Association of Severity of Coronary Artery Disease With Traditional Risk Factors, Clinical Characteristics and Carotid Plaque Burden in Patients With Acute Coronary Syndrome.

Aim: To study the associations between risk factors, clinical characteristics, severity of brachiocephalic artery (BCA) atherosclerosis and severity of coronary artery (CA) disease in patients with acute coronary syndrome (ACS).

Material And Methods: The study included patients with any type of ACS and obstructive coronary artery disease confirmed by coronary angiography. A quantitative analysis of coronary angiography data was performed with an assessment of the number of CAs with significant stenosis and calculation of the SYNTAX score.

Stable Coronary Artery Disease: Who Finally Benefits from Coronary Revascularization in the Modern Era? The ISCHEMIA and Interim ISCHEMIA-EXTEND Analysis.

Coronary revascularization is one of the most studied treatment modalities in cardiology; however, there is no consensus among experts about its indications in patients with stable coronary artery disease (SCAD). Contemporary data regarding the role of revascularization in SCAD are in clear conflict with the current European guidelines. This article discusses the main statements of the most significant American and European Guidelines on myocardial revascularization of the last decade and also analyzes the appropriateness of revascularization to improve the prognosis and symptoms in SCAD in the light of new research data, primarily the ISCHEMIA study (NCT01471522) and the ACC/AHA 2021 Revascularization Guidelines based on them.

Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial.

Background: Patients with significant (≥50%) left main disease (LMD) have a high risk of cardiovascular events, and guidelines recommend revascularization to improve survival. However, the impact of intermediate LMD (stenosis, 25%-49%) on outcomes is unclear.

Methods: Randomized ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) participants who underwent coronary computed tomography angiography at baseline were categorized into those with (25%-49%) and without (<25%) intermediate LMD.

New Possibilities to Reduce the Residual Risk in Patients with Ischemic Heart Disease.

Despite a significant progress of the recent decades, incidence of cardiovascular complications in patients with manifest, stable ischemic heart disease (IHD) is still high. Furthermore, this patient group is heterogenous; individuals with a higher risk of cardiovascular complications can be isolated from this group based on the presence of comorbidities and acute IHD on the background of the therapy. Such patients require a more aggressive treatment to influence major components of the increased risk.

[Letter to the editorial office of the journal "Problems of Endocrinology" in connection with the publication of an editorial by prof. P.O.Rumyantsev "Oncoendocrinology - an innovative interdisciplinary platform for personalized medicine"].

The publication of this article is undoubtedly a significant and positive phenomenon, while the initiative of the journal «Problems of Endocrinology» with the introduction of a new section «Oncoendocrinology» should be welcomed and will serve to unite the efforts of specialists of various profiles in the appropriate direction.

[Revascularization in Stable Ischemic Heart Disease: Whether to Change the Approach?].

Current international guidelines on stable ischemic heart disease (IHD) state that coronary revascularization is indicated in cases of: limiting ischemic symptoms while on optimal medical therapy (OMT); high risk coronary anatomy; high risk stress test result. At the same time, many results supporting these conclusions were obtained in relatively old studies, conducted when the approaches to medical therapy and revascularization techniques differed greatly from contemporary practice. Many of the conclusions have been based on data from observational studies and subanalyses of randomized clinical trials, therefore methodologically are not sufficiently reliable.

[CURRENT VIEWS OF DIAGNOSTICS AND STRATEGY OF THE TREATMENT OF STABLE ISCHEMIC HEART DISEASE].

Ischemic heart disease (IHD) is a leading cause of mortality worldwide and stable IHD is one of its most important clinical forms. Recent decades brought new data on algorithms of diagnostics, pharmacotherapy and myocardium revascularization in patients with stable IHD. They were summarised in American (2012) and European (2013) recommendations on the management of this condition.

[Prediction of Subclinical Carotid Atherosclerosis With Parameters of Negative for Ischemia Exercise Testing].

Aim: to elucidate relationship between parameters of negative ischemic stress test and subclinical atherosclerosis of carotid arteries.

Material And Methods: Electrocardiographic stress test on treadmill and ultrasound study of carotid arteries (CA) were carried out in 204 patients (100 women and 104 men, mean age 54.16±8.

[Microviscosity of erythrocyte membranes in breast cancer patients: connection with the receptor phenotype of the tumor].

The state of the viscosity of erythrocyte membranes in breast cancer patients (68--in menopause and 32--with menstrual cycle) was studied in comparison with the content of steroid hormone receptors in the tumor tissue and the age of patients. It is showed that the less hormone dependence of the tumor the higher viscosity of erythrocyte membranes that manifested by a decrease in the coefficient of eximerization (CE) of pyrene in the protein/lipid and in particular, lipid/lipid membrane layers. Increasing CE of pyrene in lipid/lipid layer of erythrocyte membranes above 1.

[Exosomal intercellular communication system and its role in the process of metastatic dissemination].

Metabolism and information between cells is the basis of the existence of any multicellular organism. Malfunction of the intercellular communication play an important and sometimes decisive role in the pathogenesis of the most diseases, including cancer. According to traditional views, functional integration of individual cells in tissues, organs and organ systems is mediated by the efficient work of regulatory systems: nervous, immune, endocrine.

[Evaluation of ovarian status in women who received anti-tumor therapy in childhood and adolescence].

The paper presents the results of a study of the ovarian reserve in young women who received treatment for malignant tumors in childhood and adolescence and are in complete clinical remission. The function of the reproductive system was evaluated by serum concentrations of gonadotropins, estradiol, anti-Müllerian hormone (AMH) and inhibin B. The results were compared to the treatment, patients' age at the beginning of therapy and at the time of the examination.

[Endometrial cancer, estrogens and metabolic syndrome: scenario becomes more complicated].

Simultaneously with keeping one of the leading positions in the structure of oncogynecological morbidity, endometrial cancer (EC) presents for many decades 'the food for brains' of cancer endocrinologists. Step by step development of contemporary ideas and collecting the data on mechanisms of hormonal carcinogenesis, the role of excessive estrogenic stimulation and metabolic syndrome/insulin resistance as risk factors for EC, very probable gradual changing of the disease phenotype and significance of genetic damages (with PTEN-mutations as one of the examples), as a consequence point at potential perspectives in the usage of preventive and therapeutic approaches in this important area.

[Revascularization or conservative strategy in patients with stable coronary heart disease: a contemporary view].

Choice between revascularization and conservative strategy in patients with stable coronary heart disease (CHD) is an important clinical problem, especially when the need for revascularization is not urged by severe ischemic symptoms. Revascularization aimed to improve prognosis is most justified in patients having high risk, based both on results of coronary angiography and functional tests. In the opinion of many experts, the high-risk features at stress-test is a key to identify patients in whom revascularization is most required among persons with high-risk coronary anatomy, as well as to select candidates for invasive treatment among patients with more favorable variants of coronary lesions.

[Diabetes mellitus as a modifier of the course of tumors of the female reproductive system].

Frequency of separate malignancies and diabetes tends to an increase. This is one of the reasons that diabetes is more often attracting attention as a potential risk factor for cancer. At the same time, in general, relatively less attention is paid to the analysis of the question of whether the presence of diabetes is able to influence on features of neoplasm, inherent at the diagnosis, as well as on the clinical course of the tumor process and its outcomes.

[Family diabetes and its consequences in cancer patients].

Preliminary data are confirmed on the more rare prevalence of family history of diabetes mellitus (DM) in cancer patients, mainly females, with diabetes in comparison with diabetics without cancer pathology. Familial diabetes does not worsen additionally tumor characteristics against the same in patients with non-familial diabetes. More than that, familial diabetes in diabetics with breast cancer goes together with lesser size of tumor and demonstrates an inclination to the rarer distant metastases in breast and endometrial cancer patients.

[Hormonal-metabolic pattern of postmenopausal females with new onset of diabetes mellitus type 2: the role of cancer and hereditary predisposition to diabetes].

85 females were studied, 35 females had new onset of diabetes (DM2) and in 50 women DM2 was associated with recently diagnosed cancer (C+DM2). Group C+DM2 was characterized by higher levels ofbody mass index, insulinemia, estradiolemia, interleukin 6 in serum, and glyoxalase I activity in mononuclears. At the same time patients in C+DM2 group who had familial predisposition to DM2 were characterized by lower body mass index, body fat content, waist circumference, insulinemia, serum interleukin 6, viscosity of erythrocyte membranes and percent of comets in mononuclears in comparison with patients without familial predisposition to DM2.

[Comparison of results of elastography with hormonal and metabolic status in patients with the diagnosis of thyroid neoplasms].

In order to assess the effectiveness of compression elastography of the thyroid gland as a method for differential diagnosis to studies conducted in the pre-operative period, there were involved 34 patients with a mean age 46.6 +/- 2.7 years.

[Potential sensitivity to metformin of the diabetics suffering and not suffering with cancer: a pharmacogenetic study].

The group (totally 156 postmenopausal women) used for the study of 'standard' (S) and 'associated' (A) genetic markers of potential sensitivity to metformin (MF) consisted of 37 healthy females, 32--with diabetes (DM) without cancer, 64 cancer patients with DM, and 23 cancer patients without DM. No significant difference in carrying of S-polymorphisms was found between DM patients without and with cancer. In cancer patients without DM most characteristic data regarding potential MF-response were detected with polymorphisms of STK11 gene while data on OCT1_rs622342 and OCT1_R61C variants showed opposite trends.

[Genetic testing of constitutive sensitivity to metformin in cancer patients with and without diabetes].

Metformin (MF) belongs to the most popular andidiabetic medicines and is considered to possess a selective antineoplastic action. This selectivity at least partly may be explained by the certain features of MF pharmacogenetics. More than 150 postmenopausal females divided into 4 groups (cancer +diabetes type 2 (DM2); cancer without DM2; DM2 without cancer, and healthy) were studied.

[Individual coronary heart disease risk prediction as part of primary prevention].

Correction of traditional risk factors (RF) at the population level resulted in considerable progress in prevention of coronary heart disease (CHD) in many countries. At the same time existing approaches to individual prediction of cardiovascular diseases based on the analysis of traditional RF and global risk scoring are in some cases ineffective. This problem most notably relates to a large group of persons with low calculated risk (young patients, persons without multiple RF, women) which accounts for the greatest in absolute numbers quantity of primary cardiovascular events.

[Metformin does not suppress the aromatase expression in breast cancer tissue of patients with concurrent type 2 diabetes].

Although there is data suggesting the in vitro inhibition of aromatase in cell lines by antidiabetic biguanide metformin (MF), there is no data on the intratumoral breast cancer (BC) aromatase expression in patients already receiving therapy for type II diabetes. Paraffinized tumor samples obtained from 57 BC pts aged 48-77 yrs, >80% of pts had stage T1-2N0-3M0 BC. Thirteen of the pts didn't have diabetes, 44 pts were previously diagnosed type II diabetes and reseaved the following therapy for at least 1 year: diet only (n=14), sulphonylurea (SU, n=14), metformin (MF, n=9) or MF with SU (n=7).