There are few data available on the prevalence of hyperuricemia and its possible association with cardiovascular diseases among the very elderly population. The main part of this study enrolled 320 very elderly hospitalized patients (aged 86.4 ± 5.0 years; females, 78.1%; males, 21.9%) with coronary artery disease (CAD) and arterial hypertension (AH). The second part of the study involved 48 patients younger than 60 years, who were hospitalized with CAD diagnosis for coronary angiography study. Patients with gout were excluded from analysis. Hyperuricemia was defined as serum uric acid (SUA) more than 340 μmol/l in women and 420 μmol/l in men. Elevated serum uric acid (SUA) levels were detected in 37.4% of 320 elderly patients. Hyperuricemia was significantly more common in women (in 41.5% of cases) than in men (in 25%) (p = 0.02). In the group of very elderly patients, there was a clear correlation between hyperuricemia and clinically significant chronic heart failure (OR = 5.0; 95% CI = 2.4-10.7; p < 0.0001), as well as with stroke in history (OR = 1.9; 95% CI = 1.0-3.4; p = 0.03). Hyperuricemia remained significant risk factor of heart failure in the multiple regression analysis (p < 0.001). Atrial fibrillation was significantly more frequently diagnosed in patients with hyperuricemia compared with patients with normal levels of uric acid (OR = 2.2; 95% CI = 1.3-3.6; p = 0.001). A pronounced positive correlation was found between the SUA levels and the diameter of the left atrium (r = 0.3; p = 0.000003). In the group of 48 CAD patients under 60 years of age, hyperuricemia was significantly associated with myocardial infarction (OR = 8.8; 95% CI = 2.0-38.9; p = 0.002) and chronic heart failure (OR = 6.9; 95% CI = 1.8-26.3; p = 0.003). In general, the obtained results indicate a significant prevalence of hyperuricemia in people with CAD. A significant relationship between the increased SUA levels and the development of some cardiovascular diseases was found.

The paper discusses treatment strategy and tactics for iron deficiency anemia. It gives data on the comparative efficacy of different iron sulfate drugs, their bioavailability, effects on peroxidation processes, and side effects. The paper also considers the clinical significance of a dosage form of iron-containing drugs with a sustained iron release, as well as ways to reduce the frequency and magnitude of side effects when ferrous sulfate is used.

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П равильно установленный диагноз острого коронарного синдрома без подъема сегмента ST (ОКСбпST) является необходимым, но недостаточным условием определения тактики лечения больного. Согласно рекомендациям Европейского кардиологического общества (ESC), для этого необходимо разделение больных с ОКСбпST на группы риска с целью определения сроков направления их на коро-нарографию (КГ) [1, 2]. Каждый случай ОКСбпST нужно рассматривать исходя из потенциальной возможности реваскуляризации миокарда в экстренном (до 2 ч), срочном (до 24 ч), отсроченном (до 72 ч) и плановом порядке [1-4]. Вариабельность способов реваскуляризации-чрескожное коронарное вмешательство (ЧКВ), операция коронарного шунтирования (КШ) или их сочетание

The study purpose was investigation of bone mineral density (BMD) and metabolism in very elderly patients with heart failure. The study enrolled 125 patients (aged 75-98 years) hospitalized with coronary artery disease (CAD). The study group comprised 61 patients with clinically significant congestive heart failure (CHF) and the control group-64 age-matched patients without CHF symptoms. The main exclusion criteria were any other diseases that could cause osteoporosis and administration of medications reducing BMD. Lumbar spine and proximal femur BMD was measured by dual-energy X-ray absorptiometry. Serum osteocalcin concentration was measured by immunechemiluminescence, beta-Cross Laps levelby electrochemiluminescence. BMD in the CHF patients was lower versus the control group. Largest differences were recorded in proximal femur: BMD in the CHF patients was 719.8 ± 188.2 mg/cm 3 versus 797.7 ± 161.7 mg/cm 3 (p = 0.02) in the control group. Greater differences in BMD were detected in female patients. Proximal femur BMD had normal values only in 5% of the CHF patients, in the control groupin 31% of cases (p = 0.003). Reduced osteoblast function was observed in CHF patients: the mean osteocalcin level in the CHF patients was 1.2 ± 1.7 ng/ml versus 4.2 ± 4.1 ng/ml (р = 0.03) in the control group. Mean β-Cross Laps level in the CHF patients reached 0.73 ± 0.4 ng/ml versus 0.4 ± 0.1 ng/ml (p = 0.003) in the control group. These study findings suggest that bone mineral density in very elderly CHF patients is noticeably lower versus the patient group similar in age and main diseases. This study has demonstrated significantly reduced osteoblast function in CHF patients and slight increase in bone resorption.