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5. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial

Author

Butler, Javed, primary, Anker, Stefan D, additional, Lund, Lars H, additional, Coats, Andrew J S, additional, Filippatos, Gerasimos, additional, Siddiqi, Tariq Jamal, additional, Friede, Tim, additional, Fabien, Vincent, additional, Kosiborod, Mikhail, additional, Metra, Marco, additional, Piña, Ileana L, additional, Pinto, Fausto, additional, Rossignol, Patrick, additional, van der Meer, Peter, additional, Bahit, Cecilia, additional, Belohlavek, Jan, additional, Böhm, Michael, additional, Brugts, Jasper J, additional, Cleland, John G F, additional, Ezekowitz, Justin, additional, Bayes-Genis, Antoni, additional, Gotsman, Israel, additional, Goudev, Assen, additional, Khintibidze, Irakli, additional, Lindenfeld, Joann, additional, Mentz, Robert J, additional, Merkely, Bela, additional, Montes, Eliodoro Castro, additional, Mullens, Wilfried, additional, Nicolau, Jose C, additional, Parkhomenko, Aleksandr, additional, Ponikowski, Piotr, additional, Seferovic, Petar M, additional, Senni, Michele, additional, Shlyakhto, Evgeny, additional, Cohen-Solal, Alain, additional, Szecsödy, Peter, additional, Jensen, Klaus, additional, Dorigotti, Fabio, additional, Weir, Matthew R, additional, and Pitt, Bertram, additional

Published
2022
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7. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction:the DIAMOND trial

Author

Butler, Javed, Anker, Stefan D., Lund, Lars H., Coats, Andrew J.S., Filippatos, Gerasimos, Siddiqi, Tariq Jamal, Friede, Tim, Fabien, Vincent, Kosiborod, Mikhail, Metra, Marco, Piña, Ileana L., Pinto, Fausto, Rossignol, Patrick, van der Meer, Peter, Bahit, Cecilia, Belohlavek, Jan, Böhm, Michael, Brugts, Jasper J., Cleland, John G.F., Ezekowitz, Justin, Bayes-Genis, Antoni, Gotsman, Israel, Goudev, Assen, Khintibidze, Irakli, Lindenfeld, Joann, Mentz, Robert J., Merkely, Bela, Montes, Eliodoro Castro, Mullens, Wilfried, Nicolau, Jose C., Parkhomenko, Aleksandr, Ponikowski, Piotr, Seferovic, Petar M., Senni, Michele, Shlyakhto, Evgeny, Cohen-Solal, Alain, Szecsödy, Peter, Jensen, Klaus, Dorigotti, Fabio, Weir, Matthew R., Pitt, Bertram, Butler, Javed, Anker, Stefan D., Lund, Lars H., Coats, Andrew J.S., Filippatos, Gerasimos, Siddiqi, Tariq Jamal, Friede, Tim, Fabien, Vincent, Kosiborod, Mikhail, Metra, Marco, Piña, Ileana L., Pinto, Fausto, Rossignol, Patrick, van der Meer, Peter, Bahit, Cecilia, Belohlavek, Jan, Böhm, Michael, Brugts, Jasper J., Cleland, John G.F., Ezekowitz, Justin, Bayes-Genis, Antoni, Gotsman, Israel, Goudev, Assen, Khintibidze, Irakli, Lindenfeld, Joann, Mentz, Robert J., Merkely, Bela, Montes, Eliodoro Castro, Mullens, Wilfried, Nicolau, Jose C., Parkhomenko, Aleksandr, Ponikowski, Piotr, Seferovic, Petar M., Senni, Michele, Shlyakhto, Evgeny, Cohen-Solal, Alain, Szecsödy, Peter, Jensen, Klaus, Dorigotti, Fabio, Weir, Matthew R., and Pitt, Bertram

Abstract

AIMS: To investigate the impact of patiromer on the serum potassium level and its ability to enable specified target doses of renin-angiotensin-aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF). METHODS AND RESULTS: A total of 1642 patients with HFrEF and current or a history of RAASi-related hyperkalemia were screened and 1195 were enrolled in the run-in phase with patiromer and optimization of the RAASi therapy [≥50% recommended dose of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, and 50 mg of mineralocorticoid receptor antagonist (MRA) spironolactone or eplerenone]. Specified target doses of the RAASi therapy were achieved in 878 (84.6%) patients; 439 were randomized to patiromer and 439 to placebo. All patients, physicians, and outcome assessors were blinded to treatment assignment. The primary endpoint was between-group difference in the adjusted mean change in serum potassium. Five hierarchical secondary endpoints were assessed. At the end of treatment, the median (interquartile range) duration of follow-up was 27 (13-43) weeks, the adjusted mean change in potassium was +0.03 mmol/l in the patiromer group and +0.13 mmol/l in the placebo group [difference in the adjusted mean change between patiromer and placebo: -0.10 mmol/l (95% confidence interval, CI -0.13, 0.07); P < 0.001]. Risk of hyperkalemia >5.5 mmol/l [hazard ratio (HR) 0.63; 95% CI 0.45, 0.87; P = 0.006), reduction of MRA dose (HR 0.62; 95% CI 0.45, 0.87; P = 0.006), and total adjusted hyperkalemia events/100 person-years (77.7 vs. 118.2; HR 0.66; 95% CI 0.53, 0.81; P < 0.001) were lower with patiromer. Hyperkalemia-related morbidity-adjusted events (win ratio 1.53, P < 0.001) and total RAASi use score (win ratio 1.25, P = 0.048) favored the patiromer arm. Adverse events were similar between groups. CONCLUSION: Concurrent use of patiromer and high-dose MRAs re

Published
2022

9. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)

Author

Flather, Marcus D., Shibata, Marcelo C., Coats, Andrew J.S., Van Veldhuisen, Dirk J., Parkhomenko, Aleksandr, Borbola, Joszef, Cohen-Solal, Alain, Dumitrascu, Dan, Ferrari, Roberto, Lechat, Philippe, Soler-Soler, Jordi, Tavazzi, Luigi, Spinarova, Lenka, Toman, Jiri, Böhm, Michael, Anker, Stefan D., Thompson, Simon G., and Poole-Wilson, Philip A.

Published
2005

10. Demodulated standing solitary wave and DNA-RNA transcription

Author

Zdravković, Slobodan, Satarić, Miljko V., Parkhomenko, Aleksandr Yu., Bugay, Aleksandr N., Zdravković, Slobodan, Satarić, Miljko V., Parkhomenko, Aleksandr Yu., and Bugay, Aleksandr N.

Abstract

Nonlinear dynamics of DNA molecule at segments where DNA-RNA transcription occurs is studied. Our basic idea is that the solitary wave, moving along the chain, transforms into a demodulated one at these segments. The second idea is that the wave becomes a standing one due to interaction with DNA surrounding, e.g., RNA polymerase molecules. We explain why this is biologically convenient and show that our results match the experimental ones. In addition, we suggest how to experimentally determine crucial constant describing covalent bonds within DNA. © 2018 Author(s).

Published
2018

13. Results of Hydrochemical Monitoring of Sevastopol Black Sea's Offshore Waters.

Author

Parkhomenko, Aleksandr V., Kuftarkova, Elizaveta A., Subbotin, Aleksandr A., and Gubanov, Vladimir I.

Subjects
*COASTAL ecology, *COASTS, *SEASHORE
Abstract

The results of hydrochemical monitoring of ecological conditions of offshore Sevastopol (monitoring started in 1992) are shown (Parkhomenko et al., 2000). On the basis of 13 hydrochemical parameters (salinity, dissolved oxygen, pH, silicium, nitrite, nitrate, ammonium and organic nitrogen, phosphates and organic phosphorus, chlorophyll "a", biochemical oxygen demand (BOD), suspended matter) the quality characteristic of coastal water was obtained. During last years the improvement of ecological conditions of the investigated area was a result of the limitation of volume of noticeable industrial production and sewage waters. Trophic index (TRIX) of Sevastopol offshore water was calculated on the base of those results. TRIX calculations prove the above-mentioned trend of the quality improvement of Sevastopol offshore waters. These waters, according to the TRIX index, are classified as "intermediate", viz. between oligotrophic and mesotrophic. [ABSTRACT FROM AUTHOR]

Published
2003

14. Student ecological consciousness as determining component of ecological-oriented activity.

Author

Cherdymova, Elena I., Afanasjeva, Svetlana A., Parkhomenko, Aleksandr G., Ponyavina, Maria B., Yulova, Ekaterina S., Nesmeianova, Irina A., and Skutelnik, Oleg A.

Subjects
*ENVIRONMENTAL education, *CONSCIOUSNESS, *INFORMATION storage & retrieval systems, *ENVIRONMENTAL literacy, *ATTITUDES toward the environment
Abstract

The state of the issue: The current type of environmental consciousness determines the behavior of people in relation to the environment. Environmental education is a part of the integral pedagogical process of any educational institution, aimed at the systematic knowledge assimilation about the environment, society, development of practical skills and environmental activities. Environmental education is aimed at the formation of environmental culture of the individual to protect the environment. Material and Methods: The main method of research is testing, which promotes the study of environmental consciousness development level and its structural components among the students. Also in the process of research were used: methods of research and regulatory sources; sociopsychological diagnostics, psycho-diagnostic techniques; mathematical methods and methods of computer data processing. Results: The authors identified and justified the structural and content characteristics of environmental consciousness. The data obtained during the study of the structural components of the student environmental consciousness are compared. Individual ecological consciousness is understood by the authors as a relatively stable integral mental education of the subject, which is formed in the process of environmental training, characterized by the level of environmental knowledge, attitudes, relations to nature, intentions that determine a holistic environmentally-oriented behavior aimed at protecting the environment. Conclusions: The effective formation of ecological consciousness, in accordance with the requirements of modern society, can be when there is a designed diagnostic toolkit that allows monitoring at each stage of ecological consciousness formation. In the structure of individual ecological consciousness four structural components can be allocated: cognitive, valuablemotivational orientation, cognitive. [ABSTRACT FROM AUTHOR]

Published
2018

15. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction

Author

Javed Butler, Stefan D Anker, Lars H Lund, Andrew J S Coats, Gerasimos Filippatos, Tariq Jamal Siddiqi, Tim Friede, Vincent Fabien, Mikhail Kosiborod, Marco Metra, Ileana L Piña, Fausto Pinto, Patrick Rossignol, Peter van der Meer, Cecilia Bahit, Jan Belohlavek, Michael Böhm, Jasper J Brugts, John G F Cleland, Justin Ezekowitz, Antoni Bayes-Genis, Israel Gotsman, Assen Goudev, Irakli Khintibidze, Joann Lindenfeld, Robert J Mentz, Bela Merkely, Eliodoro Castro Montes, Wilfried Mullens, Jose C Nicolau, Aleksandr Parkhomenko, Piotr Ponikowski, Petar M Seferovic, Michele Senni, Evgeny Shlyakhto, Alain Cohen-Solal, Peter Szecsödy, Klaus Jensen, Fabio Dorigotti, Matthew R Weir, Bertram Pitt, Cardiology, Pinto, Fausto J./0000-0002-8034-4529, Lund, Lars H/0000-0003-1411-4482, Metra, Marco/0000-0001-6691-8568, Friede, Tim/0000-0001-5347-7441, Butler, Javed, Anker, Stefan D., Lund, Lars H., Coats, Andrew J. S., Filippatos, Gerasimos, Siddiqi, Tariq Jamal, Friede, Tim, Fabien, Vincent, Kosiborod, Mikhail, Metra, Marco, Pina, Ileana L., Pinto, Fausto, Rossignol, Patrick, van der Meer, Peter, Bahit, Cecilia, Belohlavek, Jan, Boehm, Michael, Brugts, Jasper J., Cleland, John G. F., Ezekowitz, Justin, Bayes-Genis, Antoni, Gotsman, Israel, Goudev, Assen, Khintibidze, Irakli, Lindenfeld, Joann, Mentz, Robert J., Merkely, Bela, Montes, Eliodoro Castro, MULLENS, Wilfried, Nicolau, Jose C., Parkhomenko, Aleksandr, Ponikowski, Piotr, Seferovic, Petar M., Senni, Michele, Shlyakhto, Evgeny, Cohen-Solal, Alain, Szecsoedy, Peter, Jensen, Klaus, Dorigotti, Fabio, Weir, Matthew R., Pitt, Bertram, Cardiovascular Centre (CVC), and Restoring Organ Function by Means of Regenerative Medicine (REGENERATE)

Subjects
Heart Failure, RANDOMIZED ALDACTONE EVALUATION, renin-angiotensin-aldosterone system inhibitors (RAASi), Stroke Volume, KIDNEY-DISEASE, Heart failure with reduced ejection fraction, Patiromer, SPIRONOLACTONE, THERAPY, Hyperkalemia, Potassium-binding polymer, Renin-Angiotensin System, Potassium, Renin-angiotensin-aldosterone system inhibitor (RAASi), Humans, Cardiology and Cardiovascular Medicine, INHIBITORS, Mineralocorticoid Receptor Antagonists
Abstract

Aims To investigate the impact of patiromer on the serum potassium level and its ability to enable specified target doses of renin–angiotensin–aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF). Methods and results A total of 1642 patients with HFrEF and current or a history of RAASi-related hyperkalemia were screened and 1195 were enrolled in the run-in phase with patiromer and optimization of the RAASi therapy [≥50% recommended dose of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, and 50 mg of mineralocorticoid receptor antagonist (MRA) spironolactone or eplerenone]. Specified target doses of the RAASi therapy were achieved in 878 (84.6%) patients; 439 were randomized to patiromer and 439 to placebo. All patients, physicians, and outcome assessors were blinded to treatment assignment. The primary endpoint was between-group difference in the adjusted mean change in serum potassium. Five hierarchical secondary endpoints were assessed. At the end of treatment, the median (interquartile range) duration of follow-up was 27 (13–43) weeks, the adjusted mean change in potassium was +0.03 mmol/l in the patiromer group and +0.13 mmol/l in the placebo group [difference in the adjusted mean change between patiromer and placebo: −0.10 mmol/l (95% confidence interval, CI −0.13, 0.07); P < 0.001]. Risk of hyperkalemia >5.5 mmol/l [hazard ratio (HR) 0.63; 95% CI 0.45, 0.87; P = 0.006), reduction of MRA dose (HR 0.62; 95% CI 0.45, 0.87; P = 0.006), and total adjusted hyperkalemia events/100 person-years (77.7 vs. 118.2; HR 0.66; 95% CI 0.53, 0.81; P < 0.001) were lower with patiromer. Hyperkalemia-related morbidity-adjusted events (win ratio 1.53, P < 0.001) and total RAASi use score (win ratio 1.25, P = 0.048) favored the patiromer arm. Adverse events were similar between groups. Conclusion Concurrent use of patiromer and high-dose MRAs reduces the risk of recurrent hyperkalemia (ClinicalTrials.gov: NCT03888066).

Published
2022

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