For many years, there has been no model capable of explaining the complex processes of interaction between various bloodclotting factors leading to a stop of bleeding. One of the most successful models able to partially reflect the mechanisms of hemostasis for a long time was the cascade theory. The cascade model perfectly explains the processes occurring during coagulation in vitro, but was completely inadequate in attempts to evaluate the processes occurring in vivo. A significant drawback of the cascade model is the impossibility to trace the interaction of cells carrying the tissue factor, platelets and plasma coagulation factors on their surface, since these conditions cannot be imitated. The cell theory, which has replaced the cascade theory, pays attention not only to the interaction of plasma coagulation factors, but also takes into account the role of platelets as important participants of coagulation processes. It is based on a four-stage reaction cascade that includes the following stages: initiation, amplification, propagation, and termination.The cell theory of hemostasis is able to reflect the complex process of interaction of all the links of hemostasis and answer questions related to the problems in patients with disorders of the coagulation system. The cell theory of hemostasis allows to reflect more precisely the processes of hemostasis in vivo and to interpret correctly the results of tests and pathophysiological mechanisms of disorders of the coagulation system. Global tests (thrombin generation assay, thromboelastography, thrombodynamics) used for hemostasis system evaluation are more complimentary with cell theory of hemostasis.

In recent years there is a positive trend in the development of preventive medicine, in particular, primary prevention of diseases. However, in most cases, patients seek help from a doctor after the manifestation of the disease, and therefore, early identification of risk factors (RF) remains relevant. Conduction of a large number of studies that are aimed at studying modifiable RF associated with the development of cardiovascular diseases (CVD), allowed the experts of the American Heart Association to develop recommendations “Life's Simple 7”, which makes it possible to structure methods of primary prevention of CVD and minimize the risk of their development. In 2019, experts from the American College of Cardiology presented a simplified version of these recommendations, to improve approaches to primary prevention and their effectiveness not only for doctors but also for patients. Thus, by involving the patient in the decision-making process about follow-up treatment, doctors can achieve a high level of compliance, which is essential for improving the prognosis. The “ABCDE” recommendations, in name of which are reflected the first letters of the leading CVD RF, include such paragraphs as RF assessment, the use of antiaggregating therapy, correction of blood pressure, cholesterol levels, smoking elimination, correction of high glucose levels and diabetes treatment, weight loss, assessment of social and economic factors affecting the morbidity in a particular patient. Despite the undoubted benefit of the “ABCDE” recommendations, some problems of primary prevention currently cannot be solved: the inability to accurately assess social and economic RF; the imperfection of the used CVD risk scales. The updated version of the recommendations allows not only to assess the existing RF of the patient, but also to effectively correct them. In addition, the patient himself can read the recommendations, which improves understanding of the primary prevention importance.

Introduction. Thromboembolic syndrome is a dangerous complication of atrial fibrillation (AF). Left atrial appendage (LAA) is the most frequent location of the thrombus formation in AF. Enlargement of the LAA, special anatomical forms of the appendage are accepted as a risk factors of the LAA thrombosis.Aim: to assess the revealing macro-/microthrombosis LAA in dependence of the morphological form of the appendage in autopsy.Methods. 85 cadaveric hearts were investigated. LAA was measured in three dimensions, the anatomical form of the LAA were estimated by Wang et al. classification. Histological investigation of the LAA slices was made in Hematoxylin Eosin colouring.Results. Macrothrombosis was revealed in 4 LAA. Microthrombus in the LAA were revealed in 46 (54,1%) specimens. We did not find statistical significance between frequency micro thrombosis of the LAA and morphology of the appendage (p = 0,3) with the trend to revealing more microthrombus in anatomic form of the LAA «chicken wing» (65% of this morphological type). Analysis of the diseases died patients showed absence AF in 54,3% cases of the LAA microthrombosis group. AF was diagnosed only in 16 (45,7%) cases in stroke group with revealed micro thrombosis in the LAA.Conclusion. The investigation did not show statistical significance between the anatomical form of LAA and revealing of appendage microthrombosis. Possibly, there is a common pathomorphological process of the LAA thrombosis independence of the AF presence. Further trials are needed to confirm this consumption.

Chronic noninfectious diseases (cardiovascular, bronchopulmonary, oncological diseases and diabetes mellitus) are presently the most common cause of death worldwide, with cardiovascular diseases (CVD) being predominant. For this reason, the key goal of a physician is not only to treat but also to prevent diseases. Acetylsalicylic acid (ASA) is considered one of the most effective drugs for secondary prevention of CVD. However, the use of ASA for primary prevention is still debated. Results of many studies of ASA are inconsistent. Some studies have suggested that using ASA in patients aged 40-70 with a high 10-year risk of CVD and a low risk of bleeding may reduce the incidence of CVD. Administration of ASA to patients with a high or medium risk of CVD is also considered.