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Aim. To evaluate the contribution of arterial hypertension (AH), high lowdensity lipoprotein cholesterol (LDL-C) level and their combination to the development of (myocardial infarction) MI and stroke.Material and methods. The analysis is based on data from 1 and 2 observations of ESSE-RF study (Epidemiology of cardiovascular diseases in various regions of the Russian Federation)". A multi-s tage cluster random sample was used, formed according to the territorial principle on the basis of medical and preventive institutions (health facilities). Socio-demographic data (gender, age, education, wealth), smoking status and medical history were determined. Blood pressure (BP) was measured twice, on the right arm, in a sitting position with an automatic blood pressure monitor. Blood samples and its derivatives (serum and plasma) were stored at a temperature of -70ºC. LDL-C value was also included into analysis (LDl- C ≥3 mmol/l). Prospective monitoring of new cases was carried out in the initial sample without patients with coronary artery disease, MI, and stroke. The median follow-up time is 7.5 years. The sample size was 19 794. 356 non-fatal cases were identified, including 222 cases of MI and 174 cases of stroke.Results. The average age was 44.7 years, in men — 43.2, and in women — 45.3. The prevalence of isolated forms of hypertension, high LDL-C level and its combination were 12.7%, 30.3% and 32%, respectively. It was revealed that the age was the lowest in healthy and those with an increased LDL-C, whereas those with hypertension and combined conditions were older. The risk of nonfatal cases of MI and stroke in the Cox models, was adjusted for gender, age and region. There was a significantly higher risk of new cases of nonfatal CVD in individuals with isolated hypertension compared with those with isolated LDL-C.Conclusion. The frequency of isolated AH and isolated LDL-C were 13% and 30%, respectively. The combined condition was detected in 30%. The presence of AH, isolated LDL-C and their combinations in the sample doubled the risk of new CVD events.

Background. Among patients who have undergone coronary artery bypass surgery (CABG), the proportion of people with diabetes mellitus (DM) is about 40 %. To date, the problem of choosing the optimal method of surgical myocardial revascularization, which can provide the best result in this cohort, remains completely unresolved. The aim of the study. To assess the in-hospital and long-term results of bimammary and traditional bypass surgery in patients with type 2 diabetes mellitus. Methods. From September 2018 to December 2021, 176 CABG surgeries were performed in patients with coronary heart disease (CHD) and type 2 diabetes at the Federal Center for Cardiovascular Surgery (Krasnoyarsk). Group 1 (n = 45) included patients who underwent myocardial revascularization using two mammary arteries; group 2 (n = 131) included patients who underwent myocardial revascularization using traditional technique. After propensity score matching, 45 patients were selected into each group, comparable by basic preoperative characteristics. Results. In group 1, cardiopulmonary bypass surgeries were performed in 23 (51.1 %) patients (group 1CPB), off-pump surgeries – in 22 (58.2 %) (group 1OP); in group 2, all patients underwent cardiopulmonary bypass surgeries. Hospital mortality was recorded in group 2 in 1 (2.2 %) case. Deep sternal infection developed in 1 (4.5 %) patient in group 1OP. Long-term survival in group 2 was 85.3 %, in group 1CPB – 83.3 % (p = 0.689), in group 1OP – 84.2 % (p = 0.739). 84.2 % of patients in group 2 and 100 % in groups 1CPB and 1OP had no cardiovascular events (p = 0.144 and p = 0.145, respectively). Conclusion. Bimammary bypass surgery in patients with type 2 diabetes is a safe and effective method of surgical treatment of coronary artery disease in both shortand long-term period and may be the operation of choice in patients with multivessel disease. There were no differences in patient survival up to 45 months; bimammary revascularization was associated with 100 % absence of cardiac mortality.

Aim. To evaluate the long-term results of complete bilateral internal thoracic artery (BITA) grafting and traditional coronary bypass grafting (CABG) in patients with multivessel CAD.Material and methods. From June 2018 to December 2021, 646 CABG operations were performed in patients with multivessel CAD at the Federal Center for Cardiovascular Surgery (Krasnoyarsk). There were 178 patients receiving BITA grafting and 468 — traditional revascularization technique. After propensity score matching, 356 patients were selected, of which 99 had on-pump BITA (group 1), 178 — on-pump traditional revascularization (group 2), and 79 — off-pump BITA (group 3). There were more males (p=0,143 and p=0,547). The groups were comparable in age (p=0,343 and p=0,104), body mass index (p=0,532 and p=0,759), diabetes (p= 0,705 and p=0,667), the number of hemodynamically significant coronary stenoses (p=0,370 and p=0,595).Results. The follow-up period lasted 32,8±8,52 months. Long-term patient survival was 83,9% in group 2,93% in group 1 (p=0,041) and 94% in group 3 (p=0,039). Freedom from cardiovascular mortality was 100% in both groups of BITA grafting and 92,5% in group 2 (p=0,001 and p=0,039), freedom from major cardiovascular events was 94,2% in group 1, 85,1% in group 2 and 98,5% in group 3 (p=0,032 and p=0,03).Conclusion. BITA grafting is a modern effective and safe method of surgical myocardial revascularization both on- and off-pump. Up to 33 months. BITA grafting was associated with significantly better patient survival, complete freedom from cardiovascular mortality and a lower incidence of major cardiovascular events.

Aim. To perform a population analysis of Non-High Density Lipoprotein Cholesterol level (non-HDL-c) in Russian population and to evaluate its association with cardiovascular events.Material and Methods. The material consisted of results obtained from 11 regions of the ESSE-RF1 Study and from 4 regions of the ESSE-RF2 Study. Study protocols were identical. The studies were performed in 2012-2014 and 2017, respectively. Endpoints were assessed in 19041 people aged 35-64 years. The median follow-up was 6.5 years in ESSE RF (1) and 3.8 years in ESSE RF(2). Analysis was performed for three lipid variables: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-HDLC in two samples: the general population sample and the same sample without individuals with coronary heart disease (CHD), myocardial infarction (MI) and/or stroke history and not taking statins (the population sample of "without a history of cardiovascular diseases [CVD]". The analysis of nonlinear associations was performed using the generalized additive Cox model. The combined cardiovascular endpoint was represented by cardiovascular death and nonfatal MI and stroke. Traditional and laboratory FRs, socio-demographic parameters were analyzed. The significance level for all tested hypotheses was set to be 0.05.Results. The prevalence of elevated non-HDL-C level (>3.7 mmol/l) was found to be 74.6%. No gender differences were found: there was 74.6% for men and 74.5% for women. Both mean values and prevalence of elevated non-HDL-C were increased with age in women, and its level was slightly decreased in men after 55 years old. Almost all analyzed RFs were significantly associated with elevated non-HDL-C in these two population samples. In both samples elevated total CH and elevated LDL-C were associated with all-cause mortality after correction for all RFs. On the contrary, the non-HDL-C was associated with CVD combined end pints. It has been shown that the risk of these end points increases uniformly with increase in levels of non HDL cholesterol, no nonlinear associations were found.Conclusion. The results of a population-based analysis of non-HDL-C performed in the Russian population for the first time confirmed that elevated non-HDL-C levels contribute significantly to determining the risk of cardiovascular events in the medium term. It can be assumed that the new risk scales (SCORE2 and SCORE OP) proposed by the European Society of Cardiology and the European Society of Preventive Cardiology, which include non-HDL C instead of TC, will allow adequate assessment of 10-year cardiovascular risk for Russians. However, continued monitoring of endpoints in order to obtain stable associations is required.

Aim. To study the prevalence of myocardial infarction (MI) in the population of Russian regions and its contribution to cardiovascular events.Material and methods. The analysis material was representative samples of the population aged 35-64 years from 11 Russian regions, examined within the multicenter study “Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation”. The response rate was about 80%. The study used a community-based systematic stratified multiply random sample. During the study, information on prior MI was obtained using a standard questionnaire. Anthropometry and measurement of blood pressure (BP) and heart rate (HR) with an automatic BP monitor were performed. Resting electrocardiography (ECG) was performed, followed by Minnesota coding. Major and minor QQS waves and STT segments were considered as ischemic ECG abnormalities. Biochemical parameters were determined using an Arkhitect 000 Clinical Chemistry Analyzer. The median prospective follow-up was 6,21 [5,25; 6,75] years. A composite endpoint (CE) was analyzed, including cardiovascular death and non-fatal MI. During the follow-up period, 363 all-cause deaths were detected, of which 134 were from cardiovascular diseases, while 196 — CEs. Statistical analysis was carried out in R 3.6.1 environment.Results. The MI prevalence among the Russian population was 2,9%; 5,2% for men and 1,5% for women, increasing with age. Men with prior MI were more likely to take statins and beta-blockers than women as follows: 39,0% vs 25,6% and 29,3% vs 27,1%, respectively. MI newly diagnosed within the follow-up period was associated with the following risk factors (RFs): smoking, increased BP, HR, triglycerides and glucose. For individuals with prior MI, a significant relationship was found only with smoking. Multiple comparison of the contribution of RFs, ECG abnormalities, and prior MI showed that the inclusion of ischemic ECG abnormalities in the analysis significantly increases the risk of cardiovascular events in individuals without prior MI compared with individuals without both MI and ECG changes. A high CE risk was noted in patients with prior MI: relative risk (RR), 4,73 (2,92-7,65); the addition of ischemic ECG abnormalities increased the RR to 5,75 (3,76-8,8).Conclusion. The RR of CEs in patients with prior MI without or with ischemic ECG changes is 4,73 and 5,75 times higher than in patients without MI and ECG abnormalities. The risk factors identified in this case cannot explain such an increase in CEs. It is obvious that people with prior MI need rehabilitation. The presence of RFs in patients with newly diagnosed MI indicates insufficient primary prevention, which suggests that strengthening preventive measures to eliminate conventional risk factors in patients with newly diagnosed MI will help reduce the risk of recurrent MI or cardiovascular mortality.

Aim. To study the prevalence of carbohydrate metabolism disorders in a repre - sentative sample of the working-age population of the Krasnoyarsk Krai aged 25-64 years and to identify the association of these disorders with cardiovascular pathology.Material and methods. A random representative sample within the all-Russian epidemiological study ESSE-RF included 1603 residents of the Krasnoyarsk Krai aged 25 to 64 years. The gradation of carbohydrate metabolism disorders was carried out on the basis of fasting plasma glucose level in accordance with the criteria of the American Diabetes Association (ADA). Hypertension (HTN) was defined as office BP ≥140/90 mm Hg or an indication of previous use of antihypertensive drugs. The presence of myocardial infarction (MI), stroke, coronary artery disease (CAD) was detected by anamnesis collection. Statistical processing was carried out using IBM SPSS v 22 and Microsoft Excel 2021 programs. When comparing differences by sex, age, level of education, and type of residence, differences was assessed by chi-squared test and considered significant at p≤0,05.Results. In total representative sample of Krasnoyarsk Krai population, 3,6% of participants indicated prior diabetes, while its prevalence naturally increased with age. The detection rate of fasting glucose of 5,6-6,9 mmol/l among individuals without prior diabetes (impaired fasting glycemia (IFG), as one of the criteria for prediabetes, according to ADA guidelines) was 22,5% of the general population. Fasting hyperglycemia (HG) ≥7,0 mmol/l without prior diabetes was registered in 3,8%. This figure can be roughly considered as the proportion of people with newly diagnosed diabetes. IFG and HG were significantly more common among men, as well as among those with primary and secondary education compared with higher education. In rural residents, all types of carbohydrate metabolism disorders were more common than in urban ones. Compared with the normoglycemic group, the presence of prior diabetes, IFG and GH was associated with a significantly higher prevalence of hypertension, CAD and stroke.Conclusion. The prevalence of IFG, fasting HG ≥7,0 mmol/l and diagnosed diabetes in a representative sample of the Krasnoyarsk Krai aged 25-64 years exceeds the national average, although it is consistent with the data of a number of other Siberian regions. The prevalence of both carbohydrate metabolism disorders in general and the percentage of possible undiagnosed diabetes increases with age. At the same time, there are more such individuals among those with primary and secondary education, as well as among rural residents. The approximate proportion of undiagnosed diabetes in the study population reaches 50%. Timely detection of carbohydrate metabolism disorders can contribute to the earlier implementation of active preventive measures and reduce the risk of cardiovascular events.

Aim. Using a representative sample of the Krasnoyarsk Krai population, to evaluate the distribution of the atherogenic index of plasma (AIP), logarithmically transformed ratio of molar concentrations of triglycerides to high-density lipoprotein-cholesterol, and to identify possible associations between AIP, various cardiovascular diseases, and metabolic parameters.Material and methods. The study included a random representative sample of 1603 residents of the Krasnoyarsk and Berezovsky rural district aged 25-64 years as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Statistical processing was performed using IBM SPSS v22 and Microsoft Excel 2021 programs. We assessed the prevalence of hypertension (HTN), coronary artery disease, myocardial infarction (MI), stroke and renal dysfunction in the whole sample and in groups with different risk depending on AIP. Differences between groups were tested by Yates’s chi-squared test and were considered significant at p≤0,05.Results. Depending on AIP value, 73,5% of participants were in the low-risk group (AIP 0,24). The prevalence of prior MI or stroke in the moderate and high-risk group for AIP was significantly higher than in the low-risk group (p=0,024). A regular increase in HTN prevalence was registered from 42,6% in the lowrisk group to 71,4% in the high-risk group for AIP (p

Aim. To study the relationship between the levels of synthesis of reactive oxygen species (ROS) by platelets and neutrophils in patients with coronary heart disease (CHD) before and after coronary artery bypass grafting (CABG), depending on sensitivity to acetylsalicylic acid (ASA).Material and methods. The study included 95 patients with coronary artery disease who are indicated for CABG surgery. The control group consisted of 30 healthy donors. The antiplatelet therapy was stopped for at least 5 days before CABG. In the postoperative period, from the first day, all patients were received 100 mg of an enteric form of acetylsalicylic acid (ASA). Resistance to ASA was determined at the level of platelet aggregation with arachidonic acid ≥20% by optical agregometry at least at one observation point: before CABG, on 1-3 day and on 8-10 day after surgery. We evaluated the spontaneous and induced lucigenin-dependent chemiluminescence (CL) of platelets (ADP induction) and neutrophils (zymosan induction) by the exit time to maximum intensity (Tmax), maximum intensity (Imax) and area (S) under the CL curve.Results. 70.5% sensitive (sASA) and 29.5% resistant (rASA) to ASA patients were revealed. Prior to CABG, in sASA patients, the Imax of spontaneous and zymosan-induced neutrophil CL and CL platelet activity was increased relative to control values. Tmax of spontaneous platelet CL, Imax and S under the ADP-induced platelet CL curve were lower in sASA patients, if to compare with rASA patients. On the 1st and 8-10th day after CABG in sASA patients, the CL indicators of neutrophil and platelet activity also remained elevated compared to control values. On the 1st day after CABG decreased levels of S under the spontaneous CL curve of neutrophils in rASA patients was established compared with sASA patients, and increased levels of Imax and S under the curve of induced neutrophil CL were detected in comparison with the control range. In rASA patients, the values of Tmax of spontaneous platelet CL decreased in relation to the values detected in the control group and sASA patients. On the 8–10th day after CABG, most indicators of spontaneous and zymosan-induced CL neutrophils in rASA patients were also increased compared to control values. In rASA patients a positive correlation of Imax-induced CL was found (r=0.83) on the 1st day after CABG and negative correlations of Tmax of spontaneous CL (r=- 0.75) and S under the curve induced CL (r=-0.70) on the 8-10th day were detected between platelets and neutrophils.Conclusion. In sASA patients with coronary heart disease before and after CABG, a high level of synthesis of superoxide radical by neutrophils and platelets was detected. The relationship between the levels of the synthesis of superoxide radical by neutrophils and platelets was found only after CABG in rASA patients. Increased synthesis of superoxide radical due to metabolic and regulatory relationships in neutrophils and platelets stimulates pro-inflammatory processes in coronary artery disease and determines the sensitivity of platelets to ASA.

Aim. To study the relationship of blood pressure (BP) and heart rate (HR) in a sample of men and women 25-64 years old and their predictive value for the development of fatal and non-fatal cardiovascular diseases (CVD) and mortality from all causes.Material and methods. Prospective observation was for cohorts of the population aged 25-64 years from 11 regions of the Russian Federation. 18,251 people were included in the analysis. Each participant gave written informed consent. All surveyed persons were interviewed with a standard questionnaire. BP was measured on the right hand with an automatic tonometer. BP and HR were measured twice with an interval of 2-3 min with the calculation of the average value. The patients were divided into 4 groups: the first group with BP80; the third group – BP≥140/90 mm Hg and HR≤80; the fourth group – BP≥140/90 mm Hg and HR>80 beats/min. Risk factors and cardiovascular history were analyzed as well. Deaths over 6 years of follow-up occurred in 393 people (141 – from CVD). Statistical analysis was performed using the open source R3.6.1 system.Results. A HR>80 beats/min was found in 26.3% of people with BP≥140/90 mm Hg, regardless of medication. Analysis of the associations between HR and BP showed that for every increase in HR by 10 beats/min, systolic BP increases by 3 mm Hg. (p80 beats/min and BP≥140/90 mm Hg had the shortest life expectancy (p80 beats/min in people with BP≥140 mm Hg amounted to 26.34%. Every 10 beats/min significantly increases the risk of mortality by 22%. Increased HR with elevated BP leads to increased adverse outcomes.

Abstract VICTORY II study objective. Evaluation of Vamloset and Co-Vamloset safety and effectiveness in reaching target blood pressure (BP) level in patients with stages 23 arterial hypertension (AH). Materials and methods. Russian multicenter prospective clinical study conducted in 8 clinical centers in 6 cities in Russian Federation included 103 patients over 18 years of age with diagnosed essential hypertension of stages 23 (in accordance with 2013 European guidelines) who previously did not receive treatment (with office systolic BP sBP160 mm Hg and/or office diastolic BP dBP100 mmHg) or did not achieve target BP levels after receiving mono- or dual therapy. Office BP target levels comprised 139 mmHg for sBP and 89 mm Hg for dBP for patients without diabetes mellitus (DM), and 139 mm Hg for sBP and 84 mm Hg for dBP for patients with DM. All patients with stage 2 AH (group 1) were prescribed Vamloset (amlodipine/valsartan, 5/80 mg), patients with stage 3 AH Vamloset (amlodipine/valsartan, 5/160 mg). Therapy correction Vamloset (amlodipine/valsartan) in doses 5/160 mg, 10/160 mg and Co-Vamloset (amlodipine/valsartan/hydrochlorothiazide) in doses 10/160/12,5 mg, 10/160/25 mg (КРКА-RUS) was performed every 4 weeks according to provided schemes. At follow-up every 4 weeks the decision on necessity of antihypertensive treatment (AHT) correction were made by medical researcher in accordance with analysis of patients complaints, general condition and physical examination, results of office BP measurement, diary of BP self-control. In 40 patients in subgroup with additional assessment 24-hour BP monitoring, pulse wave velocity measurement, central BP evaluation, augmentation index calculation, and endothelium damage markers determination were performed. Results. Active phase of the study included 100 patients aged 59.510.9 years (59% female) suffering from AH for 83.48.4 months. The patients received treatment with study medication (safety population). The protocol population (sampling Per Protocol) included 80 patients who completed the study without severe protocol violation. At the moment of study entrance 83% of patients received AHT. In all patients treatment duration comprised 15.9 weeks. In Per Protocol population target office BP level was achieved by 90.0% (95% confidence interval 81.295.6%) of the patients. Overall clinical effectiveness (extremely high, very high, high, and sufficient) was achieved in 98.8% [95% confidence interval 93.2100%] of the patients. In group of patients with stage 2 AH target office BP level was achieved by 93.8% of patients, in group with stage 3 AH by 84.4% of patients. Mean BP change in study group was -32.2 mm Hg for SBP and -16.0 mm Hg for DBP. Among patients with stage 2 AH target office BP level was achieved by 93.8% of patients, with mean BP change -30,7 mm Hg for SBP and -15.5 mm Hg for DBP. In patients with stage 3 AH target BP levels were achieved in 84.4% of patients with mean BP change -34,6 mm Hg for SBP and -16.7 mm Hg for DBP. After 16 weeks of treatment in Full Analysis Set population with recovery of missed measures using Last Observation Carried Forward 40.2% of patients reached target BP levels according to BP self-control results. Considering the limitations of results evaluation this practice requires further assessment, standardization, and improvement. According to 24-hour BP monitoring reaults after 16 weeks of treatment 26.5% of patients achieved target BP daily profile (for patients from subgroup with additional assessment in Full Analysis Set population with recovery of missed measures using Last Observation Carried Forward), that indicates additional influence of studied AHT on the prognosis of patients with stages 23 AH. Conclusion. In clinical study VICTORY II Vamloset and Co-Vamloset optimal effectiveness and safety in patients with stage 2 and 3 arterial hypertension were shown.

Aim. To study the prevalence of familial hypercholesterolemia (FH), the characteristics of the clinical features and treatment of the disease in selected regions of the Russian Federation, this article describes the design and initial characteristics of patients included in the study.Material and methods. The study participants were selected among those included in the study “Epidemiology of cardiovascular risk factors and diseases in the regions of the Russian Federation” (ESSE-RF) in different regions of the Russian Federation. The study included individuals with lowdensity lipoprotein cholesterol (LDL-C) levels >4.9 mmol/l or LDL-C levels >1.8 mmol/l, but ≤4.9 mmol/l during statin therapy, according to the data obtained in the ESSE-RF study. These persons are invited for examination and questioning by experts in the field of FH diagnostics. On the basis of the survey data and provided medical documentation, the following information is collected: age, sex, smoking status, presence of hypertension, history of coronary artery disease, stroke, atherosclerosis of cerebral and peripheral arteries, LDL-C level, type, volume and duration of lipid-lowering therapy throughout life, presence and dates of secondary causes of hyperlipidemia, information about the family history of development of early cardiovascular diseases and atherosclerotic diseases, increased levels of LDL-C in relatives of the 1st and 2nd degree of kinship. All patients are examined for the presence of tendon xanthomas (Achilles, metacarpal, elbow, knee tendons) and Corneal arcus. During the visit, blood is taken for subsequent biobanking, measurement of current blood lipid levels, elimination of secondary forms of hypercholesterolemia (for subsequent determination of liver enzymes, thyroid stimulating hormone) and genetic testing. The diagnosis of FH is based on Dutch Lipid Clinical Network Criteria (DLCN). Besides, all participants in the study are tested for compliance with the diagnosis of FH according to Simon Broome criteria. All patients with a definite or probable diagnosis of FH according to DLCN or Simon Broome criteria are subjected to ultrasound examination of carotid, femoral arteries and heart and molecular genetic testing for LDLR, APOB and PCSK9 gene variants.Results. Out of 16 360 participants of the ESSE-RF study in 10 regions, 1787 people (10,9%) met the criteria for inclusion in this study. Among them, men accounted for 35.4%, of which 1150 (7%) patients had a LDL-C level >4.9 mmol/l and 637 (3,9%) had a LDL-C level from 1,81 mmol/l to 4.9 mmol/l during lipid-lowering therapy. When compared to the original cohorts of participants from the 10 regions as compared to 3 previously surveyed regions and selected sub-groups within these cohorts we observed significant differences in several parameters such as age, total cholesterol level, triglycerides, LDL-C, the frequency of cardiovascular diseases, that may indicate regional differences in FH prevalence.Conclusion. The analysis of clinical data of the participants of the ESSE-RF study shows that more than 10% of individuals require an additional examination to verify the FH diagnosis, and regional differences in the FH prevalence are possible.

Aim. To study the contribution of hypertension (HTN) to survival and mortality in the Russian population.Material and methods. This prospective observational cohort included representative samples from 11 Russian regions (men and women aged 25-64 years, n=18251) examined in 2012-2014 as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. The examination included a questionnaire (12 modules), anthropometric and blood pressure (BP) measurements, as well as biochemical blood tests. HTN was considered aa a systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or when a subject receives antihypertensives. Treatment efficacy was considered as the proportion of persons (%) who achieved target BP among those taking antihypertensives. Depending on HTN status, all participants were divided into 4 groups: 1) those without HTN;2) those with HTN, taking antihypertensive agents and having systolic BP ≤140 mm H. and diastolic BP ≤90 mm Hg (effective therapy);3) those with HTN, taking medications, but not achieving target BP (ineffective therapy); 4) those with HTN, not taking antihypertensives. The life status of participants was updated every 2 years. Kaplan-Meier survival curves, as well as univariate and multivariate Cox proportional hazards models were created.Results. The presence of HTN significantly reduced survival (p

Aim. To study the associations of subclinical and clinical anxiety and depression, assesed by the Hospital Anxiety and Depression Scale (HADS), ≥8 points and ≥11 points, respectively, with all-cause mortality and cardiovascular mortality, as well as with the total number of nonfatal cardiovascular events (CVEs) in Russia.Material and methods. The study included male and female population aged 25-64 years from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study who signed an informed consent. The study included 16941 people (men, 6811 (40,2%)). To assess the anxiety and depression, HADS scale was used. The statistical analysis included individuals with subclinical/clinical (HADS ≥8) and clinical (HADS ≥11) anxiety and depression (HADS-A and HADS-D). The median of prospective follow-up was 5,5 years (from 2012 to 2019). The composite endpoint (CE) (cardiovascular death and nonfatal CVE occurred in 268 (4,2%) men and 203 (2,1%) women, while all-cause — in 220 (3,2%) men and 152 (1,5%) women.Results. The results obtained showed that the survival rate of men and women with varying degrees of anxiety (HADS-A ≥8 and ≥11) was associated with all-cause mortality and CE in women. However, this relationship has not been confirmed in multivariate models. In the multivariate Cox proportional hazards model 1 (M1), a significant association of depression with all-cause mortality in women was revealed — HADS-D ≥8: relative risk (RR), 2,22; 95% confidence interval (CI): 1,56-3,15 and ≥11: RR, 2,43; 95% CI: 1,65-3,59 (p

Aim. To study the production of reactive oxygen species (ROS) by platelets in patients with coronary artery disease (CAD) before and after coronary artery bypass grafting (CABG), depending on their sensitivity to acetylsalicylic acid (ASA) as a part of ASA monotherapy and dual antiplatelet therapy (DAPT) (ASA+clopidogrel).Material and methods. The study included 104 patients with CAD (ASA monotherapy, 64 patients; DAPT, 40 patients). From day 1 after CABG, they took 100 mg a day of enteric-coated ASA. In the DAPT group, clopidogrel was prescribed for 2-3 days after CABG. All measurements were performed before surgery, on the 1st day and days 8-10 after surgery. Control group consisted of 36 healthy donors. Resistance to ASA was determined at a level of optical platelet aggregation with arachidonic acid >20% at least at one observation point. The spontaneous and ADP-induced chemiluminescence (CL) of platelets with luminol and lucigenin was assessed according to the following parameters: time to maximum intensity (Tmax), maximum intensity (Imax), area (S) under the CL curve, and the ratio of ADP-induced CL S to spontaneous CL S.Results. Throughout the study, 71 patients with CAD were sensitive to ASA (sASA) (ASA monotherapy, 46 patients; DAPT, 25 patients), three patients — resistant (rASA) (ASA monotherapy, 1; DAPT, 2). Sensitivity of other 30 patients (ASA monotherapy, 17; DAPT, 13) changed in different follow-up periods. Compared to the control group, sASA patients had increased values of platelet CL parameters throughout the study, while in the rASA group (ASA monotherapy), Tmax was higher before CABG, and in the rASA group (ASA therapy+clopidogrel), Imax and S were higher on the first day after CABG, while Imax — on days 8-10 after CABG. Compared to sASA, the values of S and Imax before CABG, Imax after CABG, as well as Imax and S on the days 8-10 after CABG in rASA (ASA monotherapy) were significantly lower, while in rASA (ASA therapy+clopidogrel), only the Tmax values were lower on the 8-10 days after CABG.Conclusion. In patients with CAD, depending on the sensitivity to ASA and antiplatelet therapy after CABG, the metabolic activity of platelets in terms of ROS production differs. In sASA patients, ROS synthesis is higher than in healthy individuals, while, in rASA patients (ASA monotherapy), platelets produce ROS levels lower than in sASA. CABG surgery and the addition of clopidogrel to ASA therapy leads to increased ROS production in rASA patients in the postoperative period.

Aim. To study the prevalence of a combination of two major cardiovascular risk factors, hypertension (HTN) and lipid metabolism disorders, among the Krasnoyarsk Krai population as a whole, as well as among men and women in different age groups.Material and methods. We analyzed the data from a random representative sample of 1603 residents of the Krasnoyarsk city and Berezovsky district aged 25-64 years within the ESSE-RF epidemiological study. Statistical processing was performed using IBMSPSS 22 and Microsoft Office Excel 2007. The proportion of people with hypertension and dyslipidemia and 95% confidence intervals was calculated. The significance of differences in the prevalence of hypertension and dyslipidemia was tested using the chi-squared test with Yates’ correction. Differences were considered significant at p≤0,05.Results. The prevalence of a combination of HTN and any dyslipidemia was 40%, HTN + hypercholesterolemia — 31,6%, HTN + high low density lipoprotein cholesterol (LDL-C) — 32,3%, HTN + hypertriglyceridemia — 16,4%, HTN + reduced high density lipoprotein cholesterol (HDL-C) — 10,8%. This characteristic increased with age. The prevalence of a combination of HTN with hypercholesterolemia, with an increased LDL-C level, as well as HTN with any dyslipidemia in women aged 55-64 years was significantly higher than in men.Conclusion. The prevalence of a combination of HTN with any dyslipidemia in the Krasnoyarsk Krai among the adult population aged 25-64 years was 40% and increased with age. In women aged 55-64 years, the prevalence of a combination of HTN with hypercholesterolemia, with an increased LDL-C level, as well as HTN with any dyslipidemia was significantly higher than in men.

Aim. To study the association of T715P (rs6136), M62I (rs2228315), S290N (rs6131), V640L (rs6133) polymorphisms in the P-selectin gene with resistance to acetylsalicylic acid (ASA) in patients with coronary artery disease after coronary artery bypass grafting (CABG).Material and methods. The study included 90 patients aged 61,5±6,9 years (70 men and 20 women) with II-IV functional class (FC) angina pectoris, according to the Canadian Cardiovascular Society grading. The atherosclerotic nature of coronary artery disease is confirmed by coronary angiography. Patients stopped taking antiplatelet agents before CABG for at least 5 days. The aggregation study was carried out with an optical aggregometer using ADP inducers (5 pM) and arachidonic acid (1 µМ) before CABG, on 1-3 and 8-10 days after surgical treatment.DNA samples were examined for the presence of T715P (rs6136), M62I (rs2228315), S290N (rs6131), V640L (rs6133) polymorphisms in the P-selectin gene using realtime PCR with allele-specific primers.Results. When comparing aPTT, fibrinogen level, platelet aggregation activity with ADP inducers (5 µМ) and arachidonic acid (1 µМ), no differences were found among groups of patients with homozygous and heterozygous variants of the studied polymorphisms genotypes, both before and on 1-3, 8 -10 days after CABG. Regarding presence of ASA resistance, patient groups with homozygous variants of genotypes (T715P (rs6136), M62I (rs2228315), S290N (rs6131), V640L (rs6133)) did not statistically differ in prevailing or rare alleles from the corresponding groups with heterozygous genotypes. In the first 10 days of the postoperative period, thrombotic events (4,4%) were observed in 4 patients in the study group: acute myocardial infarction, acute cerebrovascular accident. Regarding frequency of adverse events in the first 10 days after CABG, between groups of patients with homozygous variants of the studied genotypes (T715P (rs6136), M62I (rs2228315), S290N (rs6131), V640L (rs6133) in prevailing allele and groups with heterozygous variants of the corresponding genotypes there were also no statistically significant differences.Conclusion. Rs6133, rs6163, rs2228315, rs6131 polymorphisms in the platelet P-selectin gene are not associated with ASA resistance and are not associated with increased platelet aggregation activity in patients with coronary artery disease. The rare T, C, G, A alleles of the studied polymorphisms do not lead to an increase in the risks of adverse events in the first 10 days after CABG.

Aim. To study the association of V640L (rs6133) polymorphism in the P-selectin gene with acetylsalicylic acid (ASA) resistance in patients with coronary heart disease after coronary bypass surgery (CABG).Material and methods. The study included 104 patients aged 36-78 years (mean age 61.6±6.9 years) with stable angina pectoris: 61 (58.7%) patients had functional class II (according to Canadian Cardiovascular Society), 41 (39.4%) – class III and 2 (1.9%) – class IV. Atherosclerotic lesions of the coronary arteries were confirmed by coronary angiography. The antiplatelet therapy was stopped for at least 5 days before CABG. In the postoperative period, from the first day, all patients received 100 mg of ASA in enteric form, 61 patients received alone ASA therapy, 43 patients – combined antiplatelet therapy: ASA+clopidogrel (75 mg/day). The aggregation study was performed with an optical aggregometer, using 5 μM adenosinediphosphate (ADP) and 1 mM arachidonic acid inductors before CABG, on 1-3 day and on 8-10 day after surgical treatment. DNA samples were examined for the V640L (rs6133) polymorphism in the P-selectin gene by real-time polymerase chain reaction (PCR) using the allele-specific primers.Results. The frequency of the homozygous GG genotype of the rs6133 polymorphism was 84.6%; heterozygous GT genotype – 15.4%. The amplitude of aggregation with ADP before CABG, on 1-3 day and on 8-10 day after CABG for carriers of homozygotes of allele G vs carriers of the allele T were: 47.9±19.3%, 44.5±17.8%, 30.1±13.2% vs 47.9±17.1%, 46.3±16.5%, 39.6±22.0%, respectively (p=0.497, 0.441 and 0.687, respectively). The amplitude of aggregation with arachidonic acid before CABG, on 1-3 day and on 8-10 day after CABG for carriers of homozygotesof allele G vs carriers of the allele T, were: 47.9±23.2%, 24.5±21.7%, 12.3±16.3% vs 54.3±17.8%, 29.7±23.7%, 11±10.9%, respectively (p=0.416, 0.825 and 0.872, respectively). In the first 10 days of the postoperative period, 6 thrombotic events (5.7%) were observed in the study group: 2 strokes and 4 perioperative myocardial infarctions. Five events occurred in the group of patients with the GG genotype, 1 event in the group of patients with the GT genotype.Conclusion. V640L (rs6133) polymorphism in the P-selectin gene is not associated with ASA resistance in patients with coronary artery disease after CABG. The T allele of the rs6133 polymorphism is not associated with increased platelet aggregation activity after CABG and does not increase the risk of adverse events in the first 10 days after CABG.

Aim. To study the prevalence of metabolic syndrome (MS) and its components, as well as their relationship with hyperuricemia (HU) in a representative sample of the Krasnoyarsk Krai.Material and methods. As part of a multicenter epidemiological study ESSE-RF, a representative sample of 1603 residents of the Krasnoyarsk Krai aged 25-64 was randomized. All subjects underwent a questionnaire survey, anthropometry, office blood pressure (BP) measurement, determining the levels of blood lipids, plasma glucose and serum uric acid. MS was diagnosed according to the modified NCEP ATP III criteria (2005). Statistical processing was carried out using the software package IBM SPSS v 22.Results. The total prevalence of MS was 26,8%; higher in women than in men (29,4% vs 22,9%). With age, the prevalence of MS significantly increased — from 6,9% in subjects aged 25-34 years to 45,2% in people 55-64 years old. The prevalence of MS was significantly higher among rural residents compared with urban ones (36,8% vs 23,1%). Education level significantly affected prevalence of MS: in people with basic education, MS was found in 35,7%, with secondary — in 30,3%, with higher — in 17,8%. Regression analysis showed that hypertriglyceridemia, blood pressure >130/85 mm Hg and glucose ≥5,6 mmol/l were a significant predictors of HU in all subjects. For men, significant predictors of HU were hypertriglyceridemia and abdominal obesity, and for women — glucose ≥5,6 mmol/l and lipid-lowering therapy.Conclusion. The prevalence of MS in the Krasnoyarsk Krai, according to the modified NCEP ATP III criteria (2005), is 26,8%. MS is more often recorded in women than in men and in rural residents than in urban ones. With an increase in the education level, MS is less common. With age, the prevalence of MS significantly increases. The correlation of HU is not revealed with all the components of MS and has sex differences.

Aim. To study the association of heart rate (HR) with the health parameters obtained in the ESSE-RF study.Material and methods. The data of the multicenter epidemiological study of ESSE-RF were used in the work. 8,343 men and 13,531 women aged 25-64 years were examined. The response to the survey was about 80%. The analysis is performed depending on the elevated heart rate. Education, place of residence, region, lipid profile, levels of C-reactive protein (CRP) and glucose, history of diabetes, anxiety and depression, elevated blood pressure were analyzed as factors possibly associated with increased heart rate. Epidemiological diagnosis of ischemic heart disease (IHD) was established using the Rose questionnaire, an electrocardiogram analysis, followed by the Minnesota code coding.Results. Almost every fifth inhabitant had a pulse rate of more than 80 beats/min. No significant difference was found between the sexes. The increase in heart rate in men, starting in the age group 25-34 years to 45-54, and in women only up to 35-44 years with subsequent reduction in men and women was found. The prevalence of increased heart rate varies from region to region. The highest heart rate in men is recorded in Orenburg (33.1%), Ossetia (Alania) and Volgograd (29.7% and 27.6%, respectively), in women – in Vladivostok (37.4%), and the lowest heart rate in both gender groups– in Samara (9.4% for men and 8.1% for women). Increase in heart rate in men with secondary education [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.10-1.40], smokers and quitters (OR 1.90, 95% CI 1.63-2.27), who did not drink alcohol during the last year (OR 1.18, 95% CI 1.021.37), living in rural areas (OR 1.22, 95% CI 1.04-1.42), who are obese (OR 1.27, 95% CI, 1.101.45), having elevated blood pressure (OR 2.24, 95% CI 1.88-2.67), elevated levels of triglycerides, glucose and CRP was found after correction for age, region and all indicators included in the analysis (multidimensional model). The heart rate >80 beats/min was found significantly less often in people with history of myocardial infarction. A different model was found in women, it included, like in men, living in the village, elevated levels of blood pressure, triglycerides, glucose and CRP, but not education, smoking and alcohol consumption, obesity. Anxiety, low level of high-density lipoproteins and history of diabetes mellitus were also in the model in women.Сonclusion. Significant associations between increased heart rate and metabolic risk factors, inflammation and residence in the village are found.

Aim. To evaluate 10-year risk of potential development of type 2 diabetes (DM) in Russian population with the FINDRISC score, and to assess its associations with social, demographic and behavioral factors by the data from epidemiological study ESSE-RF. Material and methods. In the work, the data used, from multi-center study (Epidemiology of cardiovascular diseases in various regions of Russian Federation: ESSE-RF). Totally, 21923 persons investigated, age 25-64 y.o., of those 1045 (3,76% males, 5,39% females) had DM. To the final analysis 20878 persons included (8058 males, 12820 females) with no DM, for whom the 10-year risk was assessed with the FINDRISC (The FINnish Diabetes RIsk SCore). Level of risk and probability of DM onset were evaluated by the points summation. Also, associations were analyzed with education, marital status, place of inhabitance, income, smoking and alcohol status.Results. The threshold for high DM risk in Russian population was set at ≥12 level, with AUC 0,76, that represents good quality of model. The prevalence of the high risk by Russian criteria was 20,4%. Multifactorial analysis demonstrated that after correction for region and age, DM high risk was associated with smoking cessation (odds ratio (OR) 1,34; 95% confidence interval (CI) 1,14-1,58; р=0,0004) and alcohol consumption (OR 2,01; 95% CI 1,48-2,71; р=0,0001), and in women — with low income, low educational level and being married.Conclusion. Mean score by FINDRISC was 6,5±0,03, and absolute risk 5,3%. There were associations found of higher DM risk (≥12 points) with behavioral factors in males and social-demographic factors in women.

Aim. To investigate on the prevalence of hyperuricaemia (HU) among citizens and rural areas inhabitants of Krasnoyarsk region, and to assess possible relation of HU with arterial hypertansion (AH), HU and renal function.Material and methods. The study was done under the framework of ESSE-RF, included 1603 persons of age 25-64, had been selected by the random three-stage stratified selection. All participants underwent questionning, office BP measurement. Uric acid level (UA) was measured with urease method on Architect 8000 (USA) equipment. Statistics was done on IBM SPSS v. 22, StatSoft STATISTICA v. 10 and LibreOffice v. 5. Significance of differences by quantitative criteria was checked with Mann-Whitney criteria, by qualitative criteria — by hi-square. Differences were significant at p

Abstract Background To estimate the prevalence, awareness, treatment and control of arterial hypertension among adult inhabitants of Krasnoyarsk Krai using the data from Russian multicenter epidemiological study ESSE-RF (Epidemiological Survey of cardiovascular diSEases in different regions of the Russian Federation). Methods The study included 1603 subjects 25 to 64 years old selected by means of systemic multistage stratified randomization among urban and rural inhabitants of Krasnoyarsk Krai recruited between February 2014 and June 2014. Office blood pressure (BP) was measured twice with “Omron” automated BP device on the right arm in the sitting position in presence of medical personnel. Arterial hypertension (HTN) was defined as systolic BP of at least 140 mmHg and/or diastolic BP of at least 90 mmHg or self-reported previous elevated BP registration or use of antihypertensive treatment. Treatment efficacy was defined as percentage of patients achieved the target BP level among those who received antihypertensive medications, and HTN control as percentage of people achieved the target BP level among all hypertensives. Results The gender distribution was 652 males (39.4%) and 951 females (60.6%). The average level of systolic BP was 133.4 ± 0.5 mmHg, diastolic BP – 82.9 ± 0.3 mmHg. The average prevalence of HTN was estimated at 49.4% and appeared to be higher than similar parameter based on the data of 10 regions from the ESSE-RF study (44%). The average prevalence of HTN was estimated at 56.3% in males and 43.7% in females. The HTN prevalence in rural community was significantly higher in comparison with urban community (63.4 ± 2.4 vs. 44.2 ± 1.5%, p

Aim. To study the features of the state of hemostasis and platelet enzymes activity in acetylsalicylic acid (ASA) sensitive and resistant patients with acute coronary syndrome (ACS).Material and methods. The study included 53 patients (25 men and 28 women) with ACS during the first 24 hours and after 10 days. The control group included 50 healthy volunteers. Before treatment the patients were tested on the sensitivity and resistance to ASA. The indicators of vascularplatelet and plasma hemostasis were evaluated as well as the NAD(P)- dependent dehydrogenases activity in platelets was assessed by the bioluminescent method in the first day of ACS before antiplatelet therapy and on day 10.Results. Increase in spontaneous [1.72 U (1.28-2.72 U) and 1.60 U (1.49-2.78 U), respectively] and ADP-induced [24.4% (21.1-29.8%) and 19.2% (16.1-22.9%), respectively] platelet aggregation, von Willebrand factor activity [159.0% (108.0-190.0%) and 155.0% (149.0-185.1%), respectively] was found in ASA-resistant patients with ACS in 1 and 10 day. Besides the ASA-resistant patients with ACS had very low pentose phosphate cycle and lactate dehydrogenase aerobic activity. They also demonstrated, compared with ASA-sensitive patients, higher intensity of aerobic respiration and the level of NADP-dependent substrate exchange between the tricarboxylic acid cycle and reactions of amino acid metabolism.Conclusion. Despite the dual antiplatelet therapy with ASA and clopidogrel, risk of thrombotic events is saved in ASA resistant patients with ACS. The metabolic changes in platelet influence their aggregation activity and cause an inadequate response to the antiplatelet therapy in ACS patients.

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness.Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study.Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)).Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p

Aim. To study in dynamics the specifics of hemostasis and functioning of neutrophilic granulocytes in patients with acute myocardial infarction (MI) sensitive and resistant to acetylsalicylic acid (ASC).Material and methods. Totally, 53 patients included during first 24 hours from MI onset. Controls were 50 relatively healthy volunteers. All patients before treatment and revascularization were assessed for resistance to ASC and selected to groups as sensitive (SASC) and resistant (RASC). In complex therapy there was double antiplatelet therapy (ASC+clopidogrel). The parameters of vessel-platelet and plasma hemostasis were assessed. Via the chemiluminescent analysis we studied functional activity of neutrophils.Results. In RASC patients with MI on 1st and 10th day we found increased ADP aggregation of thrombocytes (ADP 0,1 mcM) and increase of von Willebrand factor. On 10th day in SASC patients there was decrease of ADP aggregation (ADP 5 mcM), von Willebrand factor increases. Not related to ASC sensitivity, in MI patients there is increase of SFMC, thrombin time is increased and D-dimer is low. Kinetics of chemiluminescence of neutrophils in MI patients differs from controls only by increased time of reached maximum. In ASC resistant patients on 1st day of evaluation there is decrease of neutrophil activation index, which gets to normal by 10th day of treatment.Conclusion. In RASC MI patients there is increased ADP aggregation of platelets, decrease of platelets number and increase of von Willebrand factor levels. Thrombosis risk in RASC patients on 10th day of treatment is caused by remaining disordered vessel-platelet hemostasis and increased spontaneous platelets aggregation. Plasmatic hemostasis on 1st and 10th days of MI shows activated onset of clotting with increase of clotting duration and significant decrease of D-dimer. In MI there is slowed velocity of development of “respiratory boost” in neutrophilic granulocytes that is probably related to compensatory processes in organism and double antiplatelet therapy which is antiinflammatory as well.

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used, of representative selection of non-organized male and female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol (TC), cholesterol of lipoproteids low and high density were measured at SSRCPM and RSPCC.Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively.Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment of the persons with high and very high cardiovascular risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity of development and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Aim. To study the clinical and laboratory characteristics of patients with stable angina that are sensitive or resistant to acetylsalicylic acid (ASA) before and after coronary artery bypass graft (CABG) surgery. Material and methods. Patients (n=60) with stable angina III-IV functional class, undergoing CABG, were included into the study. In the first postoperative day all patients started to take ASA in enteric form at a dose of 100 mg. To determine the sensitivity to ASA platelet aggregation induced by adenosine diphosphate (ADP 5μM) and arachidonic acid (1 mM) before and after incubation with ASA in vitro was studied one day before CABG and at the 1st and 10th days after CABG using an optical aggregometer. Dielectric properties of blood and its components were also studied with the original Fourier spectrometer. Results. The ASA-resistance rate was 26.7%. The ASA-resistant patients as compared with ASA-sensitive patients more often received selective cyclooxygenase 2 (COX-2) inhibitors (44% vs. 17%, respectively, pand very high erythrocyte sedimentation rate at 10th day after CABG (80.625±21.3 mm/h vs 54.6±26.5 mm/h; respectively, p=0.028). 33% of patients had resistance to en-teric form of ASA during 10-day therapy after CABG, however, platelet aggregation induced by arachidonic acid was low in in vitro platelet incubation with ASA. This points at decreased bioavailability of enteric forms of ASA. “Transient” ASA-resistance was detected in 12.5% of ASA-resistant patients on the 1st day after CABG due to cardiopulmonary bypass. Significant differences in the dielectric characteristics of blood and platelets were found in the groups of ASA-resistant and ASA-sensitive patients 10 days after CABG. Conclusion. Cardiopulmonary bypass, COX-2 inhibitors, renal dysfunction, the inflammatory response, may be possible reasons of the ASA-resistance after CABG. Changes in dielectric parameters of blood and platelets were found in the ASA-resistant patients.

Aim. To compare efficacy of enalapril and perindopril in patients with arterial hypertension (HT) and left ventricle systolic dysfunction.Material and methods. Patients (n=51) with HT and left ventricle systolic dysfunction (ejection fraction

Aim. To study the specifics of relation between hemostasis parameters and functional activity of neutrophil granulocytes in sensitive and resistant to acetylsalicylic acid (ASA) patients with acute coronary syndrome.Material and methods. Totally 53 patients included during the first 24 hours of ACS. Controls consisted of 50 relatively healthy individuals. All patients before the treatment and revascularization were assessed for the resistance to ASA, and selected into groups of sensitive (AS) and resistant (AR). Sensitivity test was done in vitro. In all participants the coagulation and platelet clotting systems were studied. With the luminescent method the neutrophil activity was assessed. Results. In AR with ACS there was decrease of platelets in blood, decreased level of ADP- (ADP 5 mcM) and adrenalin-induced aggregation, increases the level of ADP-induced platelets aggregation (PA) with ADP 0,1 mcM, and von Willebrand factor level. In the ASA sensitive patients there was a decrease of adrenalin induced aggregation.There were no specifics of coagulation hemostasis according to ASA sensitivity. Chemiluminiscence (CL) of neutrophils in ACS has a maximized out time. In AR there was decrease of activation. In AS functional activity of neutrophils more significantly correlates with the parameters of clotting, but in AR — with fibrinolytic and anticoagulation parameters.Conclusion. In ACS patients depending on ASA sensitivity, there are character specifics of platelet clotting: increase of ADP-induced aggregation in AR, decrease of platelet amount and the level of von Willebrand factor. In ACS patients there is a decreased velocity of "respiratory boost" in neutrophils. In AR there is more prominent dysbalance of coagulation hemostasis and "respiratory boost" of neutrophils, with the decrease of neutrophil reactivity related to clotting activity and appearance of relations with the parameters of fibrinolytic and anticoagulation activity.

Resistant hypertension is defined as hypertension uncontrolled with optimal doses of three antihypertensive agents, one of which is a diuretic. The up-to-date approaches to optimal pharmacologic and interventional treatment are discussed. Special emphasis is placed on some controversial aspects of new interventional procedures for resistant hypertension correction.

The review presents recent data on the usage of platelet functional tests in patients with ischemic heart disease after percutaneous coronary intervention and its contribution to antiplatelet therapy personalization and cardiovascular events frequency reduction.

Aim. To study blood dielectric properties of patients with unstable angina (UA) for the development of novel additional diagnostic criteria for acute myocardial ischemia.Material and methods. Totally, 61 patient studied with non-ST-elevation acute coronary syndrome (NSTEACS), of those 40 patients having on ECG the changes of ischemic type, 21 patient with ACS without ECG changes. In all patients troponin T was negative in single measurement. Comparison group consisted of the stable angina patients II FC (n=13). Controls consisted of 30 healthy donors of blood transfusion center; to 59% patients with preliminary diagnosis NSTEACS (n=61) diagnostic coronary angiography was don (CAG). To all patients we performed study of dielectric properties of the blood by the Fourier-spectroscopy method.Results. Dielectric properties of the blood in NSTEACE/UA, during the first hours of pain onset significantly differ from those in stable angina and controls. In 26% of patients dielectric properties of the blood get back later than positive changes of ECG occur (ST return to isoline).Conclusion. Diagnostic test for acute myocardial ischemia, together with ECGdiagnostics and clinical picture makes it possible, in short time, to perform expressdiagnostics of myocardial ischemia when NSTEACS/UA is suspected, especially in comorbidity patients having the same ST depression on ECG, caused by LV hypertrophy.

Aim. To study the prevalence of ischemic heart disease as one of the most common cardiovascular disorders, together with arterial hypertension (AH), diabetes mellitus (DM) and liver diseases (LD) in adult (25-64 y.o.) population of selected RF regions, the variance of those with gender and age, and association of cardiovascular risk factors (FR).Material and methods. Into analysis we included the results of representative selections studies from 13 RF regions, studied according to the program of multicenter study ESSE-RF during the years 2012­2014; totally 21923 patients studied. Investigation included standard questioning, including anamnesis. For statistics we used applied software SAS.Results. In men the prevalence of IHD is associated with the growth of comorbidity from 0 in the age group 25-34 y. to 77% in the age 55-64 y., almost duplicating every decade. For women there is analogic tendency, less prominent. In men there are significant associations only with AH, which increases the risk of IHD 2,5 times, though in women together with AH the associations are significant for LD. Comorbidities with DM do not influence the prevalence of IHD in men and women. At the same time, any association with two diseases increases the risk of IHD >304 times. The most negative is the association of all three diseases, with which IHD is 8,7 times more prevalent, than in their absence. Using multidimensional logistic regression after correction for the age and comorbidity in the patients with IHD of both genders, there are associations revealed of high density cholesterol lipoproteids (HDL) in blood and abdominal obesity. In men there are also positive associations with smoking and negative — with increased cholesterol.Conclusion. Comorbidities of IHD with AH, DM and LD in adult population are common, are associated with the general FR, are increasing with the age. Taking modern tendencies of population ageing, it is plausible to expect an increase of the prevalence of comorbidities, that requires a necessity of the healthcare services to these changes.

Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data.Material and methods. The data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level.Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 [95% CI 2,08-4,57] comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.

The review presents the current literature evidence on the most likely genetic polymorphisms of aspirin resistance, such as polymorphisms of cyclooxygenase, glycoproteins GP Ib/IIIa, GP Ibα, GP VI, and adenosine diphosphate receptors P2Y1 and P2Y12. The authors discuss the prevalence of these polymorphisms in laboratory and clinical aspirin resistance, as well as their association with the risk of cardiovascular events during aspirin treatment.