ORIGINAL ARTICLES
156 man, who were in the surgical department for subsequent reconstructive operation of carotid arteries, were analyzed. Depending on long-term one-year prognosis all patients have been divided into two groups: with unfavorable (93 individuals – 59.6 %) and favorable (63 individuals – 40.4 %) prognosis. It is proved that cardiovascular complications risk such as stroke, transient ischemic attack, myocardial infarction, patients death, and courses deterioration of multifocal atherosclerosis in any arterial region, increase or clinical presentations onset of ischemia in any organ during the first year after surgical procedure increases if there is dyslipidemia in preoperative period, pathologic value of ankle-brachial index (less than 0.9), besides intraoperative characteristic of atherosclerotic plaque (occurrence of intraplaque haemorrhage and extent of atherosclerotic plaque more than 2 cm) in patients. But among this prognostic factors the most important one is the dyslipidemia, herewith statistic regression coefficient of which is 4.64 and Wald index is 43.1. All these data determine maximal prognostic value of dyslipidemia versus other risk factors.
Subject to population screening study the ethnic peculiarities of prevalence rate of ischemic heart disease and its basic risk factors for inhabitants of Yakutia aged 60 years and over were studied as well as the contribution of some risk factors to development of IHD at people of old age residing within the conditions of Extreme North. Epidemiological methods helped to reveal high IHD prevalence rate at Yakut and Caucasian old age population residing in the Republic of Sakha Yakutia (40 and 47 % respectively, р = 0.09) and its risk factors. At advanced-age groups (for Yakut population – 90 years and older, for Caucasians – 80 years and older) the IHD occurs oftener than at the inhabitants of Yakutia aged 60–70 years. Among aged representatives of Yakut nationality compared with people of old age of Caucasian ethnic affiliation the more favourable profile of IHD risk factors was diagnosed. The significant contribution into IHD development at Yakut population is made by HDL hypocholesterolemia and obesity, and at Caucasian – C-creative protein, pulse pressure and obesity.
For inhabitants of Yakutia aged ≥ 60 almost the equally high is the prevalence rate of hyper-cholesterolemia of low-density lipoprotein cholesterol (hyper- LDL-C) in general population sampling without MS and in cohort with MS – 72.4 % and 77.9 % (р = 0.248) and has no differences by ethnic factor. Hypertriglyceridemia (hyper-TG) among the inhabitants of the city with MS occurs for every second inhabitant (58.7 %), and these values are three times higher than population ones (17.1 %). Among the aboriginal inhabitants of Yakutia the hyper-TG with MS occurs in 47.1 %, and these numbers are four times higher than the numbers of general sampling (10.5 %). Among the non-aboriginal inhabitants the hyper-TG with MS was found in 2.7 times oftener relatively to the general sampling (64.3 and 23.4 %). Hypocholesterolemia of high-density lipoprotein cholesterol (hypo-HDL-C) with MS (56.7 %) frequency is three times higher than that in general sampling (18.4 %), this concerns samplings of both aboriginal (50 %) and non-aboriginal (60 %) inhabitants.
The aim: to study the prevalence of social support (SS) and it’s influence on relative risk of myocardial infarction (MI) and stroke in female population of 25–64 years in Russia.
Material and methods: under the third screening of the WHO «MONICA-psychosocial» program random representative sample of women aged 25–64 years (n = 870) were surveyed in Novosibirsk. SS were measured according to the methodic of Berkman-Sym test (indices of close contacts (ICC) and social network (SNI)). From 1995 to 2010 women were followed for 16 years for the incidence of MI and stroke.
Results: the prevalence of low levels of ICC and SNI in women aged 25–64 was 57.1 % and 77.7 %, respectively. Low levels of ICC and SNI associated with poor self-rated health and awareness about the health, adverse behavioral habits, high job strain and family stress. Over a 16 years of study relative risk of MI in women with low ICC was higher in 4.9 times, risk of stroke was higher in 4.1 times than in those with higher levels of ICC. Low SNI increase risk MI incidence in 2.9 times, risk of stroke in 2.7 times (p for all <0.05). Rates of MI and stroke incidence were higher in married women with low ICC and SNI who were being in class «hard manual labor» compared higher SS levels.
Conclusions: our findings show high prevalence low levels of ICC and SNI, associated with poor self-rated health and reduced awareness about the health. Low ICC and SNI increase the risk of MI and stroke in female population aged 25–64 years.
Red cell distribution width (RDW), a measure of circulating erythrocyte size heterogeneity, is a new predictor of myocardial infarction (MI) prognosis. The aim of this study is to evaluate the associations of RDW with clinical and laboratory parameters and gender characteristics of patients with acute myocardial infarction. A total of 250 patients (208 male and 42 female) with an ST elevation acute MI were examined. The RDW level was measured with an automated complete blood count. It did not differ in levels of RDW between male and female with MI. Series of associations were detected between RDW and carotid atherosclerosis (r = +0.156, p = 0.013), chronic anemia (r = +0.155, p = 0.014), with the presence of cancer (r = +0.178, p = 0.005), pleural effusion (r = +0.153, p = 0.015), thrombosis of the left ventricle (r = +0.133, p = 0.036), acute encephalopathy (r = +0.178, p = 0.005), leukocytes (r = +0.132, p = 0.037), platelet (r = +0.195, p = 0.002), and sodium (r = –0.232, p = 0.006). The most significant association of RDW with pleural effusion was detected according to the results of covariance analysis. This association has reflected influence of inflammation to complications acute MI.
The purpose was to investigate a frequency of hyperuricemia and its relations with risk factors of degenerative pathology at patients who are elder than 60 years.
Methods and result. We examined 212 patients with arterial hypertension and degenerative pathology of aortic valve, of which 76 with nonobstructive aortal calcification and 136 patients with aortic valve stenosis. In blood glucose level, lipids, uric acid, TTH and free T4 were defined.
Results: A frequency of hyperuricemia was 30.7 %, overt hypothyroidism 11,3 %, high normal TTH level 11.8 %. In women a combination of hyperuricemia and overt hypothyroidism was 39.3 %, in men it was 8.1 %. A negative correlation was found between glucose level and hyperuricemia.
Investigated the effect of diets and dietary energy supply on the state of carbohydrate and fat metabolism and endocrine status in the group of new comers of the Far North. Studies have shown that of the Far North as a carbohydrate, and type of food indigenous inadequate. Ration with the percentage of the main components (PROT : FAT : CARB) 16: 40: 44 % is optimal in structure and has anti-atherogenic properties, energy value may vary depending on the severity of the labor.
REVIEWS
By the beginning of the 21st century, there are more than 25 hypotheses and «theories» of atherosclerosis. 240 factors contributing to the emergence of atherosclerotic changes in the vascular wall have been described. In recent years, a lot of authors are inclined to the view that atherosclerosis is a chronic immune inflammatory process, which proceeds like hypersensitivity reaction of the delayed type. Inflammatory reactions, both during the decompensation of chronic cerebrovascular insufficiency, and atherosclerosis in general, can be caused by persistent infection of brachiocephalic, cerebral and coronary arteries. The aim of this work was to explore and analyze the foreign studies to determine the role of infections in the development of atherosclerotic changes in vessels. It was found that various infectious agents may be involved in the development of atherosclerosis both individually and in combination. Bacteria and viruses can participate in the formation and destabilization of atherosclerotic plaques leading to endothelial damage, launching systemic immune reactions, inducing cell infiltration and production of proinflammatory factors, initiating coagulation in the endothelium. To date there is no consensus about what is the role of infectious pathogens in atherosclerotic inflammation – are they a primary cause or just «bystanders» that potentiate the already started process.
Analytical review of literature provides information about efficacy and safety of percutaneous coronary interventions in the elderly with acute coronary syndrome.
OBITUARIES
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