Aim of the study. To evaluate the organization of medical care for acute coronary syndrome (ACS) patients in PCI capable and PCI non-capable hospitals from 2009-2012. Materials. Russian Registry of Acute Coronary Syndromes (ACS Registry) with an internet tracking was created in 2008 year. We performed an observational study of 139 882 ACS patients (56% M, 44% F; av. age - 65 years (56;75) [25%;75%]); ACS with ST elevation pts (ACS STe) - 45 707, ACS non ST elevation pts -84 603. Pts. were hospitalized due to ACS, prospectively enrolled in 167 hospitals from January 2009 to January 2013 in the ongoing ACS Registry. The ACS registry is carried out in cooperation with the Russian Ministry of Health. Results. The majority pts. before ACS had cardiovascular diseases and bad control of arterial hypertension. Many ACS STe pts to correspond for high risk in-hospital and 6-months death (GRACE risk score) (45,4% и 36,7%, accordingly). In 2012 fibrinolysis was used in 30,3% (positive dynamic on 8,3% from 2009). Percutaneous coronary interventions (PCI) for ACS STe pts. were used in 28,2% (primary PCI more than 80% pts). Conclusion. Russian ACS Registry may provide with information concerting characteristics and treatments of ACS pts. in different hospitals from Russia.

Pulmonary arterial hypertension (PAH) is a severe progressive disease, characterized by advanced remodeling of small pulmonary arteries and arterioles, which ultimately leads to right heart failure and death. Due to discovery of PAH pathophysiological targets, new medications have been developed and implemented into clinical practice. These medications compensate the deficiencies of endogenous prostacyclin and nitric oxide and also block the effects of endothelin-1 (ET-1). The role of the latter in PAH pathophysiology is related to its strong vasoconstrictory properties, as well as to a number of effects responsible for arterial wall remodeling. Clinical use of endothelin receptor antagonists (ERA) started in 2001, with the first agent of the class, bosentan, whose efficacy was demonstrated in a number randomized controlled trials. Macitentan is a novel potent double action oral ERA, developed with the purpose to improve efficacy and safety of PAH treatment through its tissue specificity. The new molecule blocks endothelin receptors type A and B and possesses improved physicochemical properties allowing for improved tissue penetration. Macitentan prevents an increase in pulmonary arterial pressure, right ventricle hypertrophy and improves survival in animal models. The SERAPHIN Study evaluated the effects of macitentan on morbidity/mortality in 742 PAH patients, randomized to macitentan 3 mg or 10 mg daily or placebo. Macitentan 3 mg and 10 mg daily was shown to reduce morbidity and mortality by 30% and 45%, respectively. By 6 month of the follow-up, there was an improvement in 6-minute walking test by + 16.8 m for macitentan 3 mg and +22.0 m for macitentan 10 mg daily. An improvement of the functional class, compared to baseline, was observed by 6 mo in 13% of placebo patients, 20% of macitentan 3 mg daily patients (p=0.04) and in 22% of 10 mg daily patients (0.006). Compared to placebo, macitentan significantly reduced pulmonary vascular resistance and improved cardiac index. It demonstrated a favorable safety profile. US Food and Drug Administration (FDA) approved macitentan (OPSUMIT) 10 mg once daily for the treatment of pulmonary arterial hypertension to delay disease progression.

Purpose of research: to study the predictive value of the results of laboratory diagnostic tool in patients with acute myocardial infarction complicated by diabetes. Materials and methods: the study group -235 patients with acute myocardial infarction and type 2 diabetes. The control group - 210 patients without diabetes. Analyzed hospital clinical outcomes, laboratory methods, changes in ECG, Ultrasound cardiography, ECG monitoring, coronary angiography. Results: in the group of diabetes was significantly more frequent cases of chronic heart failure, heart rhythm disturbances. In the group of patients with diabetes, anemia was significantly frequent than in controls (18.18% versus 44.5%), as well as elevated levels of blood leukocytes and ESR levels of C-reactive protein. ECG data and Holter's monitoring show a greater frequency of persistent myocardial ischemia. Patients with diabetes and distal damage of coronary vessels (31.4% vs. 9.1% P = 0.05) was significantly higher compared with controls. Conclusion: the prognosis of patients with diabetes mellitus is caused by an active inflammatory process, the greater frequency of anemia, postinfarction ischemia, a greater degree of coronary lesions, especially the distal parts.

In the article the authors consider some concerns of clinical efficacy and safety of rosuvastatin - the most powerful representative of the group of statins. The review contains the results of clinical trials, demonstrating its high lipid-lowering efficacy, impact on surrogate and primary endpoints in studies on primary and secondary prevention. They also discuss safety treatment concerns with this drug, and its possible side effects. The authors present data on the comparative efficacy and tolerability of generic form of rosuvastatin (Mertenil, Gedeon Richter) which had been received by Russian and foreign researchers, the evidence about the comparability of therapeutic efficacy and safety of the generic to the original form.

The article presents our research results in creating risk group stratification scores in patients with ACS (183 patients) with expecting coronary artery bypass in conditions of heart-lung bypass. These scores based on the complex evaluation of clinical instrumental and biochemical predictors allow to stratify groups of risk and predicting postoperative cardiovascular complications in patients with ACS with expecting coronary artery bypass more effectively than common EuroSCORE.

Aim. To study influence of coronary heart disease (CHD) in family history on distribution of polymorphism apolipoprotein A1, В and E genes of the lipidtransport systems and major adverse cardiac events (MACE) in patients of Uzbek nationality with unstable angina (UA). Material and methods. There were examined 125 patients of Uzbek nationality with UA. I group (n=63) consisted of patients with burdened family history and II group (n=62) without family history. The control group consisted of 58 healthy persons. The G-A polymorphism of apolipoprotein A1 (APO A1) gene, -516C/T polymorphism of apolipoprotein В (APO B) gene and є2/є3/є4 polymorphism of apolipoprotein E (APO E) gene was determined using reagents Diatom TM DNA Prep 200 (production of LLC « IsoGen Laboratory») Results. In studying the distribution of «damaging» alleles of studied genes among the patients with UA in comparison with healthy persons, has been found a more prevalence of A allele carriers of the APO А1 (HR 3,63, 95% CI 1,638,04, P=0,002). The distribution of «damaging» alleles in comparative analysis of the II group with healthy persons did not differ significantly, whereas in I group had significantly greater accumulation of alleles: «А» G-А polymorphism of APO А1 gene (HR 5,99, 95% CI 2,52-14,24,P=0,001), «є4» polymorphism of APO E gene (HR 2,91, 95%, CI 1,12-7,62 P=0,044). At the same time there was no difference in the frequency of carriage «T» allele of -516C / T polymorphism of APO B gene. In patients with carriage of «damaging» alleles it was observed high frequency surgical revascularisations (HR 3,43, 95 %, CI 1,26-9,31, P=0,02) within one year. Conclusion. Presence of CHD in family history among patients of Uzbek nationality with UA is associated with the accumulation of «damaging» alleles: «А» (M1-) G-A polymorphism of APO A1, «є4» of APO E gene, and «D» I/D polymorphism of ACE gene. In patients with carriage of «damaging» alleles it was observed high frequency surgical revascularisations within one year.

Objective: to evaluate myocardial deformation properties of LV in patients at different terms after heart transplantation. Material and methods: this study encompassed 45 individuals who undergone orthotopic heart transplantation (OHT) and 25 volunteers with no heart disorders. Onstandard heart transthoracic echocardiography (EchoCG), myocardial LV wall deformation (global strain) in four-chambered (LV4GS), three-chambered (LV3GS) and two-chambered (LV2GS) projections was evaluated, and the mean GS was calculated. The studies were performed at the following terms: first one- in a month after OHT, second- 1-6 months after OHT, and the third- at 6-12 months after OHT. Results: LV myocardial deformation properties in patients at different terms after heart transplantation. In 1 month after the OHT in the presence of normal LV EF estimates, the decreased myocardial deformation properties tended to the improvement at 6 months after the operation was registered. The statistically significant positive value dynamics characterizing the myocardial fiber systolic strain was noted at 12 month: absolute estimates of 2GS, 4 GS and GScp increased by 19.9%, 20.1% and 22.4%, accordingly compared to those observed 1 month later after OHT. At 12 months, patients having 4GS and GScp who undergone heart transplantation was not different form the healthy individuals. Conclusion. Our data suggest that the study of myocardial deformation reveals myocardial dysfunction prior to changes registered in standard EchoCG, i.e. at early terms of its development.

The aim. The study was parameters of heart rhythm variability, QT- and JT-intervals in patients with ischemic heart disease and type 2 diabetes (DM). Material and methods. 131 patients aged 3069 years with unstable angina and acute myocardial infarction has been included in research. Among observable in 101 (71.6 %) patients the DM is diagnosed. Results. It is revealed, that absence of the adequate control of glycemia in patients with DM (level of glycosylated hemoglobin more than 6.5%) resulted in decrease as parasympathetic and sympathetic influences of vegetative nervous system on the sinus node. Development of repeated coronary events in patients with DM within one year of supervision associated with reduction of mainly sympathetic influences by heart (decrease of the parameter LF and relation of spectra LF/HF) that was accompanied by infringement depolarization and repolarization of myocardium. The greatest reduction of parameter LF came to light in patients with fatal outcome within one year of supervision. Conclusion. Absence of the adequate control glycemia is accompanied by infringement of regulation of vegetative nervous system in patients with ischemic heart disease and type 2 diabetes.