Aim of the study was to assess the impact of comorbidity on the hospital and 2-year stage of treatment for myocardial infarction (MI) in men and women under 60 years of age.

Material and methods. The analysis included 350 patients with MI younger than 60 years of age. The majority of patients (87.4 %) were men. For all patients, the risk was calculated according to the GRACE ASC Risk Model scale and an analysis was made of the severity of comorbidity according to the own model “K9” (patent RU2734993C1 from October 27, 2020), based on the summation of 9 diseases: diabetes mellitus, atrial fibrillation, stroke, arterial hypertension, obesity, peripheral atherosclerosis, thrombocytopenia, anemia, chronic kidney disease.

Results. Comorbidity (the presence of 2 or more diseases) was recorded insignificantly more often in men (65.9 % versus 53.6 %, p = 0.12). In men, but not in women, comorbidity was associated with a 23.5 % reduction in percutaneous coronary intervention (p = 0.006). Both in-hospital mortality and the risk of major cardiovascular events (death/MI/stroke) 2 years after discharge were minimal (up to 0.7 % and up to 8.1 %, respectively) in the absence of comorbidity in both men and women, higher in comorbid women (3.4 and 12.5 %, respectively) and maximum in comorbid men (6.1 and 18.4 %, respectively). Comorbidity more significantly aggravated the 2-year prognosis in patients undergoing percutaneous coronary intervention than in receiving primary conservative treatment, increasing the risk of developing the death/MI/stroke end point by 3 times (16.7 and 5.8 %, respectively, p = 0.013). The addition of comorbidity data to the GRACE scale in the Cox regression analysis can significantly improve the prognosis of the onset of the 2-year endpoint, increasing the χ² value from 64.08 to 79.86, and the value of the area under the ROC-curve (AUC) to 0.79 (95 % confidence interval (95 % CI) 0.71–0.88). At the same time, ROC analysis showed that the modified GRACE scale predicts the onset of the death/ MI/stroke endpoint in men much better than in women: AUC 0.81 (95 % CI 0.72–0.90) and AUC 0.67 (95 % CI 0.51–0.83), respectively.

Conclusions. Comorbidity is comparable to the GRACE scale and effectively predicts the likelihood of hospital mortality. At the same time, the GRACE scale has an unsatisfactory predictive value for the 2-year endpoint “death/MI/stroke”. Modification of the GRACE scale with data on comorbidity has important clinical implications in men, but not in women, allowing more effective stratification of the risk of adverse events in the long term after myocardial infarction.

Aim of the study was to investigate the features of the fatty acid (FA) profile of erythrocyte membranes of patients with fatty liver disease (FLD) of mixed genesis (metabolic + alcoholic) from the point of view of atherogenic changes.

Material and methods. 31 men (50.6 ± 9.9 years old) with FLD of mixed genesis, the degree of liver fibrosis corresponded to 0-1 (FibroScan ® 502 Echosens, France), and 28 persons of the comparison group, comparable in age, were examined. The study of the composition of FAs of erythrocyte membranes was carried out using gas chromatography/mass spectrometry – a system based on three quadrupoles Agilent 7000B (USA).

Results. Patients with FLD of mixed genesis had higher level of palmitoleic (p = 0.03), pentadecanoic (p = 0.05), omega-6 to omega-3 polyunsaturated fatter acids (PUFA) ratio (p = 0.03) and, conversely, lower level of docosahexaenoic (p = 0.0002), total content of eicosapentaenoic and docosahexaenoic FA (p = 0.0007), of all omega-3 PUFA (p = 0.001) in the membranes of erythrocytes compared to healthy persons. There are trends towards a decrease in the content of omega-3 eicosapentaenoic acid and an increase in the ratio of SFA/PUFA in patients with fibroids of mixed genesis in contrast to healthy individuals. The level of individual FA provided high diagnostic accuracy in differentiating patients with FLD of mixed genesis from healthy individuals: palmitoleic (9-C16:1) (area under ROC (AUC) 0.702, sensitivity 66.7 %, specificity 69.6 %), docosahexaenoic (C22:6n-3) (AUC 0.795, sensitivity 77.3 %, specificity 78.3 %), as well as the total content of eicosapentaenoic and docosegexaenoic FA (C20:5n-3 + C22:6n-3) (AUC 0.777, sensitivity 70.1 %, specificity 82.6 %).

Conclusions. The revealed features of the profile of erythrocyte membrane FA in FLD of mixed genesis – increase of saturated, monounsaturated, omega-6 PUFA content and reduce of omega-3 PUFA concentration are atherogenic. The continuation of research in terms of the use of FAs as biomarkers of this pathology and targets for therapeutic effects should be considered promising.

The increase in cardiovascular diseases and their complications, diabetes mellitus and metabolic syndrome determines the relevance of early diagnosis and prevention of lipid metabolism disorders by identifying and studying genetic markers of predisposition to dyslipidemia in various populations depending on gender, age and ethnicity.

Aim of the study was to investigate the associations of candidate genes CSK, MTHFR, ACE, ADRA2B and TCF7L2 with dyslipidemia in the young indigenous and non-indigenous population living in the Khanty-Mansy autonomous Okrug – Ugra.

Material and methods. 863 young people aged 18–44 years were examined, clinical population included nonindigenous and indigenous men and women with metabolic syndrome (n = 344), the comparison group included non-indigenous and indigenous men and women without metabolic syndrome (n = 519). A study of the lipid profile and molecular genetic study was carried out using the polymerase chain reaction method for single nucleotide polymorphisms (SNPs): rs1378942 of the gene CSK, rs1801133 (C677T) of the gene MTHFR, gene ADRA2B, rs7903146 of the gene TCF7L2, rs1799752 of the gene ACE.

Results. A high frequency of hypercholesterolemia (79.0 %) and hypertriglyceridemia (65.8 %) was found in the examined men and women. Statistically significant differences were established in the frequency of dyslipidemia in patients with metabolic syndrome by ethnicity and gender (p < 0.001). In the general cohort of men with metabolic syndrome hypercholesterolemia is associated with the TT genotype of SNP rs1801133 (C677T) of the gene MTHFR (p = 0.039), in the women – with the DD genotype of the gene ADRA2B (p = 0.010). In indigenous men of the clinical group an association of hypercholesterolemia with the minor T allele of the gene MTHFR (p = 0.005), of hypertriglyceridemia – with the minor T allele of the gene MTHFR (p = 0.031) and the T allele of the gene TCF7L2 (p = 0.031) was revealed. Among indigenous women of the clinical group hypercholesterolemia is associated with carriage of the minor T allele of the gene CSK (p < 0.001) and hypertriglyceridemia – with the D allele of the gene ADRA2B (p = 0.046).

Conclusions. Carriage of minor alleles T of the MTHFR gene and D of the ADRA2B gene is associated with hypercholesterolemia among the examined young people and is statistically significantly higher in the group of patients with metabolic syndrome, as well as among indigenous residents of the KhantyMansiysk Autonomous Okrug – Ugra.

Aim of the study was to evaluate the effect of elevated level of low-density lipoprotein cholesterol (LDL-C) on surfactant protein SP-A and SP-D content in blood, as a new factor of atherogenesis, in men and women in Novosibirsk.

Materials and methods. The study included 174 people (87 men and 87 women), residents of Novosibirsk, aged 45 to 69 years. An anthropometric examination, measurement of blood pressure, determination of the lipid spectrum, blood glucose and surfactant proteins SP-A and SP-D content (enzyme immunoassay).

Results. According to the results of the examination, 82 examined persons (47.1 %) were included in the group with LDL-C content > 3.0 mmol/l(main group), 92 – in the group with LDL-C content ≤ 3.0 mmol/l (comparison group) (52.9 %). The value of high SP-A and SP-D content (upper quartile) was determined, which amounted to ≥ 1413 pg/ml SP-A in men and ≥ 1649 pg/ml in women, and ≥ 1772 ng/ml SP-D in men and ≥ 1626 ng/ml in women. It was found that in the main group, the body weight of the examined persons was lower than in the comparison group, and high SP-A level was more common (p = 0.033). In the total sample a direct association of upper quartile SP-A level with LDL-C content > 3.0 mmol/l was revealed (p = 0.021). Using multivariate analysis, it was found that LDL-C concentration > 3.0 mmol/l is an independent factor that directly affects the dependent variable the presence of high SP-A level in general totality of examined individuals (odds ratio 2.20, 95 % confidence interval 1.05–4.62, p = 0.036).

Conclusions. In men and women of Novosibirsk, aged 45–69 years, high blood SP-A level (≥ 1413 pg/ml in men and ≥ 1649 pg/ml in women) occurs more often at LDL-C content > 3.0 mmol/l than at LDL-C level ≤ 3.0 mmol/l. In the total sample of the examined persons, a direct association of high SP-A with LDL-C content > 3.0 mmol/l was revealed, and using multivariate analysis it was found that LDL-C concentration > 3.0 mmol/l directly affects the presence of high blood SP-A level and increases the probability of this event by 2.2 times.

Lesions of the microcirculatory bed of the retina are an urgent problem due to their prevalence, severity of irreversible changes and their association with an unfavorable cardiovascular prognosis. Their pathogenesis is associated with endothelial dysfunction. Determining the processes of the formation and progression of retinopathy (RP) will bring closer the solution of problematic issues in ophthalmology and cardiology, and reduce cardiovascular morbidity and mortality.

Aim. To study the processes of formation and progression of retinopathy in the initial stages of mixed origin (hypertensive, diabetic, unspecified etiology).

Material and methods. The origin and progression of I–II degree RP under the influence of predictors of this symptom has been revealed through statistical analysis using the data of the 2008–2013 prospective follow-up of 22 clinical indicators of a natural group of initially healthy 7.959 male workers of locomotive crews of the Trans-Baikal Railway aged 18–66 years. Multivariate stepwise analysis, a 2 × 2 confusion matrix, Cox and Kaplan-Meier proportional hazard models were used, and a relative risk was assessed.

Results. Such predictors of grade I–II RP as arterial hypertension, I–III degree obesity, smoking, dyslipidemia, left ventricular hypertrophy, family history of early cardiovascular disease, hyperglycemia, aortic atherosclerosis, creatininemia, atherosclerotic plaque / intima-media complex thickening, microalbuminuria, type 2 diabetes mellitus and age showed statistical heterogeneity in mathematical models. The distinctive feature was the different mutually exclusive assessment of the predictors’ significance in the models used. Thus, the predictors of I–II degree RP showed their specific identification characteristics, defined in qualitative and quantitative dimensions, by which they could be found and studied in the cell as well as their damaging effect.

Conclusions. The course of endothelial dysfunction varies significantly when influenced by RP predictors. Its manifestations are determined by the influence of a specific factor, a set of factors or by all predictors taken together and involved simultaneously. This shows the need to determine the qualitative and quantitative ultrastructural and biochemical specific markers of endothelial dysfunction of the microvasculature of the eye appearing under the influence of RP predictors during the formation and progression of this pathological symptom in order to restore the normal function of the endothelial cell and the affected organ as a whole, as long as there is still room for therapeutic efforts.

Aim of the study was to investigate the main components of the lipid spectrum of blood serum in patients with coronary artery disease, depending on the level of estradiol (E2), testosterone (T) and age.

Material and methods. We examined 161 men aged 35–65 years (median [lower quartile; upper quartile] 53.1 [40.1; 59.4] years) with a history of myocardial infarction more than 30 days before inclusion in the study. Patients were divided into groups by age (35–55 and 56–65 years), as well as according to the content of sex hormones: T ≥ 12 nmol/l and T < 12 nmol/l, E2 ≥ 0.194 nmol/l and E2 < 0.194 nmol/l with double determination.

Results. Of the studied components of the lipid profile, the greatest number of significant changes in men with coronary artery disease in different groups, depending on age and levels of sex steroids, had triglyceride (TG) level. In men aged 35–55 and 56–65 years with hypogonadism, TG concentration was higher compared to peers with normal androgen levels. In the older age group, relatively younger male patients, both when comparing a cohort of men with low T and with its normal values, TG content was also higher. In groups of patients with T level > 12 nmol/l and ≤ 12 nmol, when controlling for height and body weight, there is a statistically significant direct association of age in men of 56–65 years with TG concentration (r = 0.483, p = 0.023 and r = 0.549, p = 0.008, respectively). It was found that in patients with coronary artery disease in the age groups of 35–55 years and 56–65 years with E2 content ≥ 0.194 nmol/l, the TG level was higher than in men with normal estrogen concentration (p = 0.008 and p = 0.033, respectively). In a partial correlation analysis with control of height and body weight in men aged 35–55 years with coronary artery disease, a statistically significant relationship was found between the level of E2  ≥ 0.194 nmol/l and TG content (r = 0.566, p = 0.009), a similar relationship independent of anthropometric parameters was verified and in the older age group (r = 0.316, p = 0.011). In a multivariate analysis, the level of TG was determined by E2 concentration, the other variables under consideration did not statistically significantly affect it.

Conclusions. Hypogonadism in men in each age group studied is associated with elevated TG content. A significant role in the development of hypertriglyceridemia in men is played by hyperestrogenemia in both age groups, being an independent, independent of androgenic status, proatherogenic factor.

The aim of the study is to identify factors affecting adherence to treatment in men and women with myocardial infarction (MI).

Material and methods. The study included 150 patients diagnosed with MI (47 women and 103 men). Treatment readiness was assessed according to the S.V. Davydov method and with the calculation of the integral indicator of adherence to treatment (IIAT).

Results. During 6-month follow-up, men and women with MI were comparable in mortality rates, however, men were more frequently hospitalized for cardiovascular complications. Adherence to treatment was high in both genders. Treatment readiness at the time of MI indicated higher satisfaction with the results of treatment in women, and higher willingness to pay for treatment, higher confidence in the treatment strategy and a higher IIAT in men. Both women and men with MI reported a comparable number of outpatient visits within 6 months (not exceeding 56 %). Only small number of patients reached the target heart rate (HR) and low-density lipoprotein (LDL) content within 6 months. Patients of both genders who reached and not reached the target LDL level and HR did not differ in mortality rates, hospitalizations and adherence to treatment within 6 months. At the same time, patients who reached the target HR, regardless of gender, were more likely to make outpatient postMI visits compared with those who did not reach the targets; men with MI who did not achieve the target HR were less likely to visit a doctor, whereas women with MI who achieved the target HR and LDL were more likely to have a high IIAT during in-patient care and were more willing to pay for further treatment (an exclusive characteristic of women who reached target HR). Moreover, we have identified predictors of IIAT and achievement of HR and LDL in women and men with MI.

Conclusions. Patients with MI present with sex-specific factors that are affecting treatment adherence, which should be accounted for in the development of measures for secondary prevention of disease.

Aim of the study was to investigate the association of serum Klotho protein content and lipid parameters with atherosclerosis of the brachiocephalic arteries (BCA) in men.

Material and methods. A cross-sectional comparative study that included men aged 50–65 years (n = 63, age 54 [53; 60] years (median [lower quartile; upper quartile])) underwent ultrasound examination of BCA at the outpatient department of the Institute of Internal and Preventive Medicine. Biochemical parameters were determined by standard enzymatic methods. Serum concentration of Klotho protein was measured by enzyme immunoassay.

Results. A trend towards content of Klotho protein in serum was found in the group of persons with BCA atherosclerosis compared to the group without BCA atherosclerosis (705 [463; 1255] and 447 [282; 881] pg/ml, respectively, p = 0.061). Also, in men of this group, higher level of triglycerides (TG) (1.7 [1.1; 2.2] and 1.4 [0.9; 1.8] mmol/l, p = 0.046) and lower high-density lipoprotein cholesterol (HDL-C) content (1.1 [0.8; 1.3] m 1.4 [0.9; 1.6] mmol/l, p = 0.016) has been found. Correlation analysis in the group of men with BCA atherosclerosis revealed a direct relationship of Klotho protein with TG level (0.290; p = 0.031) and a negative relationship with HDL-C content (–0.361; p = 0.046). The results of logistic regression analysis showed that the probability of atherosclerotic plaques presence in BCA increased by 1.2 times (95 % confidence interval (95 % CI) 1.0–1.4, p = 0.038) with increasing age and by 9.2 times (95 % CI 2, 3–36.5, p = 0.002) in the presence of hypertension.

Conclusions. In a clinical sample of men aged 50–65 years, the relative risk of carotid atherosclerosis is directly associated with age and the presence of hypertension and is not associated with the level of Klotho serum protein.

The aim of the study was to conduct an associative analysis between trait anxiety and selfdetermination of one’s cardiovascular health among young people.

Material and methods. In a typical area of a large industrial and scientific center (Novosibirsk) in 2013–2016 a study of a random sample of young people aged 25–44 was performed, which included 975 participants, 427 of which 427 are men. To assess trait anxiety, a form of Spielberger self-assessment scales was proposed.

Results. Men and women with a high level of trait anxiety (HTA) in 57.1 and 64.9 % cases, respectively, believed that they could not classify themselves as healthy people, especially since a third of the respondents complained about their health status; almost 30 % of participants with HTA did not take care of their health (p < 0.001). Persons of both sexes in 41 % cases and 38.6% women with HTA admitted a high probability of a severe illness soon (p < 0.01). However, even pronounced pain sensations in persons of both sexes with HTA in 60.3 % cases was not the reason for seeking medical help, especially since they did not have confidence in the routine examination of a doctor (47.4 % persons of both sexes and 57.1 % men). Only 5.1 % of both sexes examined with HTA would go to the doctor if they were unwell at work (p < 0.05). If they had the flu or had a temperature, then 44.9 % people with HTA worked as usual, with low TA – 26.6 % (p < 0.01).

Conclusions. Personal anxiety contributes to a lower health self-esteem, especially cardiovascular, and does not encourage timely seeking medical help.

The purpose of this review was to find an answer to the question: “Is there an association of adipokines (adiponectin, adipsin, interleukin-6, lipocalin-2, PAI-1, resistin, MCP-1, leptin, TNF-α, visfatin, omentin-1) with coronary artery disease and abdominal obesity in people under 65 years of age?”. Articles investigating patients aged 18 to 65 years with coronary heart disease were included. The analysis included only publications of the last 10 years (2013–2023). As a result of the analyzed literature, most of the publications of the last 10 years are devoted to studies conducted on persons over 65 years of age. At the same time, the available large studies and meta-analyses indicate a large contribution of adipocytokines to the development and course of coronary heart disease. Based on this, it is very relevant to study the adipocytokine profile in young and middle-aged people with coronary heart disease, especially against the background of AO.

The article discusses the prevalence of chronic heart failure and the possibility of its detection at an early, asymptomatic stage, when timely treatment can slow the progression of the disease. The data on the widely used and recognized biomarkers and their informative value for diagnostics of the “hidden: forms are presented, and also on the search of new markers. We used information on the topic from publications based on PubMed and Google Scholar databases, 5 years in depth.