The aim – to study the clinical, anamnestic and instrumental parameters associated with short-term prognosis in patients with pulmonary embolism (PE). Materials and methods. This study was conducted from September 1, 2019 to December 31, 2020 on the basis of the city clinical hospital. The preliminary analysis included 187 patients with acute pulmonary embolism. The study found that 25 (13.3 %) patients died within 30 days (group I): 19 (76.0 %) patients belonged to a high risk of predicted early death and 6 (24.0 %) – to intermediate-high risk. For further analysis, a comparison group (group II) was formed and included 106 (56.7 %) patients who survived within 30 days of the onset of an acute episode of PE: 54 (50.9 %) patients belonged to high risk, 52 (49.1 %) – to intermediate high risk. All patients with pulmonary embolism received anticoagulant therapy according to the current ESC guidelines. Results. The average age of patients in group I was 69.08 ± 14.15 years and was significantly higher than in group II: 65.25 ± 13.29 (p = 0.0169). The proportion of high-risk patients was significantly greater in the І group, the proportion of patients of intermediate-high risk was significantly greater in group II (p = 0.0409). The incidence of classes IV and V according to the PESI index, assessed in patients of intermediate-high risk, was the same in both groups, while patients with the PESI index class III prevailed in group II (p = 0.0380). The risk factors for venous thromboembolism occurred more frequently in patients of group I, i.e. congestive heart failure (p = 0.0065) and obesity (p = 0.0482). Conclusions. There is a high mortality rate within 30 days (13.3 %) in hospitalized patients with acute PE, including 26 % of high-risk patients and 10.3 % of intermediate-high risk. Age over 65 years, the presence of congestive heart failure and obesity are independent factors that, according to uni- and multivariate logistic regression analysis, are associated with poor short-term prognosis in patients with PE. Key words: pulmonary embolism, venous thromboembolism, short-term prognosis, anticoagulant therapy.

The aim – to define the clinical and anamnestic features of myocardial infarction, which determine the prognosis of patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) in the acute period.Materials and methods. The study included 33 patients with MINOCA (group I), and 73 patients with myocardial infarction (MI) with obstructive coronary artery disease (CAD) (group II) who were hospitalized in Clinical hospital # 8. Angiography, echocardiography, ECG, clinical laboratory tests were performed for all patients.Results and discussion. As a result of a comparative analysis, it was found that the number of women in the group of patients with MINOCA (group I) was significantly higher than in group II (p=0.00001). The prevalence of risk factors such as hyperlipoproteinemia and smoking (p=0.0497; p=0.0096) in group I was lower than in group II. The average level of diastolic blood preasure in group I was significantly higher than in group II (p=0.002911). It was found that in the group I level of hemoglobin (p=0.003834), leukocytes (p=0.000376) and lymphocytes (p=0.003423) was significantly lower than in the group II, in group II diastolic dysfunction type I was prevailed (p=0.0084).Conclusions. Study showed that women were more likely to have MINOCA than men. Proportion of patients with hyperlipidemia and smoking in the group I was lower than in the group II. Patients in the group I more likely had diastolic dysfunction, lower hemoglobin and leukocytes level than in patient with MI with obstructive CAD. Independent factors associated with the development of complications in the acute period of MINOCA were a decrease in diastolic blood preasure, an increase in systolic blood preasure and age (multivariate regression logistic analysis).

No abstract

The aim – to investigate the relation between levels of inflammatory factors and clinical course of the ischemic heart disease with and without coronary atherosclerosis. Materials and methods. We examined 105 patients with stable ischemic heart disease (IHD), age 36 to 84 years (mean age 58.5 ± 9.47 years). There were 48.6 % (n = 51) men and 51.4 % (n = 54) women. Based on angiography data, patients were divided into two groups: group I – 53 patients with IHD and non-obstructive coronary arteries (INOCA), group II – 52 patients diagnosed with stable IHD with more than 50 % stenosis. In addition to general clinical methods of examination, the levels of interleukin-6 (IL-6) and highly sensitive C-reactive protein (hsCRP) were determined in all patients. The control group consisted of 20 healthy individuals compared by age and sex. Results. According to the results, it was found that in patients with IHD the level of IL-6 was significantly higher compared to the control, in group I: 4.40 [2.12–9.56] pg/ml and 2.46 [2.29–3.47] pg/ml, respectively (p = 0.027), and in group II – 4.15 [2.80–6.68] pg/ml, which also differed from the control group (p = 0.006). There was no significant difference in the level of IL-6 between groups of patients with IHD depending on the lesion of the coronary arteries (p = 0.99). Among patients with IHD, the level of IL-6 was increased in 40.7 % (n = 22) of patients with INOCA and 34.6 % (n = 18) in patients with stenotic atherosclerosis (group II) (p = 0.22). However, the proportion of women with elevated levels of IL-6 was higher in the INOCA (66.7 %) compared to women with stenotic atherosclerosis (26.7 %) (p = 0.033). Positive correlations were found between the level of IL-6 and the incidence of ventricular arrhythmias in patients of group I (r = 0.44, p = 0.025), as well as between IL-6 and positive cycling stress-test (r = 0.39, p = 0.01), IL-6 and hsCRP (r = 0.43, p = 0.004). According to the results of multivariate regression logistic analysis, an association was established in patients with INOCA between elevated levels of IL-6 and age, hsCRP, history of myocardial infarction and the number of affected vessels (p = 0.04, p = 0.01, p = 0.04, p = 0.037 respectively). Conclusions. Significant differences in the level of IL-6 were found in patients with IHD compared to the control group. It was found that in patients with elevated levels of IL-6, there was higher proportion of women in the INOCA group, compared to the patients with stenotic atherosclerosis. An association was established in patients with INOCA between elevated levels of IL-6 and age, history of myocardial infarction and the number of affected vessels. Key words: ischemic heart disease, INOCA, іnterleukin-6, highly sensitive C-reactive protein.

No abstract