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Aim. To study the clinical and anatomical myocardium features according to invasive and non-invasive examination methods in men and women with coronary artery disease (CAD) in combination with diabetes mellitus (DM).Material and methods. A single-step clinical study included 77 men and 68 women with angina of the II-III functional classes, observed in the Republican clinical hospital in Nazran. Depending on the presence of type 2 DM and gender, patients were divided into 4 groups: Group I — men with CAD+DM (n=34), Group II — women with CAD+DM (n=36), Group III — men with CAD without DM (n=43), group IV — women with CAD without DM (n=32). All patients underwent electrocardiography (ECG), echocardiography (EchoCG) and coronary angiography.Results. Hypertrophy of the left ventricle on ECG was most often diagnosed in men with CAD+DM (38%). Similar, but less pronounced tendency is observed in men without DM (23%). Among women, these parameters were 80% more often occurred among men with CAD without DM, among men and women with CAD+DM, the absolute number of such constrictions was 21-25 cases. The greatest number of stenoses ≥2 coronary arteries was observed in men with CAD+DM (~30 cases), in the group of men with CAD without DM constriction >2 vessels are found in ~20 cases. Among women, stenosis ≥2 vessels are detected twice as less as compared with men. At the same time, in the group of women with CAD+DM, the frequency of multiple stenoses was 15% higher than those of women with CAD without DM.Conclusion. Thus, using non-invasive and invasive examination methods in CAD patients, a number of complementary changes in the myocardium and coronary arteries were found. The presence of DM worsens these changes, both among men and women.

Aim. Analysis of the primary endpoints occurence in male and female cohort of coronary heart disease (CHD) patients comorbid with other somatic pathology, during 5 years.Material and methods. To the study, 320 patients included (143 males, 177 females, age 46-72 y. o.) with CHD stable angina I-III functional class, and underwent investigations in the year 2012 in three medical centers in the Republic of Ingushetia. In 2017 patients were invited for second investigation or were contacted by phone. As the primary endpoints the following accounted: revascularization surgery (CBG), endovascular surgery in coronary, carotid, peripheral arteries, diagnosed myocardial infarction, ischemic stroke, diabetes and its complications, fatal outcome from cardiovascular diseases (CVD) and death from other causes.Results. The number of CHD patients with comorbidities was 196, and with no comorbidities — 124. During the follow-up, stroke developed in 17 (5 males, 11 females) patients, myocardial infarction in 37 (20 males, 17 females), diabetes in 38 (15 males, 23 females), fatal CVD outcome in 11 (8 males, 3 females; of those in 5 — acute coronary syndrome, 4 — stroke, 3 — chronic heart failure), and death from other causes in 8 (5 males, 3 females). We also analyzed the development of composite endpoints in CHD patients depending on the presence and absence of comorbidities. Stroke was registered in 13 comorbid patients vs 3 in CHD with no other diseases. Myocardial infarction found in 33 patients with CHD and three comorbidities vs 4 cases in CHD with no comorbidities. Diabetes was found in 32 vs 6 patients, respectively; CVD death in 10 vs 1, resp.; all-cause death in 5 vs 3, resp.Conclusion. Comorbid CHD with 2 and more somatic diseases, during the 5-year period of follow-up, does increase the risk of complications and death from CVD.

Aim. To assess somatic comorbidity in male and female cohort with stable angina (sA). Material and methods. Into multicenter, simlutaneous cohort-clinical study, 300 men included (mean age 54±0,4 y.o.) and 230 women (mean age 55,7±0,5 y.o.) with sA of I-III functional class. four institutions participated from Ingushetia Republic. Clinical and instrumental assessment included anthropometry, office blood pressure, heart rate, eCG in 12 leads recording. In fasting venous blood we measured total cholesterol (mM/L) and glucose (mM/L).Results. In cohort of patients with sA the most prevalent are cholelythiasis, gastric and duodenal ulcer disease, chronic diseases of pancreas, separately or together; chronic bulbitis is found in each third person, and urinary lythiasis in 15% of cases. Gastric ulcer and duodenal ulcer diseases, chronic bronchitis and urinary lythiasis are two times more prevalent in men compare to women, but cholelythiasis and chronic diseases of pancreas show the same prevalence among men and women.Among women with sA thyroid diseases are 3 times more prevalent than in men.Conclusion. so, in sA patients comorbidity is quite common. Management and prevention in sA patients cohort should be multifactorial taken a broad spectrum of social and demographic parameters, main risk factors and comorbidities. The key role in coordination and realization of all these activities should be granted to an internist of broad spectrum or general care physician.

Early glucose metabolism disorders (GMD) are of interest in development of effective approaches to prevention of type 2 diabetes mellitus (DM). Data of international clinical trials shows that early GMD are an independent risk factor for cardiovascular disease. The possibilities of GMD prevention and early treatment are discussed. Antihyperglycemic medications classification, their mode of action and efficacy are presented from evidence-based medicine point of view. This data confirms that successful DM primary prevention at early stage of GMD reduces the risk of cardiovascular complications.

Aim. To assess the quality of life (QoL) and its gender specifics among Ingushetia Republic patients with coronary heart disease (CHD) and effort angina. Material and methods. The study included 520 patients with CHD and Functional Class II–III effort angina – 300 men (mean age 54±0,4 years) and 230 women (mean age 55,7±0,5 years). QoL was assessed with the EQ-5D questionnaire (European Quality of Life Instrument), including 5 areas: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Results. Approximately 40% of the participants reported mobility problems, while self-care problems were reported by 15% only. Disturbed usual activities were registered in 40%, and chest pain or discomfort, as typical symptoms of effort angina, were reported by 60%. Anxiety/depression symptoms were also reported by 60% of the participants. In total, approximately 10% of the patients had severely affected QoL, while 40% did not report any difficulties with usual activities or mobility. Mobility problems, chest discomfort, and anxiety/depression were more prevalent in women. The prevalence of self-care and usual activities problems was similar in both genders. Conclusion. In every second CHD patient with effort angina, QoL was affected, due to restricted usual activities, disturbed mobility, or chest discomfort, accompanied by anxiety/depression symptoms. Self-rated health deteriorated in every second patient.