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Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry.Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 – in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards – from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0±1.5 months.Results. The age of post-COVID patients with CVMM was 73.7±9.6 years, without CVD – 49.4±12.4 years (p0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p

Aim. To assess in clinical practice the structure of multimorbidity, cardiovascular pharmacotherapy and outcomes in patients with a combination of atrial fibrillation (AF) and chronic heart failure (CHF) based on prospective registries of patients with cardiovascular diseases (CVD).Materials and Methods. The data of 3795 patients with atrial fibrillation (AF) were analyzed within the registries RECVASA (Ryazan), RECVASA FP (Moscow, Kursk, Tula, Yaroslavl), REGION-PO and REGION-LD (Ryazan), REGION-Moscow, REGATA (Ryazan). The comparison groups consisted of 3016 (79.5%) patients with AF in combination with CHF and 779 (29.5%) patients with AF without CHF. The duration of prospective observation is from 2 to 6 years.Results. Patients with a combination of AF and CHF (n=3016, age was 72.0±10.3 years; 41.8% of men) compared with patients with AF without CHF (n=779, age was 70.3±12.0 years; 43.5% of men) had a higher risk of thromboembolic complications (CHA2DS2-VASc – 4.68±1.59 and 3.10±1.50; p

Aim. Based on the data from the register of patients with COVID-19 and community-acquired pneumonia (CAP), analyze the duration of the prehospital period, cardiovascular comorbidity and the quality of prehospital pharmacotherapy of concomitant cardiovascular diseases (CVD).Material and methods. Patients were included to the study which admitted to the FSBI "NMHC named after N.I. Pirogov" of the Ministry of Health of the Russian Federation with a suspected or confirmed diagnosis of COVID-19 and/or CAP. The data for prehospital therapy, information from medical histories and a patients’survey in the hospital or by telephone contact 1-2 weeks after discharge were study. The duration of the prehospital stage was determined from the date of the appearance of clinical symptoms of coronavirus infection to the date of hospitalization.Results. The average age of the patients (n=1130; 579 [51.2%] men and 551 [48.8%] women) was 57.5±12.8 years. The prehospital stage was 7 (5,0; 10,0) days and did not differ significantly in patients with the presence and absence of CVD, but was significantly less in the deceased than in the surviving patients, as well as in those who required artificial lung ventilation (ALV). 583 (51.6%) patients had at least one CVD. Cardiovascular comorbidity was registered in 222 (42.7%) patients with hypertension, 210 (95.5%) patients with coronary heart disease (CHD), 104 (91.2%) patients with atrial fibrillation (AF). The inclusion of non-cardiac chronic diseases in the analysis led to an increase in the total proportion of patients with concomitant diseases to 65.8%. Approximately a quarter of hypertensive patients did not receive antihypertensive therapy, a low proportion of patients receiving antiplatelet agents and statins for CHD was revealed – 53% and 31.8%, respectively, anticoagulants for AF – 50.9%.Conclusion. The period from the onset of symptoms to hospitalization was significantly shorter in the deceased than in the surviving patients, as well as in those who required ALV. The proportion of people with a history of at least one CVD was about half of the entire cohort of patients. In patients with CVD before COVID-19 disease, a low frequencies of prescribing antihypertensive drugs, statins, antiplatelet agents and anticoagulants (in patients with AF) were recorded at the prehospital stage.

Aim. To estimate the detection rate of heart failure (HF), using various diagnosis criteria, among patients aftr 12 months after hospital treatment for coronavirus disease 2019 (COVID-19).Material and methods. The study included 185 patients from the TARGET-VIP registry who came for a visit 12 months after hospitalization for COVID-19. To identify HF with reduced (HFrEF) and mildly reduced (HFmrEF) ejection fraction (EF), the European Society of Cardiology (ESC) criteria (2016 and 2021) were used. To identify HF with preserved EF (HFpEF), we used the ESC criteria (2016 and 2021), as well as the 2018 Russian guidelines and H2FPEF score.Results. In the analyzed group, there were no patients with EF

Aim. To evaluate the medical treatment of patients with cardiovascular disease (CVD) during the first year of follow-up after hospitalization for coronavirus disease 2019 (COVID-19) in a prospective registry.Material and methods. The material for the study was obtained from the database of the TARGET-VIP inhospital registry. The registry included 1130 people. Of 863 patients discharged from the hospital with a diagnosis of COVID-19, 473 (548%) patients with CVD were selected, and 31 (40,8%) patients were selected from 76 patients in whom the diagnosis of COVID-19 was not confirmed with CVD.Results. At the stage of discharge from the hospital, the quality of therapy for CVD was insufficient on average, the frequency of proper prescriptions was 59,5%. During the first year, there was a significant trend towards a decrease in the prevalence of antihypertensive therapy for hypertension (p=0,018), anticoagulants for atrial fibrillation (p

Aim. Assess the structure of comorbid conditions, cardiovascular pharmacotherapy and outcomes in patients with atrial fibrillation (AF) and concomitant coronary artery disease (CAD) included in the outpatient and hospital RECVASA registries.Materials and methods. 3169 patients with AF were enrolled in outpatient RECVASA (Ryazan), RECVASA AF-Yaroslavl registries and hospital RECVASA AF (Moscow, Kursk, Tula). 2497 (78.8%) registries of patients with AF had CAD and 703 (28.2%) of them had a previous myocardial infarction (MI).Results. There were 2,497 patients with a combination of AF and CAD (age was 72.2±9.9 years; 43.1% of men; CHA2DS2-VASc – 4.57±1.61 points; HAS-BLED – 1.60±0,75 points), and the group with AF without CAD included 672 patients (age was 66.0±12.3 years; 43.2% of men; CHA2DS2-VASc – 3.26±1.67 points; HAS-BLED – 1,11±0.74 points). Patients with CAD were on average 6.2 years older and had a higher risk of thromboembolic and hemorrhagic complications (p

Aim. To study comorbidity, drug therapy and outcomes in patients with atrial fibrillation (AF) included in the outpatient and hospital RECVASA registries.Material and methods. Patients with AF (n=3169; age 70.9±10.7 years; 43.1% of men) in whom comorbidity, drug therapy, short-term and longterm outcomes (follow-up period from 2 to 6 years) were included in hospital registers RECVASA AF (Moscow, Kursk, Tula), as well as outpatient registers RECVASA (Ryazan) and RECVASA AF-Yaroslavl.Results. Outpatient registries (n=934), as compared to hospital registries (n=2235), had a higher average age of patients (73.4±10.9 vs 69.9±10.5; p80 bpm, systolic blood pressure 80 bpm (RR=1.50). Anticoagulant prescription in women was associated with a lower risk of ACVA (if adjusted for age: RR=0.54; p=0.04), in contrast to men (RR=1.11; p=0.79).Conclusion. The majority of patients with AF registries in 5 regions of Russia had a combination of three or more cardiovascular diseases (73.9%), as well as chronic non-cardiac diseases (68.8%). The frequency of proper cardiovascular pharmacotherapy was insufficient (68.6%), especially at the outpatient stage (55.6%). Over the observation period (2-6 years), the average mortality per year was 10.3%, but at the same time it differed significantly in the regions (from 3.7% in Moscow to 9.7-12.5% in Yaroslavl, Ryazan and Kursk). Cardiovascular causes of deaths occurred in 62%. A higher risk of death (1.5-2.7 times) was associated with a history of stroke and MI, diabetes mellitus, COPD, heart rate>80 bpm, systolic blood pressure

Aim. To evaluate the gender characteristics, educational level, cardiovascular diseases (CVD) risk factors and adherence to drug treatment in patients with premature CVD in an outpatient prospective registerу. Material and methods. 3690 patients with hypertension, coronary artery disease, chronic heart failure, atrial fibrillation and their combinations were enrolled in the RECVASA registry in Ryazan region of Russia. Groups of patients with early development of CVD (criterion 1 – the age of 18-49 years old, criterion 2 – the age of men 18-54 years old and women – 18-64 years old) were compared with the corresponding older groups. The gender characteristics, educational level, CVD risk factors, and adherence to drug treatment were analyzed. Results. According to criterion 1, the age groups of 18-49 years old and ≥50 years old included 347 (9.4%) and 3343 (90.6%) patients, respectively, 144 (41.5%) and 902 (27, 0%), respectively were men, p5 mmol/L) was diagnosed significantly less frequently in patients with early development of CVD than in the older age group (47.8 vs 54.6%; p=0.047); these differences were obtained due to women (46.9 vs 58.8%; p=0.008), the proportion of individuals with hypercholesterolemia did not significantly differ among men. According to criterion 2, statistically significant differences in the frequency of hypercholesterolemia were not detected among both men and women. There was no differences in the incidence of family history (FH) of premature CVD in the study groups, while the proportion of patients with FH of premature CVD was significantly higher in men

Aim. To evaluate the structure of multimorbidity, outcomes and the potential effect of dapagliflozin in patients with a combination of cardiovascular disease (CVD) and type 2 diabetes in Russian clinical practice.Material and methods. The data of 10 registries with the inclusion of 22957 people, including 4370 with type 2 diabetes in 6 regions of the Russian Federation, were analyzed. Scenarios for reducing mortality from all and cardiovascular causes and hospitalizations for CVD were simulated among groups of patients with diabetes combined with myocardial infarction (MI) and diabetes combined with heart failure with reduced ejection fraction (HFrEF) based on data from the Federal Registry of diabetes, the RECVASA and REGION registries, relative risks associated with analyzed adverse events from the DECLARE study.Results. When analyzing the data of all 22957 patients with CVD included in the registries, it was found that the proportion of patients with comorbid diabetes was on average 19.0%. Of the various diagnoses of CVD, the combination with diabetes was most often recorded in patients that had MI – 2.0%, stroke – 22.5% and heart failure – 24.0%. In the RECVASA registry (Ryazan) for 4 years of follow-up of 699 patients with a combination of CVD and diabetes mortality from all causes was 20.9%, and from cardiovascular causes – 15.6%. The simulated number of potentially prevented cardiovascular deaths with dapagliflozin taking in patients with diabetes combined with MI for 4 years in Russia will be 39124, and 37440 cardiovascular hospitalizations. The number of potentially preventable deaths from all causes among patients with diabetes combined with HFrEF will be 4543, cardiovascular deaths in 1995, and the number of prevented cardiovascular hospitalizations will be 7072.Conclusion. According to data from the registries of CVD patients in 6 regions of the Russian Federation, it was revealed that in real clinical practice the proportion of people with comorbid diabetes averaged 19% both at the outpatient and hospital stages. These subgroups of multimorbid patients have both the highest risk of developing fatal and non-fatal cardiovascular complications, and the largest number of indications for prescribing drugs that affect the prognosis due to effects on both CVD and diabetes.

Aim. To assess long-term outcomes within 12 months after hospital treatment of patients with coronavirus disease 2019 (COVID-19) as part of a prospective registry.Material and methods. Outcomes in the posthospital period were assessed in 827 patients diagnosed with COVID-19 (age, 58,0±14,8 years; men, 51,3%). For periods of 30-60 days, 6 and 12 months after discharge from the hospital, cases of death, nonfatal myocardial infarction (MI) and stroke, hospitalization, acute respiratory viral infections/influenza were assessed. The follow-up period was 13,0±1,5 months.Results. During the follow-up period, 35 (4,2%) patients died, 6 (0,73%) and 4 (0,48%) cases of MI and stroke were registered. In addition, 142 (17%) patients were hospitalized, while 217 (26,2%) patients had acute respiratory viral infections/ influenza. Factors of age and length of intensive care unit stay were significantly associated (p

Aim. According to hospital-based registry, to evaluate the age characteristics and prevalence of concomitant cardiovascular and non-сardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave.Material and methods. The TARGET-VIP register included 1130 patients aged 57,5+12,8 years (men, 51,2%) hospitalized at the Pirogov National Medical and Surgical Center from April 6, 2020 to June 22, 2020 with COVID-19. Cardiovascular diseases (CVDs) were diagnosed in 51,6% of patients, non-сardiovascular chronic diseases — in 48,6%, while CVDs and/or non-сardiovascular chronic diseases — in 65,8% of patients.Results. The average age of patients significantly increased by an average of 0,77 years per week (p

AIM. Within the framework of outpatient and hospital registers of REGION (REGIster of patients who have undergone acute cerebrovascular accident) to carry out a comparative assessment of demographic and clinical-anamnestical characteristics, medical treatment and outcomes in clinical practice in patients with a combination of undergone acute cerebrovascular accident (ACVA) and atrial fibrillation (AF) in the presence or absence of myocardial infarction (MI) in the medical history.MATERIAL AND METHODS. Outpatient registers REGION (Ryazan) and hospital register REGION (Moscow) included 1886 patients who have undergone ACVA (age 70.6 ± 12.5 years, 41.9% of men), of them 516 (27.4%) people with AF. Comparison groups included 152 (8.1%) patients with a combination of ACVA, AF and MI in medical history (ACVA + AF + MI group) and 364 (19.3%) patients with ACVA, AF without MI (ACVA + AF without MI group). The presence of cardiovascular diseases (CVD), concomitant diseases, drug therapy and outcomes were analyzed.RESULTS. In the group of ACVA + AF + MI patients, compared to the ACVA + AF without MI group, the share of patients with AH (100% and 97.2%), IHD (100% and 87.1%), CHD (68.4% and 57.1%), repeated ACVA (36.9% and 23.9%), diabetes mellitus in women (39.5% and 20.4%) was statistically significantly higher. In the comparison groups, the share of smokers (13.3% and 15.5%), patients with burdened heredity of early development of CVDs (2.1% and 1.1%) and hypercholesterolemia (41.1% and 50.0%) did not differ significantly, however, in the group of ACVA + AF + MI, in comparison with the group of ACVA + AF without MI, there was a higher risk on the CHA2DS2-VASc scale (5.26 ± 1.32 and 4.09 ± 1.44; p < 0.001) and HAS-BLED scale (1.91 ± 0.76 and 1.62 ± 0.79; p < 0.01). Patients with AF of REGION register, both with and without MI, had insufficient frequency of proper medical prescriptions for CVDs (46.6% and 38.9% on average), especially prescription of anticoagulants (19.1% and 21.4%), statins in case of IHD (33.6% and 27.4%) and beta-adrenoblockers in case of CHD (39.4% and 35.6%). During the four-year period of observation, in comparison with post-stroke patients without a history of MI, the mortality rate for all causes was 1.5 times higher (56.6% and 37.6%, p = 0.0001), the incidence of non-fatal MI was higher (2.0% and 0.3%,p = 0.04). CONCLUSION. Patients with a combination of ACVA, AF and MI history are a very high risk group for adverse outcomes observed on an outpatient stage. For these patients it is very important to improve the quality of drug therapy and the effectiveness of secondary prophylaxis.

Aim. To estimate outcomes and risk of all-cause mortality, cardiovascular (CV) mortality, and non-fatal CV events in patients with a history of acute cerebrovascular accident (ACVA) according to data of outpatient prospective registries.Material and methods. 986 patients with a history of ACVA (aged 70.6Ѓ}10.9 years; 56.8% women) were enrolled into the outpatient registry REGION-Ryazan, including the registry of patients with ACVA of any remoteness (ACVA-AR) – 511 (aged 70.4Ѓ}10.5 years; 58.5% women) and the registry of patients, visited outpatient clinics for the first time after ACVA (ACVA-FT) – 475 (aged 70.8Ѓ}11.3 years; 54.9% women). Outcomes, risk of all-cause and CV mortality, composite CV endpoint (CV death, nonfatal myocardial infarction and ACVA), hospitalizations due to CV diseases (CVD) were evaluated during 37 (17;52) months of follow-up period.Results. 310 (31.2%) patients died during the follow-up. The most part of fatal outcomes (56.4%) was registered during the first year of follow-up, especially during the first 3 months (33.9%). Mortality among men (35.9%) was higher than among women (28.0%), р=0.008. 147 (28.8%) and 163 (34.3%) patients died in registries ACVA-AR and ACVA-FT, respectively (70.4% and 90.2% of fatal outcomes were from CV causes, respectively; р=0.04). The higher risk of death was associated with the following factors: age – hazard ratio (HR) 1.10 for each next year of age (95% confidence interval [95%CI] 1.09-1.12); sex (men) – HR 2.01 (95%CI 1.55-2.62); atrial fibrillation (AF) – HR 1.42 (95%CI 1,09-1,86); recurrent ACVA – HR 1.64 (95%CI 1.23-2.19); history of myocardial infarction (MI) – HR 1.45 (95%CI 1.09-1.93); low blood hemoglobin level – HR 2.44 (95%CI 1.59-3.79); heart rate ≥80 beats/min – HR 1.51 (95%CI 1.13-2.03); diabetes – HR 1.56 (95%CI 1.16-2.08); chronic obstructive pulmonary disease (COPD) – HR 1.89 (95%CI 1.34-2.66); no antihypertensive therapy in arterial hypertension – HR 2.03 (95%CI 1.42-2.88). The lower risk of death was associated with the following factors: prescription of ACE inhibitors (ACEI) – HR 0.60 (95%CI 0.42-0.85); angiotensin II receptor blockers (ARB) – HR 0.26 (95%CI 0.13-0.50), beta-blockers – HR 0.71 (95%CI 0.50-0.99); statins – HR 0.59 (95%CI 0.42-0.82). Factors, listed above, had significant association not only with all-cause mortality but also with CV mortality and composite CV endpoint. The higher rate of hospitalizations due to CVD was associated with younger age (incidence rate ratio [IRR] for 1 year 1.03; 95%CI 1.02-1.05; р

Aim. To assess age and gender characteristics and determine comorbidity, medication, and outcomes in young ambulatory patients with cardiovascular diseases (CVD) within the framework of an ambulatory prospective registry.Material and methods. The study included 3690 patients with hypertension (HTN), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and combinations thereof, which applied to 3 Ryazan hospitals. Younger CVD patients (criterion 1 — the age of 18-49 years, criterion 2 — the age of men 18-54 years old and women 18-64 years old) were compared with older representatives. The presence of CVD and comorbidities, medication, and outcomes over 6 year follow-up were analyzed.Results. The age groups of 18-49 years old and >50 years old included 347 (9,4%) and 3343 (90,6%) patients, respectively (men — 144 (41,5%) and 902 (27,0%), p2 CVDs was 41%; according to criterion 2 — 62% (p

Aim. To assess the demographic and clinical characteristics, drug treatment and outcomes in patients with a history of acute cerebrovascular accident (ACVA) and with concomitant history of myocardial infarction (MI) in clinical practice based on outpatient and hospital parts of REGION registry.Material and methods. The total 1886 patients with a history of ACVA (aged of 70.6±12.5 years, 41.9% men) were enrolled into the outpatient registry REGION (Ryazan) and the hospital registry REGION (Moscow). 356 patients had ACVA and a history of MI (group “ACVA+MI” and 1530 patients had ACVA without history of MI (group “ACVA without MI”). The incidence of cardiovascular diseases (CVD), non-CVD comorbidities, drug therapy and outcomes were analyzed.Results. In the group ACVA+MI compared with group ACVA without MI the significantly higher proportions of patients with the following conditions (diagnosis) were revealed: arterial hypertension (AH) – 99.1% and 94.2%; coronary heart disease (CHD) – 100% and 57%; chronic heart failure (CHF) – 61.5% and 41.8%; atrial fibrillation (AF) – 42.7% and 23.8%; repeated ACVA – 32.9% and 18.9%, respectively, p

Aim. To evaluate an incidence of oral anticoagulants (OAC) administration during longterm follow-up period in patients with atrial fibrillation (AF) enrolled in outpatient and hospital RECVASA registries.Material and methods. 3169 patients with AF were enrolled in outpatient registries RECVASA (Ryazan), RECVASA AF-Yaroslavl and hospital registries RECVASA AF (Moscow, Kursk, Tula), age 70.9±10.7 years, 43.1% men. The incidence of OAC administration was evaluated in hospital and outpatient settings, including longterm follow-up period (2-6 years).Results. OAC were administrated only in 42.2% of cases (1335 from 3169 patients; age 69.1±10.4 years, 43% men), including warfarin (817 patients; 26%) and non-vitamin K antagonist oral anticoagulants (NOAC) – 518 (16%). Patients with permanent and persistant types of AF had lower incidence of OAC administration (43% and 40%) than in cases of paroxysmal type (47.6%, p0.05) contrary to the pronounced difference of thromboembolic risk in these groups (6.14±1.34 and 3.77±1.39; р

Aim. To characterize patients admitted to hospital with suspected or documented COVID-19 infection and community-acquired pneumonia (CAP) and to assess the prevalence of concomitant cardiovascular, non-cardiac diseases, prehospital cardiovascular therapy and outcomes of in-hospital treatment.Material and methods. The TARGET-VIP registry includes patients admitted to the N. I. Pirogov National Medical and Surgical Center with suspected or documented COVID-19 infection and/or CAP for the period from April 6, 2020 to July 2, 2020. COVID-19 infection was diagnosed using polymerase chain reaction (PCR) tests and chest computed tomography (CT). Comorbid conditions and pre-hospital therapy were assessed.Results. A total of 1,130 patients were included in the registry (mean age, 57,5±12,8 years; men, 579 (51,2%)). Using PCR test, COVID-19 infection was established in 686 (60,7%) patients; using chest CT − 334 (29,6%) patients. The most numerous were the group with a combination of COVID-19 and CAP (n=662; 58,6%) and the group with CAP without positive PCR (n=402; 35,6%). The group of patients with COVID-19 without CAP was the smallest (n=24; 2,1%); in 3,7% of patients (n=42), CAP was not confirmed and PCR were negative. The proportion of people with cardiovascular diseases (CVD) according to the survey, in comparison with data of medical records, was higher by 2% (52,2 vs 50,2%); the proportion of persons with chronic non-cardiac diseases − higher by 6,7% (50,8 vs 44,1%). Among patients with CVD (n=598), compared with patients without CVD (n=532), following diseases was diagnosed significantly more often: diabetes (odds ratio (OR), 5,66; 95% confidence interval (CI), 3,52-9,12), respiratory disease (OR, 2.,7; 95% CI, 1,43-4,27), chronic kidney disease (OR, 3,32; 95% CI, 1,97-5,59), obesity (OR, 15,35; 95% CI, 6,62-35,59). Hospital mortality was 4,2% and significantly differs (4,7 times) in patients with and without COVID-19 according to PCR (6,6 vs 1,4%, p=0,0001), including among patients with CAP and positive or negative PCR (6,0 vs 1,2%, p=0,0002).Conclusion. COVID-19 infection was diagnosed in 60,7% of patients according to PCR and in 90,3% of patients according to the combination of PCR and chest CT. Among patients with CVD, the proportion of people with chronic noncardiac diseases was significantly higher (regardless of age and sex), in particular, with diabetes, chronic kidney disease and obesity. Questionnaires provided important data on the history of noncommunicable diseases and prehospital cardiovascular therapy. The mortality rate of patients with documented COVID-19 infection was 4,7 times higher than with undocumented.

Aim. To assess the age and sex characteristics, comorbidities and medication therapy in patients with early cardiovascular multimorbidity in out- and in-patient care.Material and methods. The REKVAZA registry includes 3,690 patients with hypertension (HTN), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF) and their combinations, who applied to primary care facilities in Ryazan in 2012-2013. The hospital registry REKVAZA-CLINIC included 17,018 patients hospitalized due to cardiovascular disease (CVD) at the National Medical Research Center for Therapy and Preventive Medicine from April 2013 to March 2020. The groups of patients with early cardiovascular multimorbidity were compared according to two criteria: criterion 1 — age 18-49 years; criterion 2 — the age of men, 18-54 years; women, 18-64 years. The structure of CVD and related diseases, as well as cardiovascular therapy were analyzed.Results. The proportion of persons with early cardiovascular multimorbidity from the total number of patients with cardiovascular multimorbidity was as follows: using criterion 1 — 4,9% (145/2959) and 4,94% (571/11557) (p=0,66), criterion 2 — 29,0% (859/ 2959) and 18,8% (2168/11557) (p2 CVDs (HTN, CAD, HF, AF, myocardial infarction, acute cerebrovascular accident), the proportion of individuals with early development of each of the listed diseases was significantly higher in the out- and in-patient registries, when using criterion 2 (14-29%) compared to criterion 1 (2-2,5%). Among patients with early onset of CVD in the outpatient registry, when criteria 1 and 2 were used, the proportion of patients with cardiovascular multimorbidity was 41,8 and 62,7% (p 1/3 of patients were found to have combined CVDs. Using criterion 2, compared with criterion 1, the proportion of persons with HTN and concomitant CVD among all patients with early HTN was 1,5 times higher (62,8 vs 41,6%; p

Aim. To evaluate the structure of combined cardiovascular diseases, drug treatment and observation of patients with a history of stroke in the framework of prospective outpatient registries. Material and methods. The study was conducted based on 3 outpatient clinics of Ryazan city. Patients with a history of acute cerebrovascular accident (ACVA) of any remoteness (AR) were included into ACVA-AR outpatient registry (n=511). Patients who had visited the outpatient clinics for the first time (FT) after cerebral stroke (n=475) were included into the ACVA-FT outpatient registry. The structure of the cardiovascular diseases (CVD), compliance with the clinical recommendations of the prescribed and received drug therapy were evaluated. The proportion of patients with dispensary observation for CVD, using preferential drug provision was determined. Results. A combination of 2 or more CVDs was found in 84.4% and 82.5% of cases, and severe cardiovascular multimorbidity (3-4 CVDs) – in 69% and 64% of cases, respectively, in ACVA-AR and ACVA-FT registers. Compliance with the clinical guidelines prescribed and received drug therapy was insufficient at the outpatient stage. Necessary prescription of drugs with a proven beneficial effect on the prognosis were observed significantly more frequent in the ACVA-FT registry, compared to the ACVA-AR registry at the enrolling stage of the study (p

Aim. To assess the characteristics of patients and short-term outcomes of the disease in patients hospitalized for cerebral stroke (CS) based on the REGION-Moscow register.Material and methods. From 2012 to 2017, 900 patients were included in the REGION-Moscow register, who were consecutively admitted to one of the clinics in Moscow, and in whom CS or transient ischemic attack (TIA) were diagnosed during hospitalization.Results. The average age of the entire cohort of patients was 71±15 years. Women were 59,4%, men — 40,6%. The average age of women was 7 years more than the average age of men. Cardiovascular risk factors or a combination of them were detected in most patients. About 75% of CS were ischemic, 10% — hemorrhagic, 2% — mixed type, 13% were transient ischemic attack. Hospital mortality on average over the 5 years were 24,0%. There was a sharp increase in hospital mortality in 2014, which coincided with the organization of the vascular center, in subsequent years there was a progressive decrease in hospital mortality.Conclusion. The development of CS in most patients was predictable and determined mainly by the presence of cardiovascular risk factors or a combination of them. Organization of the vascular center led to a gradual decrease in hospital mortality.Boytsov S. A.5 on behalf of the working group.REGION-Moscow register working group: Akimova A. V., Arutyunov G. P., Belova E. N., Blagodatskikh S. V., Boytsov S. A., Vernohaeva A. N., Viskov R. V., Voronina V. P., Gladilkina M. P., Deev A. D., Dmitrieva N. A., Drapkina O. M. Zagrebelny A. V., Kvitivadze G. K, Klyashtorny V. G., Kokareva I. V. , Kudryashov E. V., Kutishenko N. P., Lerman O. V., Lukyanov M. M., Martsevich S. Yu., Matveyeva A. D., Matskevich L. A., Mitichkin A. E., Nikitina G. I., Nikoshnova E. S. Ovsepyan M. A., Okshina E. Yu., Palamarchuk V. N., Parsadanyan N. E., Porezanova M. V., Sementsov D. P, Stakhovskaya L. V., Stepina E. V., Stolboushkina E. A., Halaeva M. A., Chernyshova M. I., Shamalov N. A.

Am. To study in the RECVASA registers the availability of data about the international normalized ratio (INR) indicator and achievement of its target values in outpatient and hospital practice in patients with atrial fibrillation (AF) receiving anticoagulant therapy with warfarin.Material and methods. Data about the INR control and the frequency of achievement of its target values at the outpatient and hospital stages were analyzed in RECVASA (Ryazan) and RECVASA FP – Yaroslavl outpatient registries, as well as in the hospital registers RECVASA FP (Moscow, Kursk, Tula) in 817 patients (46.9% of men, age 68.5±9.6 years) with AF and the prescribed anticoagulant therapy with warfarin.Results. INR was determined in 689 (84.3%) of 817 patients. The values of INR were monitored during therapy with warfarin in RECVASA (Ryazan) and RECVASA FP –Yaroslavl outpatient registries in 73.7% and 77.7% of patients, respectively, and in RECVASA FP hospital registers: 95.8% (Moscow); 81.3% (Tula) and 93.5% (Kursk). The target level of INR (2.0-3.0) was achieved in a minority of patients with AF during treatment with warfarin: inRyazan – in 26.3% of cases;Yaroslavl – 38.3%;Kursk – 34.8%;Moscow – 39.5%; Tule – 26.3%. Control of INR in hospital registries during warfarin therapy in patients with AF significantly more often (p

Aim. To determine the proportion of patients with atrial fibrillation (AF) among hospitalized patients in the departments of the multidisciplinary hospital and to study the structure of the associated cardiovascular diseases (CVD) and drug therapy within the RECVAZA AF-Tula hospital registry.Material and methods. All patients with a diagnosis of AF in the patient's chart (n=1225) were included into the RECVAZA AF-Tula registry; that is 4.2% of 29018 patients hospitalized to the Tula Regional Clinical Hospital in 2013. The structure of the associated cardiovascular diseases, as well as drug therapy, was evaluated on the basis of data in the medical documentation.Results. The mean age of patients with AF was 69.6±9.9 years, men was 47.8%. 87.5% of patients had a combination of AF with hypertension, 75.1% – with ischemic heart disease, and 81.4% – with chronic heart failure. The average number of diagnoses was 3.4 per patient. The proportion of patients with permanent, persistent and paroxysmal forms of AF was 46.4%, 20%, and 29%, respectively. The risk score according to the CHA2DS2-VASc and HAS-BLED scales was higher in patients of therapeutic profile (4.27±1.66 and 1.48±0.95) than this in patients of surgical profile (3.57±1.70 and 1.06±0.74, p

Aim. To study the pharmacological treatment of patients with acute stroke (AS) within the prospective outpatient registries.Material and methods. In the pilot phase of the study, conducting on the base of one of the out-patient clinic in Ryazan city, 200 and 115 patients were included into the outpatient registry of patients with AS history of any remoteness (AS-AR registry), and outpatient registry of the first apply (AS-FA registry) to the out-patient clinic after stroke, respectively. The correspondence of the prescribed and actually taken drug therapy to clinical recommendations, its continuity, and the adherence of patients to treatment were assessed during the prospective observation.Results. Most patients did not receive adequate therapy to reduce the risk of AS and other cardiovascular complications in the outpatient stage, especially in the period prior to the reference AS. Drugs with a proven beneficial effect on the prognosis in the post-stroke period were prescribed significantly (p and after 2 years – in the AS-FA registry, the frequency of the therapy was not significantly different from the frequency of prescribing at the stage of inclusion in the registers, with the exception of statins (they were taken 1.7 and 1.5 times less frequently). Prognostically significant prescriptions of the inclusion phase were performed in the long-term follow-up period in 49% and 70% of patients (on average 58%), respectively; however, the frequency of first-time therapy was 44% and 19% of the total number of prescriptions in this period, respectively. Adherence to treatment, according to the Morisky-Green questionnaire, was revealed in 17.7 and 51.7% of patients, respectivelyConclusion. The results of the pilot phase of the REGION study (AS-AR and AS-FA outpatient registries) showed that the quality of the prescribed drug therapy of patients in out-patient clinic is inadequate. A comparison of the data of AS-AR and AS-FA registries allows to make a preliminary conclusion that over the 5-year period separating the remoteness of AS development in these registries, the quality of patient treatment has significantly improved, although not enough. The proportion of previously performed prognostically significant prescriptions averaged only about 60% at the stage of the further prospective follow-up. In general, during the observation period, taking into account newly made prescriptions, the frequency of adequate drug therapy during the observation period decreased only for statins. Most patients were not sufficiently committed to pharmacological treatment according to the Morisky-Green questionnaire.

Aim. To assess the clinical and anamnestic characteristics, the prescription rate of angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and β-blockers in the outpatient practice, adherence to drug therapy in patients with a combination of chronic heart failure (CHF), hypertension (HT) and history of myocardial infarction (MI) in the frame of Cardiovascular Disease Registry (RECVASA). Material and methods. Data analysis in groups of patients with a combination of CHF, HT and the history of MI (n=406) and patients with a combination of CHF, HT and ischemic heart disease (IHD) without history of MI (n=1897) was performed in the frame of RECVASA registry. The structure of the associated cardiovascular and concomitant non-cardiac diseases, the severity of the clinical manifestations of CHF, IHD and HT, the prescription rate of the ACEI/ARB and β-blockers, the adherence to drug therapy (according to the Morisky-Green test) were studied in groups. Results. Patients with a combination of CHF, HT and IHD with or without MI history significantly differed in the proportion of men (47.8% vs 24.9%, respectively), prevalence of atrial fibrillation (25.9% vs 20.5%, respectively), diabetes mellitus (27.3% vs 15.7%, respectively) and the stroke history (17.2% vs 10.7%, respectively). The mean age (69.9±11.0 vs 70.3±11.0 years, respectively), as well as the prevalence of the history of respiratory diseases, chronic kidney disease, digestive diseases, obesity and anemia, did not differ significantly. Patients with a combination of CHF, HT and post-infarction cardiosclerosis (PICS) compared with patients without PICS significantly more often had CHF class 3-4 NYHA (62% vs 47.9%, respectively), HT of degree 3 (92.5% vs 84.2%, respectively), stable angina class 3-4 (84.4% vs 66.4%, respectively). Patients with PICS significantly (p

Aim. To estimate the rate of oral anticoagulants (OAC) prescription, continuity of anticoagulant therapy in hospital and ambulatory stages along with treatment adherence in patients with atrial fibrillation (AF) associated with hypertension (HT), ischemic heart disease (IHD) and chronic heart failure (CHF) within the registry of cardiovascular diseases. Material and methods. The study included 285 patients with AF combined with HT, IHD and CHF from the hospital registry RECVASA-CLINIC (n=3696). The rate of OAC prescription was evaluated in ambulatory and in-hospital stages according to medical records. Out-patient treatment was estimated via phone contact in 250 participants that represented 96.2% of all survived patients during follow-up of 24.1Ѓ}5.9 months after discharge from hospital. Medical adherence was evaluated using Morisky-Green questionnaire. Results. Mean age of patients was 73.9Ѓ}10.0 years (male – 52.6), CHA2DS2-VASc and HAS-BLED score were estimated as 5.14Ѓ}1.50 и 1.59Ѓ}0.79, respectively. Contraindications to OAC treatment were registered in 34 (11.9%) patients. In pre-hospital stage patients with paroxysmal AF received OAK more rarely comparing to those with permanent and persistent AF (31.8%, 51.7 and 55%, respectively; р

Aim. To investigate on the prevalence of oral anticoagulation prescription (OAC), of β-blockers (BAB), angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor type II blockers (ARB), and statins in patients with atrial fibrillation (AF) comorbid with arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF) at inpatient and out-patient stages of management, under framework of REKVAZA-CLINIC registry of cardiovascular diseases (CVD).Material and methods. Into the RECVAZA-CLINIC study, 3696 patients included, with diagnoses of AF, AH, CHD, CHF and combinations, hospitalized to NRCPM from 01.04.2013 to 31.12.2014, living in Moscow and Moscow Region. Of those, in current study 285 patients included (7,7%) with combinations of AF, AH, CHD, CHF. Prescription at outpatient stage of the OAC, BAB, ARB/ACEi and statins was assessed by case histories review. After the discharge, in 24,1±5,9 months, drug treatment was assessed by phone calls in 250 patients, and in 35,5±7,5 months — during office cardiologist visit in 113 randomly selected patients.Results. Mean age of the patients with combination of AF, AH, CHD and CHF was 73,9±10,0 y.o. (52,6% males). Myocardial infarction (MI) in anamnesis had 58,9% patients, stroke — 21,7%. At hospital stage, and in 2 and 3 years of follow-up, the prevalence of ACEi/ARB prescription did not decrease significantly, but statins were prescribed less comparing to in-patient stage (1,5 and 2,0 times), as OAC (1,2 and 1,4 times) and BAB (1,1 times in 3 years of follow-up). Combination of 4 drugs of the included classes, was the most commonly prescribed in-patient (68%) and most rare — before admission and in 3 years of post-discharge follow-up — 3,7 and 2,3 times more rare, than in inpatient stage. Postinfarction cardiosclerosis patients were less commonly prescribed the OAC at pre-admission stage (1,4 times) and BAB before admission and in hospital (1,2 times), as 2 years later (1,1 times). The ACEi/ARB were prescribed too rare at pre-admission and post-discharge stages (1,2 and 1,1 times), OAC for the period of 3 years (1,3 times). If comparing the patients with anamnesis of stroke, and with none, there were no significant differences of the drugs prescription frequency.Conclusion. By the data from in-hospital prospective registry RECVAZACLINIC, in patients with AF, AH, CHD, CHF at pre-admission stage, especially out-patient, the following drugs prescribed too rarely: OAC, BAB, ACEi/ARB, statins, that have beneficial impact on prognosis. It is important to increase outpatient physicians adherence to the combinations prescription for OAC, BAB, ACEi/ARB, statins in this category of patients.

Aim. To study particularities of course and outcomes of acute cerebrovascular accident (ACVA), quality of examination and medical treatment within a framework of an outpatient register.Material and methods. Two outpatient registries were organized on the base of one of Ryazan outpatient clinics within a framework of the pilot phase of the REGION study: the register of patients who had experienced ACVA of any remoteness (ACVA-AR register, n=200) and the register of patients who had visited the outpatient clinic for the first time after cerebral stroke (ACVA-FV register, n=115). Particularities of ACVA development, concomitant cardiovascular diseases (CVD) and noncardiac diseases were analyzed. We estimated accordance of methods of examination and prescribed medical treatment with clinical guidelines. Long-term outcomes were also evaluated in the course of prospective follow-up.Results. Patients of both registers had concomitant CVD (on an average 3 diagnosis) and noncardiac comorbidity (on an average 1 diagnosis). Majority of patients at the outpatient phase received inadequate treatment for cardiovascular risk decrease, especially before reference ACVA. The ACVA-FV register patients as compared to the ACVA-AR ones (who had experienced ACVA on an average 4.8 years earlier) were more often (p

Aim. To study a pattern of concomitant cardiovascular diseases (CVDs) and to estimate particularities and quality of medical antihypertensive therapy in hypertensive patients in real outpatient practice with a help of the Registry in Ryazan region.Material and methods. A total of 3690 patients with hypertension, ischemic heart disease, chronic heart failure and atrial fibrillation, who had attended general practitioners and cardiologists of 3 outpatient clinics in Ryazan city, were enrolled in the outpatient Registry of cardiovascular diseases (RECVASA). The diagnosis of hypertension was recorded in 3648 of 3690 (98.9%) outpatient charts, 28.1% of the subjects were men and 71.9% - women.Results. A total of 2907 (79.7%) of 3648 patients had combination of hypertension with other CVDs. Combination of 3-4 cardiovascular diagnoses was registered in 63.8% of the cases. 11.5% and 9.5% of the patients had a history of myocardial infarction and cerebral stroke, respectively. Diagnosis of hypertension was verified in 448 of 450 randomized hypertensive patients (99.6%). The incidence of prescription of one and two antihypertensive drugs (AHDs) was 25% and 39%, respectively, of 3 AHDs – 21%, 4 and more – 2%. AHDs were not prescribed in 13% of hypertensive patients. The mean number of prescribed AHDs was 1.73. The mean incidence rate of target blood pressure achievement was 26.1%. We have noted insufficient ACE inhibitors/angiotensin receptor blockers (ARB) and beta-blockers prescription in different concomitant CVDs. Patients with 3-4 cardiovascular diagnoses were more often prescribed combined antihypertensive treatment. Prescription of ACE inhibitors/ARB, beta-blockers and thiazide diuretics combination was preferable in 74.1% of the cases, when taking into account absolute and relative contraindications for betablockers use – in 64.0%. 15.2% of the hypertensive patients used reimbursed drugs for CVDs at the moment of the Registry enrollment as compared with 39.2% in previous years (p

Aim. To evaluate, under the frame of prospective registry, the 12-month outcomes and risks in patients with arterial hypertension (AH), ischemic heart disease (CHD), chronic heart failure (CHF) and atrial fibrillation (AF) in the real outpatient practice in Ryazan Region. Material and methods. Into the outpatient registry RECVASA (REgistry of CardioVAScular diseases) totally 3690 patients included with AH, CHD, CHF, AF and their comorbidity, visited 3 outpatient institutions in Ryzan city: 1047 (28%) of men and 2643 women, mean age 66,1±12,9 y.o. The estimation of 12-mint risk of events fter inclusion in registry RECVASA was done for 3619 (98,1%) participants. Results. By 12 month after inclusion 168 patients (4,6%) died, had stroke (S) — 62 (1,7%), myocardial infarction (MI) — 26 (0,7%), cardiovascular surgery (CVS) — 6 (0,2%). Totally 235 hospitalizations for CVD registered. The risk of death, MI development and S had been increasing by 5-9% every year of patient age, and CVD hospitalization — decreased by 2%. Combined death risk and cardiovascular death risk were significantly higher (1,3-6,4 times) with anamnesis of MI, S, diabetes mellitus (DM), chronic obstructive lung disease (COPD), CHF of 3-4 functional class (FC), in males and with blood pressure (BP) 90 bpm, glomerular filtration rate (GFR) 180/110 mmHg, HR >90/min. Risk of all-cause death was lower in those who received p-adrenoblockers, angiotensin-converting enzyme inhibitors (iACE) and angiotensin receptor blockers (ARB) 1,4-1,5 times, death from cardiovascular causes — with iACE and ARB — 2 times lower. Patients on p-blockers had 1,8 times lower risk of MI. Conclusion. Prospective follow-up of cardiovascular patients under the frame of RECVASA registry showed significant negative influence on prognosis the following: age, male gender, anamnesis of MI and S, DM, COPD, CHF (3-4 FC), angina (3-4 FC), permanent AF, BP 180/110 mmHg, GFR 90/min, combination of AH, CHD, CHF and AH, CHD, CHF, AF. Positive influence on prognosis with CVD had treatment with p-adrenoblockers, iACE, ARB.

The subject. The paper is focused on the study of the role of performance information in the decision-making process on public finance with particular accent on the legal aspects of the issue.The purpose. We aim to show that the performance results have a little impact on the public finance allocation in the next management cycle. Nowadays the financial resolutions are taken not on the basis of the results, but apart from them. The problem can be identified in many countries and currently discussed on the international level. We make an attempt to identify the main reasons for this. The research is elaborating the possible solutions for the problem and presenting possible amendments to the legislation.The methodology. The multidisciplinary approach is employed in this research as the problem is covered by different social sciences like law, economics and politics. The methods of analysis and synthesis are relevant for this paper. The examples and illustrations from different countries all over the world constitute the empirical part of the article.The main results and conclusions. The key reason for the omission or misuse of performance results in public finance is the passive role of the user of the performance information. There is a lack of legal incentives for using the performance results for those who take the financial decisions. Those who take the decisions in public finance governance should have an obligation to assess the performance information and use it for the further resolutions.Scope of the research outcome application. This research shall have substantial impact on the development of adequate legal model for the performance information use in public finance allocation. If the legal obligation to use the performance information is introduced it will have positive impact on the legal regulation of public finance in Russia. This can be relevant for the international studies of the issue and for the legal regulation of financial governance in other countries as well.

The article considers network interaction of Russian universities to solve strategic problems of macroregions development. Network interaction is a common model of cooperation between universities abroad, and in recent years, in connection with the new challenges facing Russian education, it has become relevant for Russian universities. The article briefly presents the main forms of organization and methods of managing network interaction, its advantages over traditional types of joint activities of universities. Based on the four years of work in the framework of the Association “National Arctic Research and Education Consortium” (NAREC), the authors analyze the experience of cooperation between universities in the interests of the development of the Arctic zone of the Russian Federation. Four key areas of activity are considered: 1) expert and analytical support of personnel training and research; 2) Arctic-focused educational programs and projects; 3) support and promotion of scientific research on Arctic topics among students; 4) creation of joint information space. The article demonstrates the significant results of their implementation for each of these directions. These include monitoring the state of training of personnel with higher education and developing professional standards, developing educational products, including network programs and mass open online courses on Arctic topics, participating in international projects, conducting a national competition for student papers, as well as accumulating information related to training and research on Arctic topics. Based on the best practices of the Association “NAREC” and the difficulties encountered in the implementation of the network interaction model, the authors formulated practical recommendations for the development of interregional scientific and educational cooperation.

In the context of global competition, Russian universities search for the most efficient solutions to achieve competitiveness in the global market. The particular challenges that Russian universities face today include enhancing the quality of education and research, development of export potential, integration into international academic environment, diversification and search for new financial sources. The article considers international project activity as the most efficient tool of university internationalization process and solving the university tasks. Fundraising and international projects provide substantial support for achieving the set objectives in terms of both allocating additional financial resources and attracting intellectual capacity of international partners. Due to such features as practice orientation, time limits, and the ability to integrate different types and forms of international cooperation, the projects help university to address the challenges in a complex way and achieve multiple effects and, therefore, contribute significantly to developing world-demanded research, creating scholars networks and publishing, strengthening international partnerships, capacity building, enhancing academic mobility, developing the university campus and its infrastructure. The authors present the management model of international fundraising and projects implementation at Northern (Arctic) Federal University named after M. Lomonosov, describe specific features of carrying out research and educational projects in cross-cultural context (also within the framework of cross-border cooperation in Barents Euro-Arctic Region). The article outlines the competences required for successful project implementation, gives examples of NArFU international projects aimed at solving challenges in the Arctic Region. The efficiency of the given management model is analyzed, also by presenting the results of sociological survey made with involvement of the projects participants.

In the context of the transformation of education, characterized by the rapid obsolescence of knowledge, the increasing role of technological and social innovations, the globalization of the economy and education, it is becoming increasingly important to ensure successful cooperation between universities and business. At the same time, the state gains an advantage due to the rapid transfer of new knowledge, research and innovation, enterprises and organizations increase opportunities for effective development.The aim of the study is to identify the most successful forms of interaction between educational organizations and enterprises, the mechanisms of influence of the University on the development of the region of its location, participation in socio-economic processes. The problem is considered through the prism of the concept of the “third mission” for universities, which involves active interaction of educational organizations with society, including employers. Besides, the authors use the provisions of the theory of stakeholders, which describes the parameters taking into account the interests of various actors in the process of University management.On the example of the Northern (Arctic) Federal University named after M.V. Lomonosov, the article analyzes the existing experience and successful practices of organizing such interaction, as well as the emerging problems. The information base of the study was a survey on the satisfaction of employers with the quality of University graduates’ training, conducted in SAFU in 2019.As findings, the article states the main systemic problems of interaction between universities and the sphere of production such as the lack of coordinated strategies for training in various specialties, discrepancies in understanding the sets of competencies and skills of graduates, the fragmented university-industry interaction in research and development areas, different motivations and values.The authors come to a conclusion that the University must undergo a path of transformation to ensure strategic interaction with business and industry, including the development of a common “entrepreneurial” culture in the team, as well as the expansion of interaction with public institutions and socio-economic actors in the framework of the “third mission”.

Purpose. To evaluate an efficacy of trans-epithelial phototherapeutic keratectomy (PTK) in the treatment of persistent epithelial defects (PED) of the corneal graft following penetrating keratoplasty (PKP).Material and methods. Eight eyes of 8 patients (4 males and 4 females; mean age 51.2±14.3 years) were included into this study. This study included patients who had epithelial defects of the donor graft lasting more than 3 months and have failed previous treatment modalities (extended wear of soft contact lenses, amniotic membrane transplantation. All PTK procedures were performed using the EC-5000 excimer laser by the method similar to the previously described «wet» PTK.Results. The mean corrected distant visual acuity (CDVA) was 1.76±0.28 according to the logMAR preoperatively and improved significantly to 1.1±0.22 logMAR 10 days postoperatively (p=0.0156), remained stable during the mean follow-up of 5.1±2.0 months. Mean time from PTK to complete epithelization was 4.25±1.0 days.Conclusion. «Wet» phototherapeutic keratectomy seems to be effective for patients with PED of the corneal graft following PKP who have failed conservative measures or previous surgical interventions.

Purpose. To study topical 0.05% cyclosporine A as an adjunct to LASIK in patients with a high percentage of altered (corneal) tissue (PAT) and, consequently, with a high susceptibility risk to the post-LASIK dry eye syndrome.Material and methods. This study included 23 patients (48 eyes) with PTA≥0.4 (40%) ((PTA=(PFT+CAD)/PCT, PFT – predicted flap thickness, CAD – calculated ablation depth, PCT – preoperative corneal thickness). The patients were divided into 2 study groups: (1) standard postoperative treatment and an additional topical 0.05% cyclosporine A (3 months preoperatively and within 1 month postoperatively) and (2) standard postoperative treatment. Instability of surface regularity index (ISRI), tear production and corneal sensitivity were estimated 90±10 days preoperatively and 30±3 days postoperatively.Results. There was no statistically significant difference in ISRI, tear production and corneal sensitivity between the study groups at initial control point of investigation 90±10 days preoperatively. In the follow-up period of 30±3 days postoperatively the dynamics to an ISRI increase, a reduction of tear production and corneal sensitivity compared to preoperative values was detected in both groups. The ISRI was significantly higher in the group 2 compared to the group 1 (0.37±0.06 and 0.28±0.07, respectively, p=0.017), the tear production was significantly lower in the group 2 compared to group 1 (11.4±2.7mm and 13.8±3.6mm, respectively, p=0.021), the corneal sensitivity was significantly lower in the group 2 compared to the group 1 (34.9±5.7mm and 48.2±6.6mm,respectively, p=0.003).Conclusion. The topical application of 0.05% cyclosporine A as an pre- and post-operative adjunct to LASIK in the patients with the high PAT value (≥0.4 (40%)) reduces a severity of symptoms of post-LASIK dry eye syndrome.