Publications by authors named "L L Bershteĭn"

Article Synopsis
  • The study aims to evaluate the variability in measurements of atherosclerotic plaque (ASP) area and height in carotid arteries, proposing these as potential indicators for assessing the effectiveness of secondary prevention after acute coronary syndrome (ACS).
  • Analysis was conducted on patients with confirmed ACS and recorded ASP, revealing that variability in measurements between different studies was notably higher than that within the same study, indicating inconsistencies in data collection or methodology.
  • Although some changes in ASP parameters were observed over a six-month follow-up, the differences were not statistically significant, highlighting the need for improved protocols and training for the specialists involved in these evaluations.
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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.

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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.

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Article Synopsis
  • Ischemia without obstructive coronary artery disease (INOCA) is a common condition that carries a poor prognosis, and this study aimed to understand its natural progression and related symptoms.
  • The CIAO-ISCHEMIA study assessed angina and stress echocardiography results in patients with INOCA over a year, highlighting the relationship between angina severity and ischemia.
  • Findings indicated that although INOCA participants were mostly female and had similar ischemia levels to those with coronary artery disease, there was little correlation between changes in angina and ischemia over the year.
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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.

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