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Aim. To investigate on post-COVID period in patients of the Eurasian region.Material and methods. A total of 9364 consecutively hospitalized patients were included in ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period.Results. According to ACTIV register, 63% of patients after COVID-19 had new adverse symptoms or exacerbations of the existing symptoms lasting for up to 1 year. After hospital discharge, 79,8% of patients sought unscheduled medical attention in the first 3 months, 79,1% at 4-6 months, and 64,8% at 7-12 months. Readmission rate was 11,8% in the first 3 months, 10,9% at 4-6 months, and 10,1% at 7-12 months. The most common reasons for unscheduled treatment in the first 3 months were uncontrolled hypertension, decompensated type 2 diabetes, destabilization of coronary artery disease, gastrointestinal disease, AF episodes, exacerbation of asthma and chronic obstructive pulmonary disease, decompensated heart failure (HF). The 12-month mortality of COVID-19 survivors after the discharge was 3,08%. Multivariate analysis showed that independent risk factors for fatal outcome were age (direct correlation), the levels of hemoglobin (inverse correlation), oxygen saturation (inverse correlation), and aspartate aminotransferase (direct correlation), as well as class III-IV HF, prior stroke, cancer, inhospital acute kidney injury. Based on these identified risk factors, a nomogram was constructed to determine the 3-month mortality risk after discharge.Conclusion. Analysis of ACTIV register showed that end of the acute phase of COVID-19 does not imply a complete recovery.

DRESS syndrome is a life-threatening complication rarely encountered in clinical practice. Making a correct diagnosis is complicated not only by the similarity of the clinical manifestation with several other conditions but also delayed in time onset of the first symptoms from the “causative” drug. Along with that, timely diagnosis and early treatment reduce the risk of severe course and complications of the syndrome.Clinical case. A 29-year-old female patient was admitted to the hospital due to generalized maculopapular rash, fever, generalized lymphadenopathy, fatigue, splenomegaly appeared after adding meropenem to carbamazepine therapy. Blood tests showed leukocytosis – 33.6×109/l, hypereosinophilia – 7.9×109/l, elevated liver transaminases. After exclusion of autoimmune, infectious and oncohematological diseases the diagnose of DRESS syndrome was established. On the background of methylprednisolone therapy at the dose of 1 mg/kg fast normalization of body temperature, disappearance of rash, decrease in eosinophils were observed.Discussion. The specific feature of this clinical case is the development of DRESS syndrome after adding antibiotic to anticonvulsant drug (with which this syndrome is commonly associated). This fact complicated the diagnosis. Raising doctors’ awareness about the possibility of developing such an adverse reaction to antibiotic therapy seems to be extremely important to improve the prognosis of this group of patients.

Aim. To study the lipid profile in hospitalized patients with coronavirus disease 2019 (COVID-19) depending on the outcome of its acute phase according to the AKTIV international registry.Material and methods. The AKTIV registry included men and women over 18 years of age with a diagnosis of COVID-19, who were treated in a hospital. A total of 9364 patients were included in the registry, of which 623 patients were analyzed for levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglycerides on days 1-2 of hospitalization. The level of high-density lipoprotein cholesterol (HDL-C) was calculated using the Friedewald equation.Results. We found that a decrease in LDL-C level was significantly associated with an unfavorable prognosis for hospitalized patients with COVID-19. This pattern persisted in both univariate and multivariate analyses. LDL-C levels in the final multivariate model had a significant relationship with the prognosis (an increase in the death risk by 1,7 times with a decrease per 1 mmol/l). In addition, we found that the survival of patients with an indicator level of

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period.

The international AKTIV register presents a detailed description of out- and inpatients with COVID-19 in the Eurasian region. It was found that hospitalized patients had more comorbidities. In addition, these patients were older and there were more men than among outpatients. Among the traditional risk factors, obesity and hypertension had a significant negative effect on prognosis, which was more significant for patients 60 years of age and older. Among comorbidities, CVDs had the maximum negative effect on prognosis, and this effect was more significant for patients 60 years of age and older. Among other comorbidities, type 2 and 1 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, cancer and anemia had a negative impact on the prognosis. This effect was also more significant (with the exception of type 1 diabetes) for patients 60 years and older. The death risk in patients with COVID-19 depended on the severity and type of multimorbidity. Clusters of diseases typical for deceased patients were identified and their impact on prognosis was determined. The most unfavorable was a cluster of 4 diseases, including hypertension, coronary artery disease, heart failure, and diabetes mellitus. The data obtained should be taken into account when planning measures for prevention (vaccination priority groups), treatment and rehabilitation of COVID-19 survivors.

The organizer of the registers “Dynamics analysis of comorbidities in SARSCoV-2 survivors” (AKTIV) and “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2) is the Eurasian Association of Therapists (EAT). Currently, there are no clinical registries in the Eurasian region designed to collect and analyze information on long-term outcomes of COVID-19 survivors with comorbid conditions. The aim of the register is to assess the impact of a novel coronavirus infection on long-term course of chronic non-communicable diseases 3, 6, 12 months after recovery, as well as to obtain information on the effect of comorbidity on the severity of COVID-19. Analysis of hospitalized patients of a possible second wave is planned for register “AKTIV 2”. To achieve this goal, the register will include men and women over 18 years of age diagnosed with COVID-19 who are treated in a hospital or in outpatient basis. The register includes 25 centers in 5 federal districts of the Russian Federation, centers in the Republic of Armenia, the Republic of Kazakhstan, the Republic of Kyrgyzstan, the Republic of Belarus, the Republic of Moldova, and the Republic of Uzbekistan. The estimated capacity of the register is 5400 patients.

Preservation of the quality of fresh products for companies engaged in the implementation of fresh fruit and vegetable products is an important task in managing supply chains in both transport and warehouse logistics. This work presents an estimate of the loss of quality of fresh tomato under the influence of various temperature regimes using an integral quality parameter. Integral quality parameter index consists of deviations of biochemical parameters (vitamin C, acidity, glucose and the sum of sugars) at the recommended storage temperature (plus 8°C) from the values of these the same indicators at temperatures different from it; the frequency of the participation of the indicators in the correlation dependences between the indices and the highest degree of correlation, estimated from the value of the Pearson coefficient. Using the QFD methodology, the relationship of consumer requirements with technical requirements for the quality of fresh tomato has been determined, and the parameters that have the greatest impact on quality have been established. Approbation of the parameter “integral quality” was carried out on the basis of the data of the experiment conducted in the Federal State Budgetary Scientific Institution North Caucasian Regional Research Institute of Horticulture and Viticulture (Krasnodar), on the influence of temperature regimes on the quality of tomato “Torbash” in the process of storage. The proposed model of quality forecasting can be recommended to companies selling fresh tomatoes, carrying out logistic activities in the supply chains of this vegetable production, and can also serve as a basis for assessing the quality of other fruit and vegetable products.

Aim. To study the relationship and interinfluence of aspects of therapy safety and compliance in patients with chronic cardiovascular diseases (CVD) and their risk factors in the framework of outpatient prospective register “PROFIL”.Material and methods. The register method, enriched by two original questionnaires evaluating some safety pharmacotherapy guides and compliance, was used. We also practiced 8-item Morisky Medication Adherence Scale (MMAS-8) to assess overall compliance. The survey was undertook from September 1, 2017 to May 31, 2018. All together 167 of 177 people completed the questionnaires, 162 questionnaires of 80 women and 82 men were analyzed. The mean age of patients was 67,2±11,1 years. One hundred thirty participants answered all the questions of MMAS-8.Results. We determined that 46 (28,4%) of 162 patients had various adverse events (AE) of pharmacotherapy in history, half of patients (54,3) denied the presence of AE, other participants find difficult to answer this question. According to the data of original questionnaire, almost all patients (n=158, 97,5%) were given medical recommendations for taking medications. Also 145 (91,7%) of 158 patients noted that they were taking the prescribed drugs, but only 117 patients follow blindly recommendations, 13 people did not take drugs. According to the results of MMAS-8, 77 (59,2%) people did not follow recommendations, and 53 patients fully followed them. Regular visits to the attending physician and informing the patient by the doctor, including about AE, significantly increased overall compliance (p

COVID-19 is a severe infection with high mortality. The concept of the disease has been shaped to a greater extent on the basis of large registers from the USA, Spain, Italy, and China. However, there is no information on the disease characteristics in Caucasian patients.Therefore, we created an international register with the estimated capacity of 5,000 patients — Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors (AKTIV SARS-CoV-2), which brought together professionals from the Russian Federation, Republic of Armenia, Republic of Kazakhstan, and Kyrgyz Republic. The article presents the first analysis of the register involving 1,003 patients. It was shown that the most significant difference of the Caucasian population was the higher effect of multimorbidity on the mortality risk vs other registers. More pronounced effect on mortality of such diseases as diabetes, obesity, hypertension, chronic kidney disease, and age over 60 years was also revealed.

Aim. To evaluate the dynamics of obesity and mean body mass index (BMI) in Russia and USA in various age and gender categories during 1975-2014.Material and methods. By a repeat analysis of one-moment studies of Russian and US population in 1975-1982 and 2007-2014, the values of obesity and BMI were assessed in men and women age 25-64 y. o. Into analysis, the data was included from Russian part of the Lipid Clinics study and multicenter ESSE-RF study (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation). American data acquired from the studies NHANES (National Health And Nutrition Examination Survey), open access. Total number of observations 48974.Results. In the 80s of XX century in all age groups of women the mean BMI levels were lower in USA comparing to Russia, in men there were no significant differences. For the following 30 years in Russia the situation improved for men and women 45 years old — in Russia.

2 FSBEIHEI.P. PavlovRyazanskyStateMedicalUniversity. Ryazan,RussiaAim. To evaluate the practice of beta-blockers (BB) usage in cardiovascular disease (CVD) patients with diabetes (DM) in two outpatient registries.Material and methods. Registry PROFILE is the patients (n=1531) with CVD, visited specialized cardiological department of medical research center of Moscow during the period 2011-2015, and registry RECVAZA — patients (n=3690), visited 3 city polyclinics in Ryazan city in 2012-2013. Number of DM patients is 221 (14,4%) in PROFILE and 699 (18,9%) in RECVAZA.Results. In the RECVAZA, the rate of BB prescription was almost the same in CVD and DM; in PROFILE there was significantly more frequent prescription of BB, especially after myocardial infarction (86,4%) and in chronic heart failure (72,6%). In both registries bisoprolol was in use most commonly: 61,8% in PROFILE and 75,4% in RECVAZA. Among DM patients, not taking BB, in PROFILE registry there were additional contraindications: chronic obstructive pulmonary disease and asthma, than in RECVAZA.Conclusion. Clinicians of the specialized cardiological department, comparing to clinicians in local outpatient institutions more actively prescribed BB to DM patients, especially in the cases when this could improve long-term outcomes of the disease. This matches with recent clinical guidelines.

The prevalence of obesity and obesity-related disorders has been increasing in the world during last decades, reaching the level of epidemics, being one of the key challenge for medical society and healthcare systems in developed countries.Aim. To evaluate the trends of arterial hypertension (AH) and obesity in Russia for the last 20 years.Material and methods. Into analysis, the results form 3 studies included, by identical protocol, performed in 1993, 2003, 2013 with participation of the National Research Center for Preventive Medicine. The data of general investigation was analyzed, of 55640 men and women at the age 25-64 y.o. In the analysis, the social and demographic data was included, AH, body mass index, smoking, alcohol consumption, heart rate.Results. The prevalence of AH in men in 1993 was 43,0%, declining by 2003 to 36,9%, and significantly increased in 2013 (47,3%). From 2003 to 2013 the prevalence of AH increased by approx. 20%, and of obesity — raised two times during the period. In females, contrary, AH prevalence decreased from 1993 to 2013; and if during 1993-2003 gradient was 15,4%, in 2003-2013 only 6,3%. If in 1993 the prevalence of AH predominated in females, in 2013 — in males. The relation of obesity and AH was assessed for every year of observation, by gender, in multiple regression model. It was found that, if corrected by age, educational level, smoking, alcohol consumption, and increased heartrate, chance of AH increases with obesity rate increase in both genders, 4,5-18 times. In men as in women the weakest relation of AH and obesity was found in 1993.Conclusion. Taken recent tendencies, it is important to develop strategies of prevention and management of obesity and AH, with the aim to decrease obesity-related AH development rate.

Aim. Under the framework of the outpatient registry PROFILE, to assess cardiovascular risk factors (CVR) related to food and physical activity (PA) in obese patients, using questionnaires.Material and methods. Into the study, obesity patients were included, from PROFILE registry, of those 91 completed survey on food behavior and PA.Results. The prevalence of obesity, by the registry data, was 38,8% (47,3% in women and 52,7% in men). Patients had high and very high CVR by SCORE. Arterial hypertension was found in 85,7%, and the same number had dyslipidemia, coronary heart disease — in 34,1%, glucose intolerance and type 2 diabetes — in 12,1% and 20,9%, respectively, smokers were 16,5%. Most patients had in their food related behavior the adverse factors such as low amount of fruits and vegetables, excess of refined carbohydrates and salt. In 48,4% of patients there was low level of PA. All obesity patients present with a characteristic combination of CVR factors.Conclusion. Surveying of patients under framework of outpatient registry makes it to reveal CVR factors related to food and PA, in real clinical practice.

Aim. To assess the opportunities for registry methodology for comparative evaluation of clinical and anamnestic characteristics of cardiological patients with and without obesity; to draw a “portrait” of the obese patients, common for the cohort studied.Material and methods. The data analyzed from outpatient PROFILE registry during January 2011 to 31 august 2015: totally 1531 primary patient included, of those body mass index (BMI) collected in 1371. In 565 there was obesity of various grade, in 806 BMI was not higher than 30 kg/m2. The analysis done of retrospective data.Results. According to PROFILE results, obesity was found in 41,2% of patients, and those with obesity were younger (p=0,003). Among them men and women number was equa — 50,8% and 49,2%, resp. For the obese there were characteristic presence of dyspnea, oedema and low level of physical activity (p=0,0001). The obese had 1,5-3 times more common arterial hypertension, 2 type diabetes, chronic heart failure (p=0,0001), glucose tolerance disordered (p=0,001), dyslipidemia (p=0,012). Regardless that the obese took medications more commonly (p=0,006), they more rarely reached target level of blood pressure (BP), than those non obese (p

The treatment and prevention events against cardiovascular diseases have changed the age population structure. As by forecast, in RF the part of population older than economically active age will increase to 29,1% by the year 2030, hence increasing prevalence of ischemic heart disease (CHD). Therefore, one of the main currents is assessment of risk factors impact on morbidity and mortality from CHD among elderly. One of specifics of elderly population is simultaneous presence of several factors that enhance each other. Nevertheless, the prevalence of arterial hypertension and obesity increase with the age, and part of smokers and those with hypercholesterolemia increases, and relation of mortality with some risk factors does weaken with the age. That is a “survival effect” — earlier mortality of persons with adverse prognosis. Therefore, the specifics of CHD course in elderly dictates for necessity of an approach development to complex and methodic healthcare management.

Acetylsalicylic acid (ASA) use in the primary and secondary prevention of cardiovascular diseases is focused. Mode of ASA disaggregation action is discussed. Data of randomized controlled trials on ASA efficacy and safety in primary and secondary prevention are presented. The main groups of patients who are required the ASA prevention according to current clinical guidelines are indicated. ASA benefit-risk ratio, as well as ways to improve the safety of antiplatelet therapy are presented, including use of enteric-soluble ASA forms.

The third part of the review focuses on the prediction value of exercise test findings under ECG control in ischemic heart disease with stable angina. The various scores are reviewed that apply a complex analysis of clinical and instrumental data that might estimate long-term outcomes in ischemic heart disease and to choose adequate treatment method.

Aim. To study the clinical equivalence of the two low-dose combined drugs on the base of generic and original bisoprolol and hydrochlorothiazide (HCTZ): BISANGIL® (Ozon, Russia) and LODOZ® (NYCOMED, Merck KGaA, Germany) in patients with arterial hypertension (HT) of 1-2 degrees.Material and methods. Patients with HT of 1-2 degrees (n=30; 11 men and 19 women; aged 62.7±10.7 years) were included in open crossover randomized trial. Duration of the study for each patient was 18 weeks: two 6-week courses of active treatment with each drug and two 2-week washout periods prior to each treatment course. The sequence of treatment courses was determined by randomization. Increase in bisoprolol dose and/or amlodipine addition occurred when effect was not sufficient. Therapy effectiveness (office blood pressure (BP), heart rate) and safety was monitored at visits.Results. BP reduction after 6 weeks of therapy was -21.6±11.1/10.4±11.3 mm Hg in LODOZ® group and -22.9±9.7/11.7±13.5 mm Hg in BISANGIL® group (pConclusion. The therapeutic equivalence of the studied fixed combinations of bisoprolol/HCTZ was demonstrated in treatment of patients with HT of 1-2 degrees.

Aim. To study prevalence of various types of coronary heart disease (CHD) and their prognostic value in men and women older than 55 y.o.Material and methods. We used the data from selections of previously diagnosed persons. Totally 1875 included, with response at 64% level. All persons were questionnaired by the standard survey, that included social and demographic data, anamnesis, Rose questionnaire, behaviour. All patients underwent ECG 12 leads. ECG analysis was done with Minnesota conding system.Results. Every 4th male and every 3rd female revealed angina pectoris by the Rose questionnaire, and 9,5% men and 2,7% women had anamnesis of infarction. Ischemic changes on ECG more often in women — 15,6% vs. 10,0% (p

Aim. To research the prevalence of atrial fibrillation (AF) and to compare the clinical characteristics of the patients to those without AF.Material and methods. At the moment of cross-section the Profile Study included 671 patients with various cardiovascular diseases, those who consulted at the Preventive pharmacotherapy department of the Centre.Results. AF was diagnosed in 99 patients (14,7%). There was no difference by gender with those without AF, but they were significantly older. There was no difference in prevalence of the common risk factors, ischemic heart disease and peripheral atherosclerotic disease. Anamnesis of cerebral stroke was more common for the AF group: 9,1% vs 2,8%. Anamnesis of stomach ulcer disease was also more prevalent in AF group: 9,1% vs 4,4%.Conclusion. The section-study of patients included into Profile Registry showed typical clinical properties for AF and made it to compare with those found in other registries.

One of the major problems of modern medicine is the epidemics of diabetes mellitus (DM). Population ageing, increased life expectancy, and improved treatment quality make this problem one of the key healthcare targets.Aim. To assess the diagnostic value of different criteria in the DM detection among megapolis-dwelling participants of a population study, aged 55 years and older.Material and methods. The cross-sectional data came from a representative sample of SAHR (Survey on Stress, Aging, and Health in Russia) study (n=1868, including 893 men; response rate 64%). All participants underwent a standard questionnaire survey on sociodemographic characteristics, risk factors (RFs), and medical history, as well as a clinical and laboratory examination, with the measurement of fasting glucose and glycated haemoglobin (HbA1c). DM was diagnosed if at least one of following criteria was met: 1) positive response to the question “Has a doctor ever told you that you have diabetes?”; 2) fasting glucose ≥7,0 mmol/l; and 3) HbA1c ≥6,5%. Statistical analyses were performed in SPSS (version 16.0) and SAS (version 6.12).Results. Anamnestic evidence of DM was obtained in 11,3% of the participants (10,3% of men and 12,2% of women). Levels of HbA1c ≥6,5% were registered in 16,6% (16,1% of men and 17,0% of women). Hyperglycemia (fasting glucose ≥7,0 mmol/l) was observed in 13,3% (15,3% of men and 11,5% of women). The prevalence of DM, according to all three diagnostic criteria, reached 25,3% (24,9% in men and 25,6% in women). More than a half of DM patients were not aware of their diabetes. There were no statistically significant differences in the assessed parameters by gender, age, or education.Conclusion. It is important to strengthen the potential of healthcare services in terms of increasing population awareness of DM and its consequences and facilitating early DM diagnostics, particularly in middle-aged and elderly people.

Aim. To compare the associations between employees’ health groups, defined by the results of the repeated medical examination (RME), and conventional risk factors (RFs) of cardiovascular disease (CVD) or total CVD risk; to justify the need for RME and identify the priorities for its further improvement, in order to prevent CVD among working populations.Material and methods. The study was performed as a part of a regulation-required RME, at a medical unit serving employees of a large industrial enterprise. A standard examination was combined with the assessment of such CVD RFs as tobacco smoking, alcohol consumption, stress, and body mass index.Results. The RME data were analysed for 3013 employees (51,8% men and 48,2% women). Mean age of the participants was 45,8±12,5 years (44,8±13,6 years in men and 46,9±11,2 years in women; p0,05); Health Group III to 27,3% (26,0% of men and 28,8% of women; p>0,05); and Health Group IV to 0,3% of both men and women (p>0,05). No participants were assigned Health Group V. The study demonstrated feasibility of an extended medical examination without substantial extra costs. This justifies the inclusion of early CVD RF detection and correction in the RME programme for working populations. Among working-age employees with Health Group I, more than one-third (37,4%) had moderate levels of total CVD risk. Among older age groups, 90% and 10% had moderate and high total CVD risk, respectively.Conclusion. The results of this analysis can be used for identification of prevention priorities, both for workplace-based and medical unit-based prevention among working populations, as well as for assessment and distribution of the resources required.

Background. The elevation of blood pressure (BP) affects the development of vascular inflammation. At the same time, it has been suggested that inflammation itself could be an independent risk factor (RF) of arterial hypertension (AH) development. Aim. To investigate whether the association between increased levels of C-reactive protein (CRP) and AH is independent from classical RFs. Material and methods. The data were obtained during a crosssectional survey of 1876 Muscovites (47,9% men) aged ≥55 years, who participated in the prospective study “Stress, Ageing, and Health in Russia”. In all participants, socio-demographic characteristics, health behaviours, parameters of anthropometry and rest electrocardiography (ECG) were assessed. The levels of BP and blood lipids were also measured. The outcome variable was an increase in CRP levels (>3 mg/l). Statistical methods included logistic regression; the risk estimates were presented as odds ratios (OR) and 95% confidence intervals (CI). Results. There was a positive link between AH and CRP levels of >3 mg/l. After adjustment for age and sex, OR of increased CRP levels in hypertensive participants vs. their AH-free peers was 1,688 (95% CI 1,323-2,154; p=0,0001). In the final model (adjustment for age, sex, educational level, smoking, alcohol consumption, abdominal obesity, high atherogenicity index, and coronary heart disease, CHD), this effect remained statistically significant (OR 1,450; 95% CI 1,127-1,864; p=0,004). Conclusion. In elderly Muscovites, a positive association between increased CRP levels and the elevation of BP was independent from RFs and CHD.

Obtained are the immunomagnetic particles with the immobilized highly-specific monoclonal antibodies FB 11-x to Francisella tularensis. Their usage in enzyme-linked immunoassays made it possible to detect 105 - 106 CFU/ml of F. tularensis. The binding of the bacterial cells with IMP was confirmed by the results of fluorescent microscopy.

Aim. To investigate the effects of a atorvastatin (Atoris, KRKA) on major clinical parameters in patients with high cardiovascular risk – the participants of the OSCAR Study (2006). Material and methods. The total number of high-risk patients was 930 (472 men). The mean age was 57,8 years. Coronary heart disease (CHD) was diagnosed in 80,1% of men and 70,0% of women. All participants were divided into three groups by their CHD status: no CHD; with uncomplicated CHD; with CHD complications (myocardial infarction, stroke, and revascularisation in anamnesis). In all patients, the levels of risk factors, lipid profile, anthropometric and hemodynamic parameters were assessed. A generic atorvastatin was administered in a fixed start dose of 10-20 mg/d. The duration of the study was approximately 1,5 months. Results. After 8 weeks of Atoris treatment, a significant improvement in hemodynamic and lipid parameters was observed. In patients with CHD complications, lipid profile dynamics was less manifested, but the prevalence of target lipid level achievement was higher, since these individuals started with higher doses of atorvastatin. The total risk of fatal cardiovascular events reduced significantly. Atorvastatin was well-tolerated. Conclusion. Atorvastatin (Atoris, KRKA) is effective and safe in real-world clinical practice. It reduces the risk of cardiovascular events and mortality, also improving quality of life in high-risk patients.

An attempt has been made to systematize the data on Russian cardiological clinical trials, included in the first edition of the reference book “Russian clinical and epidemiological studies in cardiology”. Design, duration, sample size, study population and other characteristics are described for these studies (n=93). The majority of the Russian studies are relatively short (approximately 70% are under 1 year), and the sample size is relatively small (approximately 50% include

Aim. To evaluate the knowledge of medical practitioners on total cardiovascular (CVD) risk assessment and ambulatory use of the SCORE instrument. Material and methods. In total, 229 medical practitioners from Russia and CIS countries participated in the anonymous survey: 72 % cardiologists and 26 % therapeutists. Mean age of the respondents was 44,6±11,7 years, with mean duration of working at the current position being 8,9±11,5 years. The survey questionnaire focused on the practical use of the SCORE risk assessment scale. Results. Ninety percent of the responders confirmed using the SCORE scale, 8,3 % were not using it, and 1,7 % did not know about the SCORE instrument. Among the SCORE components, 84 % of the practitioners correctly reported gender, age, blood pressure and total cholesterol; 75 % also correctly reported smoking; 40 % wrongly reported glucose and CVD in family history, while 30 % wrongly mentioned overweight, obesity, and waist circumference. Other risk factors (RFs) were wrongly reported by 6,6 % of the doctors (including education, reported by 3,3 %). Patients with diabetes mellitus and microalbuminuria, with three or more RF, or with total CVD risk >5 % were classified as having high total CVD risk by 80 % of the responders. Patients with confirmed CVD diagnosis were regarded as having high CVD risk by 67 % of the practitioners. Symptom-free patients with a very high level of a single RF were classified as having high CVD risk by 20 % of the responders only. Total CVD risk reduction, as a main goal of arterial hypertension treatment, was reported by 62 % of cardiologists and 58 % of therapeutists. Up to 54 % of the responders had RFs themselves. The interest in educational programmes for doctors, focusing on SCORE use in clinical practice, was very high (90 %). Conclusion. The study demonstrated inadequate knowledge of the practitioners on the methodology of total CVD risk assessment, an important instrument of primary prevention. The doctors attending medical educational programmes showed better levels of knowledge.

Aim. To develop, test and evaluate the workplace (wp) programme of multifactorial prevention of cardiovascular disease (CVD). Material and methods. In a technical research institute, with 523 employees, a complex programme of CVD prevention was introduced, including preventive examination, preventive intervention, and clinical effectiveness monitoring. Preventive examination included complex assessment of CVD and CVD risk factors (RFs) (response rate 89,5 %). Preventive intervention, developed with consideration of CVD prevention demand, was performed in the intervention group (IG). The control group (CG) was formed according to “case-control” principle. In clinical effectiveness analysis, the dynamics of blood pressure (BP), total cholesterol (TC), psycho-emotional RFs, and SCORE-calculated CVD risk was assessed. Results. Preventive examination demonstrated high prevalence of arterial hypertension (AH), metabolic and psycho-emotional RFs at wp, together with high interest in RF correction. Preventive intervention resulted in a significant reduction in systolic BP (SBP) — by 9 mm Hg, in diastolic BP (DBP) — by 9,7 mm Hg, in TC — by 0,7 mmol/l, and also in SCORE-calculated CVD risk — from 3,8 % to 3,0 %. Conclusion. Complex CVD prevention at wp was associated with substantial beneficial effects within first 12 months.

Monoclonal antibodies (MAb) were produced against two B. pseudomallei high-purified membrane proteins with Mr 29 kDa (p29) and 45 kDa (p45). Monoclonal antibodies from culture supernatant fluids of 4F2 and 1G11 clones showed specific interaction with protein moiety of p29 both Burkholderia pseudomallei and Burkholderia mallei in ELISA and Western blotting. However, MAb of 3G4 clone were bound to the LPS-protein structures of these microbial cells. Analysis of interaction of Mabs from 4F2 and 1G11 clones with antigens of different lysates of pathogenic cells confirmed high specificity of these antibodies to p29 membrane protein of B. pseudomallei and B. mallei.

The influence of monotherapy with enam on the overall coronary risk: dynamics of correctable cardiovascular risk factors in patients with metabolic syndrome.