At the same time, despite the various consensus papers on assessing thrombotic and bleeding risk, monitoring antiplatelet therapy, including those published by Russian experts, in practice there are many subtleties and questions about the practical aspects of using laboratory tests. In addition, the definition of platelet phenotype does not have a clear concept. The review purpose was to describe laboratory methods for assessing the platelet function, to give more information to cardiologists about its practical value and to understand what basic scientists and physicians mean by the term “platelet phenotype”.

Традиционно оценка нарушений функции тромбоцитов использовалась врачами-гематологами для диагностики наследственных тромбоцитопатий (таких, как синдром Бернарда-Сулье, псевдоболезнь Виллебранда, тромбастения Гланцмана и др.), и приобретенных (симптоматических) тромбоцитопатий (возникающих при гемобластозах, уремии, циррозах печени и т.д.), а также для прогнозирования риска интраоперационного кровотечения в этих группах пациентов. Позже методы тестирования функции тромбоцитов стали использоваться врачами-кардиологами сначала в экспериментальных и клинических исследованиях, а затем много лет проводились попытки внедрения их в клиническую практику. В настоящее время появились данные об ассоциации гиперреактивных тромбоцитов с патогенезом развития сердечно-сосудистых событий и потенциальный спектр применения тестов расширился. При этом, несмотря на наличие различных согласительных документов о возможности оценки тромботического и геморрагического риска, мониторинга антитромбоцитарной терапии под контролем функции тромбоцитов, в том числе выпущенных российскими экспертами, остается много тонкостей и вопросов об аспектах их применения в реальной клинической практике (трудности разработки надежного алгоритма тестирования, большое количество заметных различий в параметрах анализа и интерпретации таких тестов, доказательная база и экономическая целесообразность рутинного использования). Кроме того, само понятие фенотипа тромбоцитов не имеет четкой концепции. Цель обзора — описать лабораторные методы оценки функциональной активности тромбоцитов на сегодняшний день, дать представление практикующему врачу-кардиологу о месте их применения и разобраться, что понимают под термином "фенотип тромбоцитов" ученые и врачи.

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The authors declare that there are no conflicts of interest present.