[Antibodies to cardiolipin and hemostasis in rheumatic patients during development of rheumatic valvular disease].

The observational study included 79 rheumatic patients aged 14-49 years. The diagnosis of acute rheumatic fever (ARF) was made in 29 patients (13-first attack, 16-recurrence), 50 patients had rheumatic heart disease (RHD) without signs of activity, 40 healthy donors served control. Antibodies to cardiolipin (a-CL) in the blood were determined by enzyme immunoassay, hemostasis was assessed by the level of antithrombin III, platelet aggregation, readings of electrocoagulograms. ARF patients were examined throughout the year, RHD patients--only once. Compared to the controls, both ARF and RHD patients demonstrated higher occurrence of a-CL, enhanced platelet aggregation, low antithrombin III level, hypercoagulation on electrocoagulogram, a-CL in ARF patients were detectable from the first month of the attack. By month 7-12 their count decreased, hemostasis normalized. In the onset and progression of RHD in the presence of ARF a-CL occurred more frequently. A direct relationship was found between the time of a-CL detection in the blood and severity, duration of rheumatic carditis. The data obtained validate feasibility of using a-CL for diagnosis of rheumatic carditis severity and prognosis of RHD development.