Objective: to study an association of high lipoprotein(a) [Lp(a)] levels with the development of restenosis and the progression of coronary
atherosclerosis after percutaneous coronary interventions (PCI) in patients with chronic coronary heart disease (CHD).

Subjects and methods. From 502 enrolled patients (mean age 54.7 ± 8.9 years), 92 underwent routine percutaneous transluminal coronary angioplasty (PTCA), 270 had PTCA with the bare metal stent (BMS) being implantation, 140 had PTCA using drug-eluting stents (DES). Functional
classes III and IV angina have been registered in 337 (67 %) patients; history of one myocardial infarction (MI) was noted in 234 (47 %) cases, 171 (34 %) had experienced 2 or more MIs. Blood samples for lipid and Lp(a) measurements were taken in all the patients. Restenosis was defined as at least 50 % lumen narrowing of the coronary artery segment after angioplasty. Coronary atherosclerosis progression was established in cases of the new occlusion occurring, as well as identifying a 10 % decrease in lumen diameter in comparison with baseline angiograms.

Results. Repeated coronary angiography revealed the signs of restenosis in 103 of 243 patients. Dividing patients into 3 groups according to the type of intervention demonstrated that the level of Lp(a) (median 25–75 % quartiles) was significantly higher in the restenosis group after implantation of BMS (33; 11–62 and 16; 6–39 mg/dl, respectively; p = 0.014) versus those who had undergone DES implantation (23; 10–30 and 20; 6–60 mg/dl; p = 0.7) or balloon angioplasty (17; 4–48 and 9; 4–36 mg/dl; p = 0.3). Patients with progression of coronary atherosclerosis had difference only in Lp(a) levels compared to the group without progression (36; 13–62 versus 12; 4–26 mg/dl, p < 0,001.

Conclusion. During the first year after elective PCI Lp(a) concentration determined the severity of coronary atherosclerosis in non-culprit lesions
and associated with the risk of in-stent restenosis after BMS, independly of conventional risk factors.

Objective: to study late disease outcomes in patients with prior myocardial infarction (MI).

Subjects and methods. The study enrolled 1133 patients admitted with diagnosed acute MI in the Lyubertsy District, Moscow Region, over 3 years
(2005–2007). Inhospital mortality rates were analyzed. An attempt was made to establish the patients’ life status. The fate of 111 (10 %) patients
was unclear. There were 172 deaths at the hospital; 191 patients died after discharge from hospital (an average follow-up of 1.3 years).

Results. The vast majority of patients died from coronary heart disease in the late period, which allows these deaths to be associated with prior MI and the late prognosis of life to be regarded as very serious in these patients.

Objective: to assess the nature and degree of the impact of metabolic syndrome (MS) and obstructive sleep apnoea syndrome (OSAS) severity on myocardial structural and functional changes.

Subjects and methods. The study covered 80 patients of both sexes, whose mean age was 49.62 ± 9.87 years. The patients were divided into 3 groups according to the severity of OSAS. All the patients underwent general clinical examination with anthropometric measurements, as well as cardiorespiratory monitoring and biochemical studies.

Results. The mean body mass index in the examinees was 34.52 ± 4.91 kg/m2. In severe apnoea, there was a significant increase in abdominal adipose tissue redistribution (p = 0.005), an elevation in systolic and diastolic blood pressures and uric acid levels, progression of impaired lipid profile and insulin resistance (p < 0.05). More significant hypertrophy of the left ventricle and its reduced systolic function were recorded in severe OSAS (р < 0.05). The frequency of type 1 diastolic dysfunction was lower in the mild apnoea group (30% of the patients) than that in the severe apnoea group (67 %) (p = 0.01).

Conclusion. The found myocardial structural and functional changes are due to the degree of OSAS and to the impact of MS components. Due to inadequately effective antihypertensive and hypolipidemic therapy performed in patients with MS, it is necessary to diagnose OSAS and to define the degree of its severity for its correction.

Objective: to assess the specific features of the hemorheological profile and lipid spectrum in patients in the acute phase of ischemic stroke in
the presence of arterial hypertension (AH). 

Subjects and methods. Fifty patients divided into 2 groups were examined. Group 1 included 30 patients (mean age 67 .0± 10.1 years) with acute ischemic stroke. They all were diagnosed as having grade 2 AH as evidenced by medical records. Group 2 comprised 20 apparently
healthy individuals (50 ± 48 years) without AH. The parameters of the hemorheological profile and lipid spectrum were determined in all
the enrolled patients.

Results. Among the blood macrorheological characteristics, there was a rise in plasma viscosity in the study group, which was 17 % greater
than in group 2 (2.10 ± 0.25 and 1.80 ± 0.23 mPas, respectively; p < 0.01). The most important results were obtained in the study of blood
microrheological characteristics. All the study parameters were considerably higher in the patients with acute ischemic stroke than those in the apparently healthy individuals. Thus, the formation rate for aggregates (0.50 ± 0.24 and 0.32 ± 0.20 relative units in Groups 1 and 2, respectively; p < 0.01) and their sizes (7.30 ± 1.02 and 6.20 ± 0.63 relative units, respectively; p < 0.01) were more in the study group than
those in the control one. At the same time, in the study group the integral aggregation index was 80 % higher (p < 0.01) than that in the control. However, in the patients with acute ischemic stroke, the erythrocyte rigidity index was lower than that in apparently healthy patients (0.71 ± 0.07 and 0.76 ± 0.09 relative units, respectively; p < 0.05). In Group 1 patients, impairments of the hemorheological profile were accompanied by changes in the lipid spectrum. Despite the fact that no differences in total cholesterol levels were recorded in the study groups (4.7 ± 1.5 and 5.20 ± 1.02 mmole/l in Groups 1 and 2, respectively), there was a substantial change in the other parameters of the lipid spectrum. Thus, in the patients with acute ischemic stroke, the levels of high-density lipoprotein cholesterol were 62 % lower than in the control group (p < 0.01) and the atherogenicity coefficient was 1.5-fold higher in the study group than in the control one (p < 0.01). At the same time, there were increases in triglycerides in Groups 1 and 2 (1.33 ± 0.74 and 0.96 ± 0.55 mmol/l, respectively; p < 0.05) and low-density lipoprotein cholesterol in these groups (3.10 ± 0.78 and 1.96 ± 0.60 mmol/l, respectively; p < 0.01).

Conclusion. The changes in the lipid spectrum and hemorheological profile can provide a more detailed insight into the pathogenic processes
occurring in the patients in the acute phase of ischemic stroke.

The treatment of chronic heart failure (CHF) in patients over 60 years of age may be a challenge to a general practitioner. The physiological features of the elderly and significant comorbidity frequently have a considerable impact on the effects of drugs and the magnitude of side effects. Reduced sinus node automatism, significant atherosclerosis of the aorta and great vessels, and renal dysfunction - all should be borne in mind when choosing a drug and its dosage regimen. The paper considers non-drug treatment modalities, as well as the specific features of use of some groups of drugs and therapy for concomitant diseases in elderly patients with CHF.

Objective: to evaluate the basic and pleiotropic effects of atorvastatin in patients with rheumatoid arthritis (RA) and dyslipidemia (DLP).

Subjects and methods. The blood lipid profile was studied in 204 patients with RA. According to the found lipid disturbances, the patients
were randomized into 2 groups. A study group comprised 30 patients receiving generic atorvastatin 10 mg/day as part of combination therapy.
A comparison group included 20 RA patients matched for clinical characteristics and baseline lipid levels, who took no statins. Blood lipid
parameters and the markers of inflammation, vascular wall damage, and artery rigidity were examined over time.

Results. DLP was found in 58.3 % of the patients with RA. The use of atorvastatin in combination therapy resulted in not only a decrease in atherogenic cholesterol fractions, but also in a considerable reduction in the level of the markers of systemic inflammation and endothelial damage, and in disease activity. Six-month atorvastatin therapy showed a positive impact on the elastic properties of vessels in RA patients.

Conclusion. In RA patients with DLP, atorvastatin exerted a beneficial effect not only on the blood lipid profile, but also on the magnitude of inflammation and the elastic properties of vessels, and disease activity.

Objective: to evaluate the efficacy, vasoprotective properties, and safety of amlodipine maleate used in patients with asthma concurrent with
essential hypertension (EH).

Subjects and methods. Twenty asthmatic patients in remission with grade I–II EH were examined. The patients were given amlodipine maleate (Stamlo® M, Dr. Reddy’s Laboratories) in a daily dose of 5–10 mg for an antihypertensive purpose. External respiration tests, 24-hour blood pressure monitoring, and studies of endothelial vasomotor function and arterial elastic properties were performed in patients at baseline and after a 6-month course of therapy.

Results. The good tolerability and safety of amlodipine maleate were ascertained in patients with asthma concurrent with EH, irrespective of the severity of bronchoobstructive syndrome and the degree of asthma control. These trials demonstrate not only the obvious antihypertensive effects of amlodipine maleate, but also its vasoprotective properties: its beneficial effect on endothelial vasoregulatory function and vascular wall rigidity.

Conclusion. The findings confirm that it is expedient to use Stamlo® M in patients with asthma concurrent with EH.

Lung cancer (LC) annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.
All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectious
complications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this category
of patients and expand the possibilities of their specific antitumor treatment.

The review presents data on the incidence of chronic thromboembolic pulmonary hypertension after pulmonary thromboembolism and describes
congenital and acquired coagulation abnormalities in patients with venous thromboembolism. It considers the potential factors of development of chronic thromboembolic pulmonary hypertension and some medical conditions and diseases, which favors the development of pulmonary hypertension after prior pulmonary thromboembolism.

Obstructive sleep apnoea syndrome (OSAS) is observed in the population with a frequency of 5–15 %. The importance of OSAS is due to its close relationship with cardiovascular diseases. OSAS increases a risk for sudden cardiac death and is an independent predictor of chronic heart failure in males. OSAS is shown to be associated with the preclinical forms of atherosclerosis and left ventricular dysfunction.

The paper considers platelet-vascular hemostatic disorders, describes the clinical presentation and diagnosis of major nosological entities, and gives their eponymic names.