[The pathophysiological basis of the destabilization of the clinical course in ischemic heart disease].

The role of the coagulative blood system in initiation of acute coronary events was investigated on patients with different clinical forms of ischemic heart disease (IHD). The obtained results indicate that unstable angina (UA) and myocardial infarction (MI) are two independent forms of the acute IHD with distinct qualitative peculiarities. The most common feature of UA was an increase in the functional activity of platelets both in cases proceeded in MI and in uncomplicated cases. It means that these changes may be treated as the main pathogenic factor if UA but not as a mechanism of its transformation to MI. But high degree of the risk of MI development appears if these changes are combined with preceding significant disturbances in the haemostatic balance as a result of inhibition of the activity of anticoagulative and fibrinolytic blood systems. These data show that differentiation of the diagnosis between UA and MI in its initial stage and the choice of the treatment principles should be based on the careful investigation of the coagulative potential of blood and of its most important components.