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Цель. Стратифицировать группы риска повторных коронарных событий у лиц с нестабильной стенокардией (НС) в отдаленные сроки наблюдения (12 меся-цев). Материал и методы. В исследование включено 180 пациентов с НС, которые, в зависимости от клинического течения болезни, были разделены на 2 группы: с/без развития неблагоприятных исходов (летальность, инфаркт миокарда, возвратная НС, потребность в срочной реваскуляризации миокарда, жизне-угрожающие нарушения ритма и проводимости). Определялись биомаркеры, лежащие в основе патогенеза развития НС. Результаты. Независимыми и доступными предикторами явились MPV, фибриноген и фракция выброса миокарда ЛЖ. Вероятность развития небла-гоприятных исходов НС при уровне MPV 9,1 fl (чувствительность 44%, специ-фичность -79%), фибриногена >4,4 г/л (чувствительность 62%, специфич-ность -62%), фракции выброса 54% (чувствительность 83%, специфич-ность -97%) увеличивается в 10 раз. Разработанная скрининговая шкала стратификации риска позволяет с высокой точностью (чувствительность -62,5%, специфичность -89,0%, AUC = 0,799) выделять группы высокого риска повторных коронарных событий среди лиц с НС. Заключение. Динамическая оценка биомаркеров MPV, фибриногена и ФВ ЛЖ важна для своевременного и эффективного медикаментозного и хирургиче-ского вмешательства, а также эффективной вторичной профилактики повтор-ных коронарных событий. Российский кардиологический журнал 2013, 5 (103): 18-22Ключевые слова: прогноз, нестабильная стенокардия, повторные коронар-ные события.ГУ Республиканский научно-практический центр "Кардиология", Минск, Республика Беларусь.Маркова И. А.* -мл. науч. сотрудник лаборатории хирургии сердца, Медве-дева Е. А. -к. м.н., ведущий научный сотрудник лаборатории хирургии серд ца, врач-кардиолог кардиотерапевтического отделения № 2, Гелис Л. Г. -д. м.н., главный научный сотрудник лаборатории хирургии сердца. *Автор, ответственный за переписку (Corresponding author): inha.markava@gmail.com НС -нестабильная стенокардия, ФВ ЛЖ -фракция выброса миокарда левого желудочка, ИМ -инфаркт миокарда, ОКС -острый коронарный син-дром, СРБ -С-реактивный белок, Тв -тромбиновое время, ПТв -протром-биновое время, Фг -фибриноген, АТ III -антитромбин III, АКШ -аорто-коро-нарное шунтирование, МПО -миелопероксидаза, ГЦ -гомоцистеин, ФрВ -фактор Виллебранда, MPV -показатель среднего объема тромбоцитов, BNP -предиктор ишемической дисфункции миокарда.Рукопись получена 12.08.2013 Принята к публикации 21.10.2013 Predicting the long-term risk of repeat coronary events in patients with unstable angina Markova I. A., Medvedeva E. A., Gelis L. G. Aim.To stratify the patients with unstable angina (UA) by the levels of long-term (12 month) risk of repeat coronary events. Material and methods. The study included 180 UA patients, who were divided into two groups: with or without adverse outcomes (death, myocardial infarction, recurrent UA, urgent myocardial revascularisation, life-threatening cardiac arrhythmias and blockades) during the follow-up period. The levels of biomarkers of UA pathogenesis were als...

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ance, Group A patients had higher total cholesterol (224 ± 46 vs 211 ± 40 mg/dL, p < 0.001), non-HDL cholesterol (177 ± 42 vs 150 ± 52 mg/dL, p = 0.001), and uric acid levels (5.4 ± 1.4 vs 5.2 ± 1.3, p = 0.023) than Group B patients. VAI was directly correlated with total and non-HDL cholesterol in the whole sample and in either sex; a direct correlation with blood glucose was also present in women and in the whole sample, but not in men. Conversely, VAI was inversely correlated with age, both in men (r = −0.220, p = 0.02) and in the whole sample (r = −0.120, p < 0.01). Ten-year coronary risk (CR) was assessed by the Framingham equation in patients aged less than 74 years and without history of overt cardiovascular disease (N = 343). CR was higher in Group A (16.1%) than in Group B (11.8%), p < 0.001. The difference was highly significant in women (N = 282, p < 0.001) and approached statistical significance in men (N = 61, p = 0.058). In the stepwise multiple regression analysis, VAI was independently associated with CR and was included in the equation before uric acid, non-HDL cholesterol, and eGFR in this order (r 2 = 0.163).Conclusions: VAI may be a useful parameter in the assessment of cardiovascular risk in elderly outpatients.Objective: Many forms of Smokeless Tobacco products exist worldwide. In Venezuela, Chimó is the most common form of Smokeless Tobacco. It is compound by tobacco leaf, sodium bicarbonate, brown sugar, ashes from the Mamón tree, vanilla and anisette flavoring. The ingredients vary according to the region within Venezuela. A small amount of Chimó is placed between the lip or cheek and the gum and left there for some time, usually 30 minutes. The mixture of Chimó and saliva is spit out. There are relation smokeless tobacco and hypertension in many studies The relation between hypertension and chimó has not been studied. The hypothesis was that chimó may increase hypertension risk. Design and method:An observational cross-sectional study. During the years [2013][2014] 1938 subjects aged 20 or older were evaluated in Timotes, a medical center from Andean region of Venezuela. Standard questioner and anthropometric measurements were obtained from each participant. Blood pressure was measured with OMRO HEM-907XL model equipment, twice, in the non-dominant arm supported to the heart level, in sitting position, after five minutes of rest. Results:Overall, 1938 subjects with a mean age of 47.8 ± 0.62 years in men and 50.1 ± 0.50 years in women (p = 0.004), 59.5% was females. Chimó frequency use was 55.0% in men and 45.0% in women (p < 0.0001). The result of regression logis-

Aim. To evaluate the informative value of biomarkers (cardiac troponin l (cTnl), high-sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NTproBNP), stimulating growth factor (ST2)) as laboratory markers of myocardial ischemia-reperfusion injury in patients with ST-segment elevation acute coronary syndrome (STEACS) undergoing endovascular revascularization.Material and methods. The study included 115 patients with STEACS who underwent endovascular myocardial revascularization. To identify the informative value of biomarkers, the levels of cTnl, NTproBNP, hsCRP, sST2 were analyzed at baseline, as well as after reperfusion therapy on the 2nd (cTnl) and 5th (sST2, hsCRP, NTproBNP) days. Contrast-enhanced cardiac magnetic resonance imaging was performed 5 days after endovascular intervention.Results. Microvascular obstruction was detected in 54 patients (47%), of which 24 (44%) patients had a combination of microvascular obstruction and myocardial hemorrhage. ln 61 cases (53%), no microvascular damage was registered. lt was found that with an increase in the threshold initial NTproBNP levels >590 pg/ml, the odds ratio (OR) of myocardial reperfusion injury was 12,2 (95% confidence interval (CI), 4,81-30,92, p<0,001). In addition, we analyzed biomarker levels in the early period after myocardial infarction, at which threshold values of reperfusion injury parameters were established as follows: for cTnI >8,1 ng/ml, OR=7,17 (95% CI, 3,11-16,53, p=0,001); for hsCRP >14 mg/L, OR=12,71 (95% CI, 5,03-32,08, p=0,001); for NTproBNP >334 pg/ml, OR=11,8 (95% CI, 4,88-28,59, p=0,001); for sST2 >41 ng/ml, OR=7,17 (95% CI, 3,11-16,53, p=0,001). According to multivariate analysis, predictors of microvascular injury were the initial NTproBNP values, as well as the cTnI, hsCRP, and sST2 values in the early postinfarction period (sensitivity — 89,5%, specificity — 83,3%).Conclusion. Thus, the initial NTproBNP, as well as cTnI, hsCRP, sST2 values after percutaneous coronary intervention are more informative for assessing the risk of microvascular damage.