Vol 6, No 1 (2015)

Complex therapy effectiveness in patients with myocardial infarction and chronic heart failure is established; authors monitoring positive influence on medical psychological and social aspects of rehabilitation in post infarction patients is shown, using as monitoring core individual and complex medical psychological educational program.

The Aim. A study of the clinical efficacy and safety of a fixed combination of valsartan (ARB) with amlodipine (AK), appointed as part of the standard therapy of hypertension and coronary heart disease smoking patients with chronic obstructive pulmonary disease. Material. The study included 36 men aged 40 to 65 years. All patients were treated with statins, aspirin, selective b-blockers; 16.7% of patients received diuretics, and 19.4% - long-acting nitrates. After randomization, patients were divided into 2 groups: group 1 (n=18, mean age 55.8±5.9 years) in addition to those receiving treatment angiotensin-converting enzyme (ACE) and group 2 (n=18, average age 58.0±4.9 years) - combined preparation Eksforzh® (amlodipine 5-10/160 mg valsartan). Study duration - 4 months.Methods. In a study clinical examination wasconducted, bicycle stress test (HEM-test), echocardiography (echocardiography), daily monitoring of blood pressure (BP), spirometry, determination of the concentration of lipids and lipoproteins, glucose, fibrinogen, uric acid, creatinine with calculation of glomerular filtration rate by MDRD.Used questionnaires: Hospital Anxiety and Depression Scale (HADS), St George's Hospital (SGRQ) and quality of life (QOL) SF-36. The Results. The appointment of the drug to patients Eksforzh® accompanied by a significant reduction in levels of “office” in systolic blood pressure at 39.2±9.7 mm Hg. Art. ( p <0.001), diastolic blood pressure of 16.9±5.7 mm Hg. Art. ( p <0.001) and pulse pressure to 22.2±5.9 mm Hg. Art. ( p <0.001) versus no such favorable dynamics in patients of group 1. On therapy with Eksforzh® all 18 patients achieved target BP<140/90 mm Hg. Art. At the same time on therapy with Eksforzh® positive changes in circadian BP profile.After 4 months of taking the drug Eksforzh® in patients with comorbidity observed favorable growth of the basic parameters of physical performance: an increase in the duration of exercise performed (FN) for HEM-sample (22.2%, p <0.01), the power threshold FN (on 23.6%, p <0.01), lengthening the time before the onset of an attack of angina pectoris (8.6%, p <0.05) and ischemia (8.3%, p <0.05). In contrast, patients in group 1 receiving ACE inhibitors, there was a decrease in the duration of the FN (10.2%, p <0.05) and time (29%, p <0.05) to the development of angina attack.In patients in group 2 positive changes were found in the structural and functional parameters of the heart according to echocardiography due to lower average pressure in the pulmonary artery. While taking the drug Eksforzh® the improvement of respiratory function parameters was shown, as well as indicators of psychological status and quality of life against the negative dynamics of these parameters in patients in group 1. Conclusion. Combined preparation Eksforzh® should be considered as a first choice in patients with concomitant cardiovascular and bronchopulmonary diseases due to its high clinical efficacy and good tolerability.

Familial hypercholesterolemia (FHC) - hereditary dyslipidemia, which is based on mutations in the gene for low-density lipoprotein receptor.However, there is variability in the clinical manifestations of the disease difficult to assess individual risk.Materials and methods. Under our supervision for 10 years were 109 patients with FHC, 17 mutation in the receptor density lipoprotein. FHC diagnosis established by the criteria of the British leadership Simon Broom. To search for mutations in low-density lipoprotein receptor was performed automated fluorescent SSCP-analysis of exons of the gene analysis of restriction fragment length polymorphism and the direct sequencing of DNA on a gel sequencer ALFExpress-2 (Amersham Biosciences) using the program ALFwin Sequence Analyzer.The Results. We analyzed five clinical cases of patients with genetically confirmed diagnosis of FHC. Shows a wide phenotypic variability FHC: the possibility of early debut of coronary heart disease, coronary tropism for the pool some patients and cerebral - others, the possibility of a long asymptomatic disease.Conclusion. The absence of clinical manifestations of atherosclerosis and wide phenotypic variability at FHC require targeted screening for FHC, at least among patients with coronary heart disease in order to timely and adequate preventive measures, especially in cases where the mutation is set low density lipoprotein receptor.

This article provides an analysis of the results of a large international randomized clinical trial PLATO, in which to learn a new antiplatelet ticagrelor compared with clopidogrel in addition to aspirin in patients with acute coronary syndrome (ACS). Material contains a description of the study design, the main results concerning the efficacy and safety of ticagrelor. In addition, the material presented those parts of modern clinical practice guidelines, which describes the location of ticagrelor in the treatment of ACS and which are modified according to a PLATO study.

The article provides an overview of pleiotropic activity and clinical efficacy of one of the representatives of the class of angiotensin receptor blockers II - olmesartan medoxomil. Analyzed is a wide range of established in experimental and clinical studies and vasoconstriction, cardioprotective, anti-atherogenic, anti-inflammatory and other effects of olmesartan medoxomil. Given clinical studies evaluating anti-atherosclerotic effects of this drug.

14 марта 2015 г. компания «АстраЗенека» представила в полном объеме результаты крупномасштабного исследования PEGASUS-TIMI 54, в рамках которого проводилась оценка применения препарата тикагрелор в комбинации с низкими дозами ацетилсалициловой кислоты (АСК) по сравнению с плацебо в комбинации с низкими дозировками АСК для вторичной профилактики атеротромботических осложнений у пациентов, перенесших инфаркт миокарда в течение 1-3 лет до включения в исследование.