Original paper
The assessment of selected coagulation and fibrinolysis markers in the course of chronic venous insufficiency treated by micronized flavonoid fraction

Introduction: Chronic venous insufficiency (CVI) is a complex of clinical symptoms connected with a fixed disturbance of venous blood backflow in the lower limbs. Aetiopathogenesis of CVI is multifactorial and not fully clear yet.
Aim: To determine the influence of micronized purified flavonoid fraction (MPFF) on selected parameters of the coagulation system and fibrinolysis in patients with CVI depending on the severity of the disease.
Material and methods: The studies were conducted in 51 patients with the degree of progression C0–C2 according to the CEAP classification (group B1), 55 patients with the degree of progression C5–C6 (group B2), and 53 patients forming the control group. The preparation of the micronized purified flavonoid fraction (Detralex, Servier) was applied at the dose of 1000 mg/day for 14 days in groups B1 and B2. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (F) concentration, antithrombin III (AT III) activity and the level of thrombin–antithrombin III (TAT III) complexes were determined in groups B1 and B2 before and after the therapy and once in the control group. The results were statistically analyzed with Student’s t-test.
Results: The AT III activity was significantly higher in patients with CVI, compared to the control group. A statistically significant difference was observed in fibrinogen concentrations together with elongation of APTT and signif-icantly higher TAT complex concentrations in patients with CVI compared with the controls. Depending on the severity of CVI, the MPFF therapy caused a decrease of fibrinogen concentration, APTT shortening, a decrease of AT III activity and a decrease of TAT and PT concentrations.
Conclusions: Micronized purified flavonoid fraction, due to its antithrombotic action, may cause the normalization of some coagulation and fibrinolysis parameters. TAT index correlates with the degree of progression of CVI and can be used as a laboratory marker of the severity of the disease.