Aim. To present the treatment of Acute coronary syndrome (ACS) in clinical practice in the Republic of Karelia and the results of Cardiovascular centers working. Material and methods. The prospective study included 9949 patients successively hospitalized from 01.01.2020 to 01.01.2020 in the Regional cardiovascular center (Petrozavodsk, Russia), 6335 were included in Federal register. Risk factors, clinical features, reperfusion strategy as well as the rate of clinical complications, drug therapy and outcomes were assessed. Results. 9949 patients were treated in Regional cardiovascular center from 01.01.2010 to 01.01.2020 due to acute coronary syndrome, and 6335 were included to the Federal registry. 40.2% of patients had ST-elevation Myocardial Infarction and 59.8% ACS without ST elevation. The first group was younger (the average age was 69) than the second (the average age was 74). The drug therapy of ACS in the hospital was following: 98.7% of patients took aspirin; b-blockers 92.3%, statins 97.4%. The outcomes of ACS during the hospital discharge were following: Q-wave myocardial infarction (MI) was diagnosed in 34.2% cases, non-Q-wave MI in 23.4%, unstable angina 20.5%, repeated MI 18.7% and 2.5% MI unspecified localization. The analysis of the clinical features of ACS shows that significant number of patients (24.8%) had severe complications. So, ventricle arrhythmias were diagnosed in 17.3% of cases, acute left ventricle insufficiency in 7.6%, cardiogenic shock in 3.0%, cardiac arrest in 1.9%, myocardial rupture in 0.4%. The hospital mortality rate reached 6.38%. Conclusion. The article presents data about treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia based on 10-years register. Difficulties of management and reperfusion interventions, the volume of drug therapy, the frequency of complications, as well as outcomes and hospital mortality are discussed. The presented data show the results of modernization of the medical care program for patients with acute coronary syndrome in practical healthcare in the region.

No abstract

The article presents the results of the 5-years follow-up for the patients who had acute coronary syndrome. The results of the hospital treatment were demonstrated. In addition, the study showed the adherence to the therapy, long-term consequences and clinical outcomes following acute coronary syndrome in the clinical practice in the Republic of Karelia

Aim. To study the clinical course, treatment, and outcomes in the patients with ST segment elevation acute coronary syndrome (STeACS) in real clinical practiceMaterial and methods. Our study is based on data of 5694 patients who were sequentially hospitalized in the Regional Vascular Center from 01.01.2009 to 01.01.2019 due to STeACS and included in the Federal Hospital Register. Men prevailed (65.8%); the average age was 68 years old. 14.1% of the patients had the history of myocardial infarction (MI) before this hospitalization. The reperfusion strategy, drug therapy, as well as the risks of complications and outcomes in real clinical practice of the Republic of Karelia were analyzed. Descriptive statistics methods were used to evaluate the results.Results. In the study group a high frequency of reperfusion interventions (83.5%) with a predominance of percutaneous coronary intervention (PCI; 76.2%) was revealed, as well as optimal drug therapy in most patients. Thus, 99.4% of patients took aspirin, 82.8% – clopidogrel, 91.1% – anticoagulants, 91.6% – beta-blockers, 95.6% – statins, 94.2% – angiotensin-converting-enzyme inhibitors/angiotensin II receptors blockers. A risk assessment of hospital and 6-month mortality was performed using GRACE score. The distribution of the hospital risk mortality were the following: 25.7% of patients had a low (49-125 points), 33.7% an average (126-154 points), and 40.6% of patients had a high risk (more than 154 points). At the same time, the risk of 6-month mortality in a half of the patients (51.6%) was low (27-99 points), the average risk (100-127 points) was determined in 23.0% of patients and the high risk (more than 127 points) – in 25.5% of patients. Life threatening complications developed in 38.1% of patients and the most frequent ones were arrhythmias (31.5%). The outcomes at the discharge from the hospital were as follows: 1432 patients (63.5%) had Q MI, 390 (17.3%) – non Q MI, 76 (3.4%) – unstable angina, 21 (0.9%) – MI of unspecified localization and 317 patients (14.1%) – repeated myocardial infarction.Conclusion. According to the results of a 10-year hospital registry of patients with STeACS, a high frequency of reperfusion interventions and an optimal drug therapy in most patients was revealed. However, to increase the effectiveness of treatment, it is necessary to minimize temporary losses both at the prehospital treatment and during reperfusion.

Эпидемиологическая ситуация с сердечно-сосудистыми заболеваниями определяет высокий интерес в изучении патогенеза атеросклероза и поиске новых факторов риска, коррекция которых позволит повысить эффективность первичной и вторичной профилактики. Большое внимание уделяется изучению взаимосвязи уровня био-маркеров воспаления у пациентов с различными формами ишемической болезни сердца и наличием/отсутствием традиционных факторов риска (ТФР). Цель. Изучить взаимосвязь между наличием ТФР и уровнем биомаркеров воспаления и эндотелиальной дисфункции у пациентов, переносящих острый коронарный сидром (ОКС). Материал и методы. В исследование включено 62 пациента в возрасте от 24 до 50 лет (средний возраст 43,98±4,73), госпитализированных по поводу ОКС. Про-ведена оценка ТФР и концентрации в сыворотке следующих биомаркеров: высокочувствительный С-реактивный белок (вчСРБ), гомоцистеин, растворимые сосуди-стые (sVCAM-1) и внутриклеточные (sICAM-1) молекулы адгезии 1 типа, растворимый Е-селектин (sE-селектин), нитрат, неоптерин, матриксная металлопротеиназа 3 типа (ММР-3). Результаты. В исследуемой группе выявлена высокая распространенность ТФР, в том числе корригируемых. Установлена взаимосвязь между рядом ТФР и повышен-ной концентрацией определенных биомаркеров воспаления. Так, у пациентов с отягощенной наследственностью по ранним сердечно-сосудистым заболеваниям со-держание sVCAM-1 оказалось достоверно выше (1047,78±516,98 нг/мл) в сравнении с пациентами без данного ТФР (705,57±239,28 нг/мл), p=0,017, высокое содержание ММР-3 (9,31±3,63 нг/мл) было ассоциировано с наличием артериальной гипертонии, тогда как у пациентов без данного ТФР концентрация ММР-3 была достоверно ниже (5,02±3,66 нг/мл), р=0,011. Кроме того, у пациентов, страдающих абдоминальным ожирением, концентрация нитрата в плазме была выше в сравне-нии с пациентами без данного ТФР как при ОКС (208,45±91,85 нг/мл vs 154,53 нг/мл, р=0,028), так и в отдаленном периоде (193,53±40,02 нг/мл vs 173,48 нг/мл, р=0,028). Заключение. Исследование продемонстрировало значимую взаимосвязь между наличием ряда ТФР и повышенными концентрациями определенных биомаркеров воспаления и эндотелиальной дисфункции у пациентов, переносящих ОКС, что, вероятно, ассоциировано с высокими темпами прогрессирования атеросклероза, по-вышенным риском атеротромботических событий, осложненного течения ишемической болезни сердца и неблагоприятным исходом. Ключевые слова: биомаркеры воспаления, традиционные факторы риска, острый коронарный синдром, эндотелиальная дисфункция. Actuality of cardiovascular diseases today determines the high interest to study pathogenesis of atherosclerosis and to searching new risk factors which could help to optimize primary and secondary prevention. Study the correlation between biomarkers of inflammation and traditional risk factors (TRF) in patients with different forms of ischemic heart disease is really important today. Aim. To determine the correlation between TRF and the level of biomarkers of the inflammation and endothelial dysfunction in patients with acute cor...