AIM:To determine whether cigarette smoking, as a risk factor for CAD, affects (anti)oxidant status.MATERIAL AND METHODS:The study included patients with CAD, divided according to their smoking status and the number of cigarettes smoked during a day. Biological markers of oxidative stress (concentration of oxidants and activity of antioxidant enzymes) were measured in all subjects.RESULTS:The study included 300 patients with CAD, (average age of 63 ± 11 years), predominantly males. Of the total, 34.0% were active smokers, 23.0% were former smokers, and 43.0% were non-smokers. Most of the active smokers smoked 1-20 cigarettes/day. In terms of concentration of oxidants (MDA and HP) there was not a significant difference between smokers versus non-smokers. As for the activity of antioxidant enzymes (SOD, CAT and GPX), a statistically significant difference was found in the activity of GPX among the active smokers with CAD and the non-smokers with CAD (p = 0.039).CONCLUSION:Smoking as a risk factor for CAD is closely associated with increased oxidative stress, and the number of cigarettes smoked plays an important role in increasing the level of oxidative damage and reducing antioxidant defence.

BACKGROUND:Diabetes is diagnosed in 10-20% of patients with acute coronary syndrome (ACS) not known to be diabetics. Elevated blood glucose is an independent risk factor for cardiac events, regardless of presence of diabetes.AIM:Evaluating the prevalence of new-diagnosed DM among patients with ACS, and assessing the relationship between stress glycaemia and new diagnosed DM with in-hospital cardiac events.METHODS:Prospective observational study, in patients with ACS, in whom we analyzed parameters of glycemic metabolism, clinical data, and in-hospital cardiac events. We comparatively analyzed patients according to the HgbA1C and known DM in five groups: non-DM (< 5.6%), new pre-DM (5.6-6.5%), new DM (≥ 6.5%), controlled (<7%) and uncontrolled (≥7%) known DM.RESULTS:150 patients, (93 male and 57 female) were included. Impaired glucose metabolism was detected in 44.5% of patients, 7.9% of whom were newly-diagnosed DM. The highest levels of stress glycaemia were found in new and uncontrolled known DM. The in-hospital event rate was 20.7%, the mortality rate 7.3%, being the highest in new diagnosed and uncontrolled known DM patients.CONCLUSIONS:The prevalence of unknown DM was high among patients with ACS. Stress glycaemia and failure to achieve glycemic controlee, were an independent predictors of in-hospital cardiac events.

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The health system in Macedonia is organized by public or private property health institutions divided on three levels: primary, secondary and tertiary health care. According to the legal regulations and their acts, regulatory authorities for preventive care are the health institutions of primary health care (whether they have private or public character), heath care establishments and some of the hospitals. In the period of transition starting from 1991 up to this day, numerous health system modifications have been made concerning health reforms: common alterations in health legislation change in property of health institutions, realignment of authorities etc. The adjustment of the system to the new circumstances and constant changes has provoked partial disruption in the established system for preventive health care activity. Health expenses for 2006 (% of GDP): 7.02% Causes of death, in general: circulatory system diseases -57.3% of the total number of deceased, neoplasm's -18.5%, endocrine, nutritive, and metabolic diseases -4.2% etc [2].

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