BackgroundAtrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all‐cause mortality may guide interventions.Methods and ResultsIn the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose‐adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all‐cause mortality in the 14 171 participants in the intention‐to‐treat population. The median age was 73 years, and the mean CHADS 2 score was 3.5. Over 1.9 years of median follow‐up, 1214 (8.6%) patients died. Kaplan–Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all‐cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33–1.70, P<0.0001) and age ≥75 years (hazard ratio 1.69, 95% CI 1.51–1.90, P<0.0001) were associated with higher all‐cause mortality. Multiple additional characteristics were independently associated with higher mortality, with decreasing creatinine clearance, chronic obstructive pulmonary disease, male sex, peripheral vascular disease, and diabetes being among the most strongly associated (model C‐index 0.677).ConclusionsIn a large population of patients anticoagulated for nonvalvular atrial fibrillation, ≈7 in 10 deaths were cardiovascular, whereas <1 in 10 deaths were caused by nonhemorrhagic stroke or systemic embolism. Optimal prevention and treatment of heart failure, renal impairment, chronic obstructive pulmonary disease, and diabetes may improve survival.Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00403767.

The results of this study show diverse CLL incidence and prevalence patterns in the adult population of the Russian Federation and Ukraine. Authors propose a more comprehensive study with large region involvement to provide a more precise description of the incidence and prevalence of CLL in Eastern European countries and to better understand disparities reported versus the USA and other Western countries.

In patients with early rheumatoid arthritis ultrasound of joints can determine the level of disease activity and is a promising noninvasive method of the pharmacotherapy monitoring. Adding ramipril to the standard threatment course helps to improve the ultrasound picture, to decrease the articular syndrome and leads to the positive dynamics of the inflammatory markers.

Ингибиторы ангиотензинпревращающего фермента (иАПФ) обладают противовоспалительными, антипролиферативными свой-ствами и могут влиять на процессы ангиогенеза через снижение эффектов ангиотензина II (АТІІ). Применение иАПФ в комплекс-ной терапии ревматоидного артрита (РА) может быть эффективно и для контроля активности заболевания, и для снижения ри Angiotensin-converting enzyme (ACE) inhibitors have anti-inflammatory and antiproliferative properties and can affect the processes of angiogenesis, by reducing the effects of angiotensin II (ATII). The use of ACE inhibitors in the combination

BackgroundThe evaluation of early destruction markers in rheumatoid arthritis (RA) is of significant clinical importance for improving the patient`s life quality. One of the immunological markers of RA early diagnosis and of severe disease is antibodies to cyclic citrullinated peptide (ACCP). Instrumental methods for early diagnosis of RA include the ultrasound of joints. Vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) can stimulate the processes of angiogenesis and proliferation, which in turn can increase the infiltration and hyperplasia of synovia, the growth of pannus mass and contribute to the development of bone and cartilage erosions.Objectives: to establish the correlation of growth factor indicators with markers of the destructive course of rheumatoid arthritis.Methods194 patients with a diagnosis of RA were examined, among the examined patients women prevailed - 86.6%, the age was 47.7 ± 10.22 years. Positive by the presence of ACCP (> 20 U/ml) was 76.8%, and negative - 23.2%. The ELISA in the serum was determined by the concentration of CRP and TNF-α (Vector-Best, Russia), antibodies to cyclic citrulinated peptide (ACCP) (Euroimmun, Germany), VEGF and FGF (BCM Diagnostic, Canada). Ultrasound of the joints was performed by the device “ESAOTE MyLAB40” (Netherlands, 2011) with a linear sensor of 7.5 L 70 (frequency 7.5 MHz), semi-quantitative evaluation of indicators was used: effusion into the joint space (JS), synovial thickness, vascularization of the synovial membrane (SM), the presence of pannus and bone-cartilage erosion.ResultsDirect correlations with CRP and ACCP levels (p = 0.02; p = 0.01, respectively), TNFα and DAS28 (p <0.001) were established during analysis of the correlation links between VEGF and RA clinical course indicators. Analysis of the correlation of VEGF and ultrasound indices of the joints in the examined patients RA established strong direct links with the JS effusion parameters and the SM vascularization assessment (p <0.001, in all cases), and a direct interaction of weak force with the indicator of pannus (p = 0.04) was found. Regression analysis of the dependence of the variability of the SM vascularization assessment on the level of VEGF in the blood showed a sufficient value of the coefficient of determination (0.57), and the data of the normalized index DW = 2.09 reliably indicate the absence of autocorrelation (0.06).Direct correlations with Rö stage (p <0.001) and the rate of CRP (p = 0.02) were established during analysis of correlation links of FGF with the RA clinical course. Analysis of the correlation of FGF and ultrasound indices of the joints in the examined RA patients established strong direct correlations with the indicators of the thickness of SM, pannus, and bone-cartilage erosion (p <0.001, in all cases), the direct correlation of weak force (p = 0.04) was with the SM vascularization assessment index. Regression analysis of the dependence of the variability of the SM thickness indicator on the FGF blood level showed a sufficient v...