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Rationale. Coronary artery disease (CAD) is the most common cardiovascular disease, being responsible for the largest number of deaths and disabilities. The use of lipid-lowering drugs is one of the most important aspects of pharmacological rehabilitation of patients with CAD. Objective of the work . Study the features of pharmacological rehabilitation of patients with chronic heart failure (CHF) associated with type 2 diabetes mellitus (DM) using a combination therapy of lipid-lowering Ezetimibe and Rosuvastatin. Materials and methods. 70 patients with coronary artery disease with a clinical picture of moderate CHF and concomitant type 2 diabetes were enrolled in the study. The patients enrolled in the study were recommended to change their lifestyle, including quitting smoking, increasing physical activity, and adhering to a cholesterol-free diet. After a month, the patients were divided into 2 groups of 35 people each by a simple randomization method. The comparison group (n = 35) received a combination of Rosuvastatin 20 mg/day and Ezetimibe 10 mg/day, the control group (n = 35) received only Rosuvastatin 20 mg/day. The duration of the study was 12 months. The follow-up visits were scheduled at 1, 3, 6 and 12 months after they started taking drugs. Results. At the end of the study, there were no statistically significant differences between the study groups in the number of adverse cardiovascular events (14.3% vs 20.0%, respectively, p = 0.751). There were differences in the total number of hospitalizations caused by cardiovascular diseases (14.3% vs 40%, respectively, p = 0.032). Conclusions . The prescription of combination lipidemic therapy with Rosuvastatin at a dose of 20 mg/day and Ezetimibe at a dose of 10 mg/day results in decreased hospitalizations caused by cardiovascular diseases.

Psyllium is a predominantly soluble fiber among other natural plant-based dietary fiber used in food and pharmaceuticals and is sold as a laxative fiber. Isphagula (lat. ispaghula)– international nonproprietary name of a medicine of «psyllium». Accordingly to ATX belongs to the group of «Laxatives», subgroup «A06AC «Laxatives increasing volume of intestinal contents» (Bulking laxatives) and has the following code and name: «A06AC01 «Ispaghula» (plantain oval seeds)». Isphagula is a medical dietary fiber; in the context of gastrointestinal problems in terms of «ispaghula» and «psyllium» are synonymous. Psyllium flour has virtually no digestible carbohydrates. This fact is a significant advantage of psyllium over oat bran, in which such carbohydrates are more than 60%. A distinctive feature of psyllium is that it is almost completely (80–85%) consists of fiber (about 70% of which is soluble), which in contact with water turns into a soft gel. Only 1 gram of fiber ground fiber flour is able to absorb up to 45 ml of water. In the colon, psyllium is resistant to fermentation, remains intact in the feces and significantly increases the water content in the feces, providing a laxative effect. Psyllium softens hard stools in constipation, normalizes loose stools in diarrhea, and normalizes stool shape in patients with IBS, relieving gastrointestinal symptoms. Dietary supplement «Fitomucil® Norm» contains 4.5 g of psyllium (Plantago psyllium), and dry pulp of prunes (Prunus domestica) – 0.5 g. This combination of psyllium and prunes can be widely used in patients with constipation and other functional digestive disorders in different age groups, including pregnant and lactating women, as a first-line remedy.

Aim.The purpose of this study was to examine the association of increasing concentrations of endothelin-1 and soluble forms of ST2 protein (sST2) in the blood plasma of patients with chronic heart failure (CHF) who underwent implantation of a cardioverter-defibrillator, with the development of cardiovascular events (death from cardiovascular diseases, decompensated CHF, acute coronary syndrome or acute ischemic stroke) to determine whether these biomarkers can be used as predictors of an unfavorable course of the disease.Material and methods. A 6-month cohort study included 40 patients with CHF who received an ICD 4-12 weeks before their inclusion in the study. At the beginning of the study the concentrations of endothelin-1 and sST2 in plasma by ELISA were analyzed, along with conventional diagnostic techniques typical of a specialized cardiology clinic.Results.Phenotype with a favorable course of the disease was identified in 21 patients (group 1), and with a unfavorable course was seen in 19 (group 2). The concentration of endothelin-1 and sST2 in the blood plasma of the 2nd group patients was higher than in patients of the 1st group. The link of cardiovascular events with high levels of soluble ST2 protein and endothelin-1 in blood plasma has been identified. Variation of the decision rule threshold on the ROC-curve has allowed sST2 concentration of 34.93 ng/ml to be determined as a cutoff point. Accuracy of two-class classification (determination of the posterior probability of cardiovascular events) after identifying such cut-off point was characterized by 93% sensitivity and 72% specificity (area under ROC-curve – 0.87). If the value of the plasma concentrations of sST2 more 34.93 ng/ml the relative risk of cardiovascular events was 4.4 (95% CI 1.7–11.1). The use of endothelin-1 surplus in plasma (cut-off point – 0.34 fmol/ml) in predicting cardiovascular events was lower: the sensitivity – 88%, specificity – 68% (area under ROC-curve – 0.74). When the concentration of endothelin-1 in blood plasma was more than 0.34 fmol/ml the relative risk of cardiovascular events was 2.7 (95% CI 1.2–6.3).Conclusion.The increase in the sST2 and endothelin-1 concentration in blood plasma may be considered as a predictor of cardiovascular events in CHF patients after implantation of cardioverter-defibrillator.

The article analyzes the effectiveness and safety of treatment cytoprotectant meldonium dihydrate and inotropic stimulator of levosimendan on an annual prognosis in patients with myocardial infarction complicated by acute heart failure II-III class Killip, subjected to percutaneous transluminal coronary angioplasty.

Currently there is enough evidence for that the use of omega-3-faty acids compounds in ischemic heart disease is followed by the decrease of mortality, and the efficacy of this usage in multivessel coronary lesions after primary percutaneous intervention (PCI) has not been studied.Aim.To evaluate the efficacy of long-term intake of the omega-3-polyunsaturated fatty acids compounds on the course of ischemic heart disease at the background of multiple coronary lesion after primary PCI.Material and methods.Totally 101 patient included at the age of 35-70 y.o., who had underwent primary PCI for the myocardial infarction with ST elevation and multiple vessel lesion of coronary arteries. The patients were selected into 2 groups: 1 group (n=68) — conservative tactics with the standard pharmacotherapy; 2nd group (n=33) — Omacor was added to the standard therapy.Results.In 36 months of follow-up in the Omacor group there was significant decrease of repeated myocardial infarctions, decompensating heart failure, angina progression and rhythm disorders. In 2nd group patients during the 36-month follow-up a better antiischemic effect achieved with 80,9% decrease of angina from the baseline (pConclusion.Long-term prescription of omega-3-polyunsaturated fatty acids in ST elevation myocardial infarction with multiple vessel coronary lesions after primary PCI leads to the improvement of clinical condition, which then leads to the increase of exercise tolerance and better life quality.