Aim. To investigate on the prevalence of hyperuricaemia (HU) among citizens and rural areas inhabitants of Krasnoyarsk region, and to assess possible relation of HU with arterial hypertansion (AH), HU and renal function.

Material and methods. The study was done under the framework of ESSE-RF, included 1603 persons of age 25-64, had been selected by the random three-stage stratified selection. All participants underwent questionning, office BP measurement. Uric acid level (UA) was measured with urease method on Architect 8000 (USA) equipment. Statistics was done on IBM SPSS v. 22, StatSoft STATISTICA v. 10 and LibreOffice v. 5. Significance of differences by quantitative criteria was checked with Mann-Whitney criteria, by qualitative criteria — by hi-square. Differences were significant at p<0,01.

Results. The prevalence of HU in general was 30,2% among participants, with the mean UA level 338,5 mM/L (males had significantly higher). The significant higher levels were revealed in citizens than in rural inhabitants. There was no significant difference in UA level through age subgroups. Part of hypertensives was 1,27 times more than in those with normal UA (57,7% versus 45,7%), and 1,36 more prevalent in females (57,1% versus 42,1%). The similar was found in comparison of hypertensives among hyperuricaemics, and AH prevalence in Krasnoyarsk region (57,7% versus 49,4%), and almost completely due to females prevalence (57,1% versus 43,7%). The calculated glomerular filtration rate was significantly lower in HU persons than in those with normal UA.

Conclusion. A relatively high prevalence of HU was found in the territories of Krasnoyarsk region, showing higher levels than those by ESSE-RF results. In males the disordered UA level is higher than in females and more prevalent. Citizens have HU more prevalent than rural inhabitants. The relative risk of hypertension development increases in HU more than in persons with normal UA. In HU functional kidney condition is significantly impaired.

Aim. To investigate on the possible associations of dehydroepiandrosterone sulfate (DHEA-S) levels in blood serum, with cardiovascular diseases (CVD), risk factors (RF) and all-case mortality, as CV mortality, and to assess the specifics.

Material and methods. The results analyzed, of the prospective cohort study “Stress, ageing and health”, that included 1876 persons at age 55 years and older. According to the protocol, all participants were assessed on the RF and CVD. Mortality was assessed based on the continuous death registry, with the standard methods. During 8-year observation, 473 deaths registered, including CVD — 286. Statistics was done with SAS software.

Results. Mean DHEA-S levels were 1,5 times higher in men than in women. A significant decline of concentration was found with the age, and decrease gradient was 2 times faster in men. Prevalence of the low DHEA-S level in 55 and older was 17,4%, increased from 7,0% among 55-64 y. o. to 46,2% at age 85 and older (p<0,0001). There were no significant relations with ischemic heart disease (CHD), diabetes and chronic heart failure in men and women. Mean level of DHEA-S was significantly higher in male smokers, and prevalence of low DHEA-S levels in male smokers was lower than in non-smokers. Low concentrations of the studied parameter decreased with the raise of compression force in dynamometry. Similarly, C-reactive protein (CRP) and total cholesterol (TC) in the 1st quintile significantly predicted lower level of DHEA-S. Application of the multiple logistic regression made it to evaluate the independent associations of low DHEA-S and RF, similar for both sexes: age, smoking, low dynamometry, cholesterol level outside the 2-4 quintiles, low CRP. In multiple model of prognostic significance of DHEA-S for all-cause mortality and CV mortality in men there were no significant relations (HR 1,13 13 (0,86-1,50), р=0,38; and HR 1,18 (0,84-2,67), р=0,34, respectively). In female cohort, on the contrary, death risk in low DHEA-S was 1,5 times higher, than in higher concentrations (HR 1,58, 95% CI 1,12-2,24, p=0,009). The significance of differences remained with correction for the age, raised BP, CHF, low dynamometry and TC levels outside 2-4 quintiles. For CV mortality in women the low DHEA-S was significant at 9%.

Conclusion. Low DHEA-S is independent predictor of all-cause mortality in women 55 years and older, but does not significantly associate with mortality in men of the same age.

Aim. To compare mortality parameters in coronary heart disease (CHD) in Russia and USA, and to assess the reasons for differences; to underline the necessity for adequate completion of death certificates.

Material and methods. Age-related and standardized mortality coefficients (SMC) for ages older than 50, in Russia and the US, were calculated, that are relevant to three- and four-digit codes of the “International Statistical Classification of Diseases and Related Health Problems, 10th”. As a standard for mortality coefficients, the European Standard Population (ЕСН-2013) was applied.

Results. SMC from all types of CHD among men 50 years and older in RF was 2153,1, and in USA 712,6; among women, respectively, 1288,3 and 421,2. The part of deaths from “acute” CHD was 19,5% and 34,2% (males, RF and USA), 14,9% and 34,7% (females, RF and USA). Mortality from myocardial infarction (MI) (ICD-X code I21) in Russia is 1,6 times lower than in the USA, but by the chart “Other forms of acute ischemic heart disease”, I24) mortality in RG among women is 22 times higher, and in men — 35 times. The article discusses such discrepancies.

Conclusion. Differences in mortality from CHD in the US and Russia are due to a range of reasons, many of them related to selection of primary cause of death and specifics of ICD-X code selection.

Aim. To investigate on the role of alcohol in sudden cardiac death onset (SCD) in economically active inhabitants.

Material and methods. Totally, medical documentation was analyzed, of 1447 economically active inhabitants of Bryansk region in 2012, died due to circulatory causes: the outpatient chart, the inpatient chart, medical death certificate, forensic autopsy, common autopsy. The SCD criteria fulfilled 106 cases. With a unified questionnaire, 26 relatives were surveyed, and medical staff, of those who agreed to respond. In section of 61 corpse, alcohol concentration was measured, with the level of intoxication defined.

Results. By the data from official documents, the part of alcohol cardiomyopathy (ICD I42.6) was 7% from all death cases of suddenly died economically active inhabitants. Outpatient charts and case histories documented the fact of alcohol abuse in 36% of those who requested medical help while alive. Relatives or medical staff, contacted with the died just before the death, confirmed alcohol overconsumption in 42%. Corpse blood investigation revealed 27% specimens with alcohol, and about a half of cases the concentration was at more than moderate intoxication.

Conclusion. Alcohol plays significant role in SCD development in economically active inhabitants. Abuse with the alcohol beverages leads to development and progression of structural and functonal changes in the heart — the substrate for life-threatening ventricular arrhythmias. Also, in many cases alcohol might be the trigger for fatal rhythm disorders.

Aim. To investigate on the prevalence of the main cardiovascular RF among inhabitants of rural regions in three countries: Russia, Kyrgyzstan, Kazakhstan, with the analysis of ethnic specifics (by the data from Interepid study).

Material and methods. The study has been conducted under the framework of international project “Interepid”. Into analysis, the representative selections included, of rural inhabitants from Volga district of Samara Region of Russia (n=1050), from Chuysky Region of Kyrgyzstan Republic (n=1341) and Karaganda Region of Kazakhstan Republic (n=1807), age 25-64 y. o. Under the framework of “Interepid”, the investigation included questionnaires by special chart, objective data and laboratory tests. Smoking was set if at least one cigarette per day. Arterial hypertension was set by criteria of increased BP and in normal BP if on treatment. Obesity criteria: body mass index ≥30 kg/m2 as body mass in kilograms divided by height in meters squared.

Results. Among the three analyzed countries, smoking was most prevalent in the Russians in Kazakhstan, and the lowest — in Russia. Russian men smoked more commonly comparing to native inhabitants in Kazakhstan, as in Kyrgyzstan. Arterial hypertension prevalence in the five analyzed groups showed the most prevalence among Russian population in Kyrgyzstan. In Kazakhstan and Kyrgyzstan, among men the mean SBP values were significantly higher in Russians. Obesity was the most prevalent among rural inhabitants of Kyrgyzstan, among men and women of  Kyrgyz nationality, and the peak of this parameter was at 50-59 y. o.; obesity prevalence declined after 60 y. o.

Conclusion. There remains high prevalence of CVD risk factors on the postsoviet area. The data obtained, points on ethnic differences of the main CVD risk factors inside the countries. It was shown that at populational level the Russians, living in rural areas of Middle Asia countries have more risk factors comparing to the Russians living in Russia (Samarskaya Region).

Aim. To evaluate gender differences in the disease course and in treatment at inpatient stage of management of ST elevation acute coronary syndrome (STEACS) patients by the data from the Russian Registry of Acute Coronary Syndromes “RECORD-3”.

Material and methods. The study was conducted based on the data from Russian registry “RECORD-3”, in 47 institutions of 37 cities of Russia. The Registry included all consequtive patients with ACS, hospitalized in the participated institutions during march-april 2015, totally 2370 ACS patients. From the general group, patients were selected with the admission diagnosis STEACS (n=864). Mean age of STEACS patients was 62,6±12,4 y. Among them, 712 (82,4%) were primarily hospitalized into centers with invasive methods available, others (n=152, 17,6%) to non-invasive. The analysis was conducted, of the in-patient stage of patients, including reperfusion methods, and analysis of medication therapy.

Results. More than a half of patients (68%) with STEACS were males, and hospitalized women were 10 years older. Females with ACS were at baseline clinically more complicated with arterial hypertension (AH), angina, chronic heart failure (CHF), diabetes 2 type, and atrial fibrillation in anamnesis. Higher number of acute heart failure was found (HF) (Killip II-IV) in females with ACS. There were no gender differences by the time of onset of pain to admittance and of doorballoon time. However coronary and ventriculography (CVG), percutaneous interventions (PCI), thrombolysis were done significantly (p=0,0001) rarer in females than in males. Higher mortality was found in females with STEACS comparing to males. There was higher rate of mortality in STEACS of females comparing to males (17,5% vs. 6,3%, p=0,0001). Monofactorial analysis revealed factors related to non-direction of patients to coronary arteriography: older age (more than 60 y. o.), female gender, cardiovascular comorbidity, acute heart failure at admittance.

Conclusion. By the results of data analysis of “RECORD-3”, there were special characteristics of STEACS patients revealed for females: mean age is 10 years older than males; higher rate of cardiovascular comorbidity; reperfusion performed more rare, including outpatient stage of management. All these lead to significantly worse outcomes.

Aim. With the multimarker approach, to investigate and implement an integrative biomarker for non-invasive risk assessment of the presence and severity of coronary atherosclerosis.

Material and methods. Totally, 205 consecutive patients included, age 18 and older, mean age 62,8±9,0 y., admitted and investigated in-patient at National Research Center for Preventive Medicine of the Ministry of Health in 2011-2013, underwent diagnostic coronary arteriography (CG) and duplex carotid scanning. Localization and grade of coronary atherosclerosis were assessed with the score Gensini (GS).

Results. The analysis was done in 3 groups: no coronary atherosclerosis (GS =0), with coronary atherosclerosis of any grade (GS >0), and severe (GS ≥35). Based in the preliminary analysis of mathemathical models that included visual and biochemical markers, the most siginificant were selected that have been included into the integrated biomarker. Value of i-BIO >4 points with sensitivity 87,9% makes it to reveal coronary atherosclerosis patients, when i-BIO >9, with specificity 79,8%, makes it to rule out the persons with no coronary atherosclerosis.

Conclusion. The invented complex parameter i-BIO might be regarded as a novel integrative biomarker of coronary atherosclerosis and its severity grade.

The article is focused on the reasons for lack of a precise data and issues related to population assessment of morbidity/mortality in subsequent myocardial infarctions (re-MI). Significant factors for re-MI development are age older than 60 y., comorbidities, treatments. The evaluation and significance of re-MI risk factors do influence the specifics of database formulation, parameters selection for analysis. The reasons underscored, that lead to secondary prevention of cardiovascular events, but not second infarction itself. Briefly the approaches to secondary prevention listed.

The data characterizing the features of the level, dynamics and structure of mortality from circulatory system diseases (BSC) in the Republic of Bashkortostan (RB) as a whole and able-bodied age are presented and the influence of the resources of the health system and the per capita gross municipal product on the mortality from BSC, taking into account their spatial distribution . The materials of the Territorial Body of the Federal State Statistics Service for Belarus (Table C-51, "Distribution of the deceased by sex, age groups and causes of death") were used. Data were considered that are a combination of observations on 54 municipalities and 21 cities of the Republic of Belarus, traced in the dynamics from 2002 to 2015. Autoregressive panel models of spatial lag are used as a research tool. As a result of the analysis it was found that there is a direct indirect effect on the mortality rate from the SSC of the resources of the health care system, taking into account their spatial distribution, and when assessing the change in the mortality rate from diseases of the circulatory system, it is necessary to take into account the spatial intermunicipal distribution of influence factors.

Aim. To assess the influence of synthetic progesterone — drospirenone, on remodeling of the left ventricle myocardium (LV) in ovariectomized (OE) female rats under circumstances of experimental heart failure (EHF).

Material and methods. The study was done on 25 female Wistar rats, mass 260-300 g. Twenty animals (in 2 months after bilateral ovariectomy) underwent modeling of EHF by subcutaneous load of 0,1% mesaton solution for 14 days with following swimming to profound exhaustion. Four rats were removed on 14th day of EHF. Sixteen experimental animals with EHF were selected to 3 groups: 10 underwent 14 days subcutaneous load of drospirenon (Sigma-Aldrich, USA), dose 2 mg/kg (n=5) and 0,5 mg/kg (n=5), 6 were being loaded saline 0,2 mL daily. On 28th day the animals were removed from the experiment. With light microscopy method, immune cytochemistry, morphometry the LV myocardium was investigated.

Results. In OE rodents on the 14th day of EHF there was clear and significant heteromorphism of contractile cardiomyocytes (CMC) with the signs of hypertrophy and dystrophy; increase of the volume density (VD) of stroma, reorganized extracellular matrix (EM), expression of metalloproteases-2,9 (MMP-2,9) and tissue inhibitor of metalloproteases-1 (TIMP-1), CMC with apoptosis. After remodeling of EHF at 28th day in myocardium there was further increase of CMC number with significantly changed morphology and tinctorial properties, degradation of EM components. In rats receiving 14 days drospirenon, regardless of dosage, there was regression of pathological changes, decrease of CMC hypertrophy grade, as the nuclei, decrease of CMC with the signs of apoptosis, and stabilized EM components.

Conclusion. The cardioprotective properties of drospirenon are discussed, that even in minimal therapeutic concentrations facilitates structural and functional rehabilitation of myocardium under conditions of gonade hormones deficiency and EHF.

Atrial fibrillation (AF) is one of the most prevalent rhythm disorders and might be associated with the high risk of thromboembolic complications, including stroke. For risk estimation, of the thrombotic complications, a variety of scores has been implemented, including CHA2DS2-VASc Score. According to the European Society of Cardiology Guidelines on AF management (2016), males showing more than 2 points, and females with more than 3 points by CHA2DS2-VASc, for embolism prevention, it is recommended to prescribe novel oral anticoagulants (NOAC). NOAC are effective and relatively safe comparing to vitamin K antagonists (VKA), are convenient being taken per os, do not have necessity of individual dosing, have rapid onset of the maximum effect (in several hours) and predictable effect in relation to dose. Among drugs from this group, dabigatran can be highlighted, which has in comparative studies shown not only high efficacy, but is the safest among all NOAC, as it does rarely lead to hemorrhagic complications and is the only NOAC for now, with the developed and available neutralizing agent — idarucizumab.

The review focuses on the influence of magnesium deficiency on a variety of cardiovascular pathogenetic chains. The issues especially considered are vessel tone regulation, endothelial function, atherogenesis and atherothrombosis, as the functioning of cardiac conduction system. These mechanisms, disordered, lead to initiation and progression of the disorders as essential hypertension, chronic heart failure and coronary heart disease. Also, the data systematized, on the role of magnesium homeostasis correction for prevention and treatment of these pathologies.

The review is focused on the recent translational studies linking biological processes with the three common psychological states — risk factors for myocardial infarction. Subclinical inflammation, shifts of cortisol and other hormones levels are reviewed, and epidemiological data provided. In general, the data makes it to conclude that further study of myocardial infarction risk factors must be interdisciplinary, liniking psychological and psychopathological changes with relevant neuro-humoral processes.