Aim      To evaluate the proportion of type 2 myocardial infarction (MI) in the structure of mortality at a multidisciplinary hospital; to describe major causes for MI development, and characteristics of patients with a verified diagnosis of type 2 MI by data of postmortem examination.Material and methods  1574 protocols of the autopsies performed at the Central Pathology Department of the I.I. Mechnikov North-West State Medical University from 01.01.10 through 31.12.16 were studied retrospectively by the continuous sampling method. A group with verified diagnosis of type 2 MI was isolated from the total sample of autopsies. Major causes for and the proportion of type 2 MI among the causes of death were studied. Also, major demographic parameters, hospitalization profile, and condition of coronary arteries (CA) were compared in patients with fatal type 2 MI and those who died from atherothrombotic type 1 MI.Results Analysis of 1574 fatal cases among patients of the multidisciplinary hospital showed that in 360 cases (22.87 %), the cause of death was MI, including 137 cases of fatal type 2 MI. Proportions of men and women among the patients with postmortem verification of type 2 MI were comparable. Analysis of the age structure showed the highest incidence of type 2 MI in elderly (48.2 %) and senile (34.3 %) age. Mean age of patients with type 2 MI was 71.7 years (68.2 years for men and 75.3 years for women), which was comparable with the age range of patients with fatal type 1 MI. In both groups, men with fatal MI were significantly younger than women. Analysis of causes for type 2 MI demonstrated that the most frequent ones were tachysystolic arrhythmias (59.12 %) and severe hypoxia of different origin (35.04 %). Analysis of the type of CA lesions showed that significant lesions were significantly more frequently absent in type 2 MI (32.85 %) while in type 1 MI, the proportion of patients with unchanged CA was 1.84 %. In the group of patients with fatal type 1 MI, 67.29 % had multivascular lesions, and one in two patients had an occlusive lesion. In the group with type 2 MI, multivascular lesions were half as frequent (31.38 %), and only 4.38 % of patients had a complete occlusion of a coronary vessel. Comparison of death rate in different departments of the multidisciplinary hospital showed that only 29.2 % of patients with type 2 MI originally were managed at a specialized cardiological department; 45.3 % of patients were admitted to an internal medicine department for different conditions often not related with ischemic heart disease. Furthermore, 25.5 % of patients with subsequently developed type 2 MI originally even received scheduled or emergency medical care for a leading surgical condition.Conclusion      Cardiovascular diseases predominate among causes of mortality in a multidisciplinary hospital. This study showed that almost one in four patients dies from MI, and type 2 MI accounts for more than one third of fatal MIs. Among major causes for type 2 MI, tachysystolic arrhythmias (59.12 %) and pronounced hypoxia associated with anemia and severe respiratory failure (35.04 %) should be noted. Gender and age characteristics of patients with type 2 MI were comparable with those of patients with fatal type 1 MI. Furthermore, surgical patients accounted for 25.5 % of fatal cases of type 2 MI.

Aim. To study antithrombotic therapy (ATT) in patients with myocardial infarction (MI) type 1 and preexisting atrial fibrillation (AF), effect of ATT on prognosis. Material and methods. 100 patients with type 1 MI and preexisting AF were selected. The exclusion criterion was severe concomitant pathology. Results. Only 13.0% of AF patients took anticoagulants (AC) adequately before hospitalization. 94.0% of patients in hospital and 80.5% at discharge were prescribed triple ATT at least for 1 month with transition to dual ATT (AC + disaggregant) for 12 months. ACs were prescribed in hospital in 100.0% of cases, at discharge in 93.1%. After 1 year 8.4% of patients stopped taking ACs, after 2.31.9 years 15.7%. The incidence of ischemic and hemorrhagic events didnt differ in patients with different regimens of ATT (double/triple) and types of AСs (vitamin K antagonists/non-vitamin K antagonist ACs). In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had increased risks of stroke (OR 9.580; 95% CI 1.15379.599, p=0.0365); combined endpoint: recurrent MI + stroke + cardiovascular mortality (OR 2.556; 95% CI 1.1045.918, p=0.0284). Сonclusion. Patients with preexisting AF had a low adherence to ACs prior to MI. It increased after hospitalization and decreased during follow-up. In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had significantly increased risks of stroke, combined endpoint. There were no differences in the prognosis depending on the type of ACs, the regimens of ATT administered in accordance with ischemic and hemorrhagic risks.

Prevalence of patients with myocardial infarction (MI) and atrial fibrillation (AF) has been growing every year. These patients represent a highest risk group and, thus, require special attention of clinicians. The article foсused on mechanisms of the AF and MI interaction, special aspects of prediction depending on the type of AF and MI, and the issue of antithrombotic therapy in this patient category. A group of AF-associated, embologenic MIs was isolated, and diagnostic criteria and therapeutic regimens were provided.

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Интродукции растений отведена большая роль в обогащении районов с бедным флористическом со- ставом и увеличении разнообразия «полезных» для человека растений. Перенос растений человеком из одних районов в другие начался далеко в прошлом, продолжается до настоящего времени и обусловлен желанием создания лучших условий существования. Так, новые растения (при успешной интродукции) в различные временные периоды использовались для пищевых целей, в лесном хозяйстве и озеленении. В настоящее время многие интродуцированные виды растений стали настолько привычными в нашей повседневной жизни, что их отсутствие вызвало бы недоумение. В статье приведена информация о возникновении интродукционных пунктов на территории северной части Республики Казахстан. Освещены основные этапы распространения новых видов в озеленитель- ные насаждения района исследования. Представлен ассортимент видов растений, наиболее устойчивых к условиям Северного Казахстана. По результатам наблюдений для внедрения в озеленительные по- садки пригодны 233 вида, формы и сорта интродуцентов древесно-кустарниковых растений. Проведен анализ видового разнообразия интродуцентов на примере г. Щучинска. Посадки города представлены 65 видами, сортами и формами растений, относящихся к 47 родам и 20 семействам. Из всех выявленных видов наибольшая встречаемость была у клена ясенелистного, который является инвазионным видом. В результате проведенного анализа выявлено, что в озеленительных посадках северных городов Казах- стана применяется ограниченное количество видов растений. Plant introduction plays a major role in enriching areas with poor fl oristic composition and increasing the diversity of plants “useful” for humans. The transfer of plants by humans from one region to another began far in the past, continues to the present time, and is due to the desire to create better living conditions. Thus, new plants (if successfully introduced) were used for food purposes, forestry, and landscaping at various time periods. Currently, many introduced plant species have become so familiar in our daily lives that their absence would leave perplexed. The article provides information about the emergence of introduction points in the northern part of the Republic of Kazakhstan. The main stages of the spread of new species in the landscaping areas of the study area are highlighted. The assortment of plant species that are most resistant to the conditions of Northern Kazakhstan is presented. According to the results of observations, 233 species, forms and varieties of introduced tree and shrub plants are suitable for introduction into landscaping plantings. The analysis of the species diversity of introduced species is carried out using the example of Shchuchinsk. The plantations of the city are represented by 65 species, varieties and forms of plants belonging to 47 genera and 20 families. Of all the identifi ed species, the highest occurrence was in the ash-leaved maple, which is an invasive species. As a result of the analysis, it was revealed that a limited number of plant species are used in landscaping plantations of the northern cities of Kazakhstan.