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Scores for assessment of risk of cardiovascular events in patients with acute coronary syndrome (ACS) became wide spread during last decade. Taking into consideration high level of ACS morbidity and mortality in Russia there is a need in creation of own national scores. Aim of this study was to investigate the value of risk factors of death and to create a multivariate model of survival of patients with ACS during hospitalization., Materials and Methods: The non-randomized retrospective continuous study of 1000 case histories (medical records) of patients with ACS with assessment of value of risk factors was performed, and the multifactor model and computer program estimation of risk of death was created. While selecting risk factors emphasis was made on heart rhythm and presence of arrhythmia, and on anamnestic data., Results: Most significant factors were age, history of myocardial infarction, atrial fibrillation, and ventricular tachycardia. The created regression model of estimation of risk of death by 51.4% was explained by these factors. Using this model, we developed a computer program "Kardiorisk" which predicts risk of death with 100% sensitivity and 80% specificity.

The contribution of the polymorphic markers of the CHRNA5/A3, CYP2A6, NQO1, XPC, XRCC1, XRCC3, XPD, XPA genes to chronic obstructive pulmonary disease has been assessed. For this purpose, analysis of the gene polymorphisms in case/control groups in Tatar population has been performed. The CHRNA5 (rs16969968) (P = 0.0001, OR = 2.24), CHRNA3 (rs1051730) (P = 0.0001, OR = 2.72) were associated with significantly high risk of chronic obstructive pulmonary disease in recessive model. The disease risk was higher in homozygous carriers of normal allele of CYP2A6 (del) (P = 0.00001, OR = 2.77). Analysis showed an association of the NQO1 (rs1131341), XRCC1 (rs25487), XRCC3 (rs861539), XPC (rs2228001) and XPA (rs1800975) (P = 0.000001, OR = 2.67; P = 0.00001, OR = 0.51; P = 0.0003, OR = 1.76; P = 0.0004, OR = 0.54 and P = 0.007, OR = 0.74) in additive model with chronic obstructive pulmonary disease. We found a significant gene-by-environment interaction of smoking status and XPA (rs1800975) (Pinteract = 0.002); rs16969968, rs1051730 of CHRNA3/5 genes were significantly associated with chronic obstructive pulmonary disease only in smokers. The relationship between the CYP2A6(CYP2A6*4) and smoking pack-years was found (P = 0.0019). The TT genotype of XRCC3 (rs861539) were associated with decreased of lung function parameters: vital capacity % (P = 0.0487), forced vital capacity (%) (P = 0.0032) and forced expiratory volume in 1 s (%) (P = 0.02). The relationship between the XPA (rs1800975) and forced expiratory volume in 1 s (%) (P = 0.0028) was found.

Recently, it was shown that pacemaker f/HCN channel might be permeable not only for Na+ and K+, but also for calcium ions. Pacemaker channel HCN2 was expressed in ovarian cell culture of Chinese hamster. In the patch clamp experiments the calcium current with low amplitude 0.06±-0.87 nA and open probability 0.48% (±3.02 at -110 mV, n = 6, Ca2+ 2 mmol) was measured. HCN2-Ca2+ current significantly activated with cyclic adenosinemonophosphate by increasing of open probability and inhibited by specific If-blocker ivabradine. The calcium ion current was also shown in f-channels of neonatal rats ventriculocytes. Thus, the calcium ions conduction through HCN2 and native f-channel at physiological concentrations of extracellular fluid and physiological membrane potentials of cardiomyocytes was demonstrated.

Tachyarrhythmias (TA) - dangerous postoperative complications of coronary artery bypass grafting, threatening the lives of patients and found, according to different authors, in 13-40% of cases. VFS - an antiarrhythmic drug that belongs to a class 1C, is effective in the treatment and prevention of a variety of cardiac arrhythmias. The aim of the work was to study the clinical efficacy of VFS CHD patients with a history of tachyarrhythmias during the perioperative period of coronary bypass surgery, as well as its comparison with other antiarrhythmic drug (amiodarone). Clinical efficacy was evaluated in 218 patients with coronary heart disease at baseline with a history of tachyarrhythmia (paroxysmal atrial fibrillation or premature ventricular high grade (IV and V class on classification of Lown B. and Wolf M. in the modification of Ryan M.). Shown that the VFS is more effective than amiodarone, both in paroxysmal atrial fibrillation and ventricular arrhythmias when high gradation.

The contribution of the polymorphic markers of the matrix metalloproteinases MMP1 (-1607G > GG, rs1799750; -519A > G, rs494379), MMP2 (-735C > T, rs2285053), MMP3 (-1171 5A > 6A, rs35068180), MMP9 (-1562C > T, rs3918242; 2660A > G, rs17576), MMP12 (-82A > G, rs2276109), the disintegrin and metalloprotease 33 ADAM33 (12418A > G, rs2280091; 13491C > G, rs2787094), the tissue inhibitors of metalloproteinases TIMP2 (-418G > C, rs8179090), TIMP3 (-1296T > C, rs9619311) genes to chronic obstructive pulmonary disease has been assessed. For this purpose, PCR-RFLP analysis of the gene polymorphisms in case (N = 391) and control (N = 514) groups has been performed. The 6A6A genotype of the MMP3--1171 5A > 6A polymorphism was associated with significantly high risk of chronic obstructive pulmonary disease (OR = 2.490, Padj = 0.003979, Pcor = 0.0358 adjusted for age, sex, smoke pack-years, ethnos). Analysis showed an association of the G-G haplotype of 13491C > G and 12418A > G ADAM33 gene polymorphisms (OR = 0.39, Padj = 0.0012, Pcor = 0.006)with chronic obstructive pulmonary disease. We found a significant interaction of the smoking status and ADAM33 12418A > G (Pinteraction = 0.026) and TIMP3--1296T > C (Pinteraction = 0.044). The relationship between the GG genotype of the ADAM33 13491C > G and emphysema risk was found (OR = 1.74, Padj = 0.013, Pcor = 0.117). Severity of chronic obstructive pulmonary disease was modified by MMP9 -1562C > T in additive model (OR = 1.883, Padj = 0.028, Pcor = 0.252). The MMP3, MMP9, ADAM33, TIMP3 genes polymorphism may be an important risk factor for the development and progression of chronic obstructive pulmonary disease, important gene and environmental interactions were determined.

Vascular endothelium is not simply a barrier between blood and extra vascular bed but is a source of large number of mediators regulating various functions of the body among which nitrous oxide appears to be one of most important. Endothelial dysfunction (ED) develops in a number of processes: diabetes mellitus, smoking, arterial hypertension, hypercholesterolemia. ED promotes increase of rate development of cardiovascular diseases. One of most well known markers of ED is microalbuminuria (MAU). Drug and nondrug means are used for the treatment of ED. Calcium antagonists and angiotensin converting enzyme inhibitors both separately and as components of combination therapy are able to maximally diminish MAU.