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Along with efficacy and safety, it is extremely important to study the severity of humoral and cellular immunity during not only vaccination, but also revaccination against the Severe Acute Respiratory Syndromerelated CoronaVirus 2 (SARS-CoV-2).Aim. To compare the immunogenicity (humoral and cellular immunity) of various (heterologous and homologous) revaccination regimens against coronavirus disease 2019 (COVID-19) in a prospective observational study.Material and methods. In individuals aged ≥18 years, in the absence of contraindications to vaccination, two following types of vaccines were used for primary vaccination and revaccination: Gam-COVIDVac and CoviVac. Group I patients received Gam-COVID-Vac at each stage of primary and secondary vaccination; patients of group II — Gam-COVID-Vac at each stage of primary vaccination, CoviVac at each stage of re-vaccination; patients of group III — CoviVac at each stage of primary vaccination and Gam-COVID-Vac at each stage of revaccination; patients of group IV — CoviVac at each stage of primary and secondary vaccination. All participants (at each stage of vaccination, revaccination and 12 months after the primary vaccination) were determined the level of IgG to the receptor-binding domain of SARS-CoV-2 spike (S) protein and T-cell immunity to SARSCoV-2.Results. The maximum level of IgG at the second stage of revaccination was observed in groups I and III. In addition, in groups I, III and IV, a significant (p8). At the same time, the level of active T cells responding to SARS-CoV-2 nucleocapsid Ag stimulation by Visit 4 (stage II of revaccination) was noted in groups II (14,5) and IV (12).Conclusion. The use of the Gam-COVID-Vac vaccine as a booster dose in both homologous and heterologous vaccination regimens against the SARS-CoV-2 virus is most effective for stimulation and humoral and T-cell post-vaccination response.

During the spread of an increasing number of new variants of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), it is extremely important not only to assess the immunogenicity and efficacy, butalso the safety of various combinations of vaccines. Excessive immune response and associated signs and symptoms may occur with varying frequency as expected from the use of vaccines.Aim. To compare the reactogenicity of various (heterologous and homologous) vaccination regimens in a prospective observational study.Material and methods. In individuals aged ≥18 years, in the absence of contraindications to vaccination, two types of vaccines were used at primary vaccination and revaccination: Gam-COVID-Vac and CoviVac: group I (n=97) — Gam-COVID-Vac at each stage of primary and booster vaccination ; group II (n=7) — Gam-COVID-Vck at each stage of primary vaccination, CoviVac at each stage of revaccination; group III (n=42) — CoviVac at each stage of primary vaccination, Gam-COVID-Vac at each stage of revaccination; group IV (n=38) — CoviVac at each stage of primary and secondary vaccination. In all participants, the dynamics of IgG to SARS-CoV-2 spike glycoprotein receptor-binding domain and T-cell immunity to SARS-CoV-2 were determined over time. To control the plasma hemostasis, the method of dynamic thrombophotometry was used. Local and systemic adverse events were assessed.Results. The number of vaccinated individuals with a rise in body temperature above 370 C after the 1st stage of revaccination was significantly (pnd stage of revaccination, in general, a smaller percentage of vaccinated persons with hyperthermia was noted. In group I, a higher percentage of persons (22,9%) complaining of the appearance of weakness after stage I of revaccination was noted compared to vaccinated persons of group IV — 5,2%. An increase in the fibrin clot growth rate was noted in group III at the stage of revaccination.Conclusion. The use of various revaccination schemes (homologous and heterologous) was not associated with the development of serious adverse events. The resulting local and systemic reactions were shortlived and did not require hospitalization. More pronounced systemic reactions were noted in the form of a short-term fever and weakness when using the Gam-COVID-Vac. No cases of arterial or venous thrombosis were registered during the follow-up period.

Aim. To evaluate the prevalence of oral anticoagulant therapy at the outpatient and inpatient stages in patients hospitalized with ischemic stroke.Material and methods. This open observational prospective real-world study included 114 patients with atrial fibrillation (AF) hospitalized with confirmed stroke.Results. Only 26,3% of patients with AF hospitalized with a confirmed diagnosis of ischemic stroke took anticoagulants (70% — direct oral anticoagulants (DOACs), 30% — warfarin). At the same time, among those taking warfarin, only one patient had normal international normalized ratio (INR) at the time of hospitalization (INR 2,6). In all other cases, the INR was Conclusion. One of the common reasons for stroke in outpatients with AF is the refusal to take oral anticoagulants or insufficient INR control when taking warfarin.

The review presents up-to-date information on the physiological and pathophysiological aspects of short-term middle-altitude adaptation in healthy individuals and patients with various chronic diseases. Unlike acute mountain sickness, which develops going to ≥3000, the physiological aspects of human adaptation to 2000-2500 m remain insufficiently studied. However, these altitudes are the most visited among tourist groups and individually.

Aim. To study the association between a positive results of Heart-type fatty acid binding protein (h-FABP) test with the development of adverse outcomes during the year of observation in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) depending on the type 2 diabetes mellitus (DM-2) presence.Material and methods. The study included 153 patients with NSTEACS hospitalized in the department of emergency cardiology in the period from March 2014 to January 2017. In addition to the standard examination, all patients underwent a qualitative analysis on the h-FABP in venous blood. Results. Kaplan–Meier estimator demonstrated a significant probability of a combined end point in patients with positive h-FABP, both with and without DM-2. H-FABP also acts as a marker for the development of adverse outcomes during the year after NSTE-ACS. Patients with adverse outcomes and type 2 diabetes mellitus had the highest frequency (100%) of positive test reactions.Conclusion. H-FABP positive test when admitted to hospital may be considered as a predictor of adverse long-term outcomes in patients with NSTE-ACS. That statistics is most significant for patients with DM-2.

The ongoing pandemic of coronavirus disease 2019 makes it important to study the immunogenicity, the duration of immune response, and the safety of existing vaccines.Aim. As part of a prospective observational study, to assess associations between levels of anti-Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) S protein IgG antibodies and thrombodynamics parameters in individuals vaccinated with Gam-COVID-Vac and CoviVac vaccines.Material and methods. The study included 137 people who completed the first 3 visits: 30 people received the Gam-COVID-Vac, 107 people — CoviVac. The study participants underwent venous blood sampling before the introduction of the 1st and 2nd vaccine doses, as well as 42 days after the administration of 1st dose in order to quantify the level of IgG antibodies. At each visit, plasma hemostasis parameters were analyzed using a thrombodynamics test.Results. During the follow-up period, there was a clear increase in the level of anti-SARS-CoV-2 S protein IgG antibodies in both groups. At the same time, this increase over time was significantly greater in Gam-COVID-Vac group. There was no correlation detected between thrombodynamics test results and the levels of anti-SARS-CoV-2 S protein IgG antibodies.Conclusion. The data obtained demonstrate the ability of both vaccines to stimulate the production of anti-SARS-CoV-2 antibodies. However, immune response to Gam-COVID-Vac is much higher. The lack of correlation between thrombodynamics and the level of specific antibodies suggests that vaccination for COVID-19 with Gam-COVIDVac and CoviVac does not cause changes in plasma hemostasis and does not increase the risk of thrombosis.

Aim. To evaluate the incidence and severity of acute kidney injury (AKI), as well as its ability to reclassify the risk of premature mortality and association with inhospital mortality in patients with pulmonary embolism (PE) in the Russian population.Material and methods. From April 2018 to April 2019, the SIRENA Russian Multicenter Registry included patients with PE, as well as the deceased, in whom the PE was detected by autopsy. AKI was diagnosed according to current KDIGO guidelines (2012). Creatinine calculated according to the MDRD equation and corresponding to a glomerular filtration rate of 75 ml/min/1,73 m2 (baseline) was taken as the initial one, with subsequent assessment relative to the parameter value upon admission. The risk stratification of early death was carried out in accordance with the current ESC clinical guidelines (2019).Results. A total of 604 patients with PE were examined (men — 293 (49%), women — 311 (51%), mean age — 64±15 years). AKI was diagnosed in 223 (37%) of them. Stage 1 AKI was detected in 146 (65%), 2 — in 55 (25%), 3 — in 22 (10%) patients. Prior chronic kidney disease was recorded in 61 (10%) patients. Seventy-one (12%) patients had a high risk of death, 364 (61%) — intermediate risk, and 164 (27%) — low risk. The AKI incidence increased as the severity of PE increased: at low risk of death — 26%, intermediate — 38%, high — 59% (pConclusion. Thirty-seven percent of Russian patients with PE have AKI diagnosed by baseline creatinine. In 2/3 of the examined patients, stage 1 AKI is observed. The AKI incidence increases as the severity of PE increases. The presence of AKI reclassifies patients into a higher risk category for death and is associated with a significant increase in inhospital mortality.

Aim.To study the clinical course and management of patients with pulmonary embolism (PE) of various age groups hospitalized in a cardiology hospital.Material and methods.This prospective single-center study in the period from 2016 to 2018 included 154 patients with PE verified by computed tomography. Statistical processing was conducted using the MedCalcVersion 16.2.1 software package (Softwa, Belgium).Results.In all groups, female patients dominated, but the highest number of women (70,7%) belonged to the group of senile patients, while in the group Conclusion.In the Kemerovo Oblast, PE most often develops in patients aged 60-75 years and is characterized by a more severe clinical course compared with patients younger than 60 years. Patients over the 60 years of age have severe cardiovascular comorbidity status, atrial fibrillation/flutter and recurrent PE. Surgical treatment for senile patients is limited due to the high risk of postoperative complications, which specifies high mortality. Patients