[Terminological and demographic aspects of comorbidity].

The aim of the present review is to bring into focus the issues regarding terminological and demographic aspects of comorbidity we come across in the modern literature. In this review we gave definitions for the most widely used terms «comorbidity», «polymorbidity», and «multimorbidity». We also considered the historical aspects of their origin and showed the differences between the concepts.

[Acetylsalicylic acid for the prevention of primary myocardial infarction and ischemic stroke].

There is evidence that acetylsalicylic acid (ASA) is effective in preventing events in a number of cardiovascular diseases. However, there is a number of unresolved problems concerning the efficiency and suitability of its use as an agent for the prevention of cardiovascular events (CVEs) (myocardial infarction (Ml) and/or ischemic stroke (IS) and/or death) in subjects without any clinical manifestations and/or diagnosed coronary heart disease (primary prevention of CVEs). The aim of the review is to compare the current recommendations of, professional communities for the.

Gut microbiota and diet in patients with different glucose tolerance.

Type 2 diabetes (T2D) is a serious disease. The gut microbiota (GM) has recently been identified as a new potential risk factor in addition to well-known diabetes risk factors. To investigate the GM composition in association with the dietary patterns in patients with different glucose tolerance, we analyzed 92 patients: with normal glucose tolerance (n=48), prediabetes (preD, n=24), and T2D (n=20).

Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology.

Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines.

EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries.

Aims: To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe.

Methods And Results: EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later.

Cholesteryl ester diffusion, location and self-association constraints determine CETP activity with discoidal HDL: excimer probe study.

The transfer of cholesteryl ester by recombinant cholesteryl ester transfer protein (CETP) between reconstituted discoidal high-density lipoprotein (rHDL) was studied. Particles contained apolipoprotein A-I, unsaturated POPC or saturated DPPC and cholesteryl ester as cholesteryl 1-pyrenedecanoate (CPD) or cholesteryl laurate (CL) in donor and acceptor rHDL, respectively. Probe dynamics fulfilled the quenching sphere-of-action model.

Molecularly imprinted solid-phase extraction for selective extraction of bisphenol analogues in beverages and canned food.

This study aimed to develop a selective analytical method for the simultaneous determination of seven bisphenol analogues in beverage and canned food samples by using a new molecularly imprinted polymer (MIP) as a sorbent for solid-phase extraction (SPE). Liquid chromatography coupled to triple-quadruple tandem mass spectrometry (LC-MS/MS) was used to identify and quantify the target analytes. The MIP-SPE method exhibited a higher level of selectivity and purification than the traditional SPE method.

Prediction of the influences of missense mutations on cholesteryl ester transfer protein structure.

The structure of human plasma cholesteryl ester transfer protein (CETP) was mapped in silico by a search of the structural effects of missense mutations in the CETP gene. Sixteen deleterious substitutions were chosen among 54 known missense mutations and further ranked by stability change score into six structural and ten functional mutations with large and small stability changes, respectively. A cluster of eight mutations in a central region spanning residues 184-296 with exclusively destabilizing effects was evident.

Geographical variations in the prevalence and management of cardiovascular risk factors in outpatients with CAD: Data from the contemporary CLARIFY registry.

Aim: To determine the current prevalence and control of major cardiovascular risk factors in stable CAD outpatients worldwide.

Methods: We analysed variations in cardiovascular risk factors in stable CAD outpatients from CLARIFY, a 5-year observational longitudinal cohort study, in seven geographical zones (Western/Central Europe; Canada/South Africa/Australia/UK; Eastern Europe; Central/South America; Middle East; East Asia; and India).

Results: Patient presentation (N=32,954, mean age 64.

Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry.

Importance: In the era of widespread revascularization and effective antianginals, the prevalence and prognostic effect of anginal symptoms and myocardial ischemia among patients with stable coronary artery disease (CAD) are unknown.

Objective: To describe the current clinical patterns among patients with stable CAD and the association of anginal symptoms or myocardial ischemia with clinical outcomes.

Design, Setting, And Participants: The Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (CLARIFY) registry enrolled outpatients in 45 countries with stable CAD in 2009 to 2010 with 2-year follow-up (median, 24.

Urinary levels of bisphenol analogues in residents living near a manufacturing plant in south China.

The use of bisphenol A (BPA) has been restricted in many countries because of its potential health effects. As a result of these restrictions, a group of bisphenol analogues that are structurally similar to BPA have been developed as the alternatives for industrial applications. However, latest researches indicated that these chemicals have similar endocrine-disrupting effects as BPA in humans.

Mutation mapping of apolipoprotein A-I structure assisted with the putative cholesterol recognition regions.

Twenty-nine from 52 missense mutations in apoA-I gene are predicted to be deleterious by both SIFT and PolyPhen-2 algorithms. Among those, eight mutations with a prominent change in structure stability as modeled by the SDM tool for both lipid-free (Mei and Atkinson (2011) PDB ID: 3R2P) and HDL-bound (Wu et al. (2009) PDB ID: 3K2S) apoA-I, are referred as structural.

Sequence-specific apolipoprotein A-I effects on lecithin:cholesterol acyltransferase activity.

Existing kinetic data of cholesteryl ester formation by lecithin:cholesterol acyltransferase in discoidal high-density lipoproteins with 34 mutations of apoA-I that involved all putative helices were grouped by cluster analysis into four noncoincident regions with mutations both without any functional impairment and with profound isolated (V- and K-mutations) or common (VK-mutations) effect on V(max)(app) and K(m)(app). Data were analyzed with a new kinetic model of LCAT activity at interface that exploits the efficiency of LCAT binding to the particle, particle dimensions, and surface concentrations of phosphatidylcholine and cholesterol. V-mutations with major location in the central part and C-domain affected the second-order rate constant of cholesteryl ester formation at the solvolysis of acyl-enzyme intermediate by cholesterol as nucleophile.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology.

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality.

A mechanistic model of lecithin:cholesterol acyltransferase activity exploits discoidal HDL composition and structure.

Lecithin:cholesterol acyltransferase (LCAT) activity towards discoidal HDL with apoA-I was analyzed in conjunction with re-evaluation of conformational stability of apoA-I (Sparks et al., 1993). The reaction at water-lipid interface involves the formation of acyl-enzyme and cholesterol (Chol) as a nucleophilic agent can compete with water at deacylation step.

Prevalence, components, and correlates of metabolic syndrome (MetS) among elderly Muscovites.

The goal of this study is to estimate the prevalence of MetS, together with its components and correlates, among elderly Russians. Our population-based sample included randomly selected residents of Moscow aged 55 and older: 955 women with an average age of 67.6, and 833 men with an average age of 68.

Kinetic analysis of lecithin:cholesterol acyltransferase activity toward discoidal HDL.

The kinetics of lecithin:cholesterol acyltransferase(LCAT, EC 2.3.1.

Apolipoprotein E genotype as a most significant predictor of lipid response at lipid-lowering therapy: mechanistic and clinical studies.

APOE alleles and apolipoprotein E isoforms control plasma cholesterol level on population level. Among three ɛ2, ɛ3, ɛ4 alleles, ɛ4 allele is associated with the increase in cholesterol level, risk of atherosclerosis and Alzheimer disease, while ɛ2 allele is associated with the decrease in cholesterol level and risk of atherosclerosis. The increase in plasma triglyceride is an independent risk factor of atherosclerosis and triglyceride-high density lipoprotein coupling determines the efficiency of reverse cholesterol transport.

Local/bulk determinants of conformational stability of exchangeable apolipoproteins.

GuHCl-induced denaturation of human plasma apoA-I, apoA-II, apoA-IV, apoE3 and three recombinant apoE isoforms in solution and discoidal complexes with phosphatidylcholine (only plasma proteins) was studied. The protein conformational stability (ΔG(H(2)O)) and a slope of linear dependence of free energy of unfolding on GuHCl concentration (m-value) were estimated with the three equilibrium schemes. The data for all proteins, except apoA-II, fit with the three-state model, thus evidencing two-domain structure.

Composition, structure and substrate properties of reconstituted discoidal HDL with apolipoprotein A-I and cholesteryl ester.

To investigate the influence of lipid unsaturation and neutral lipid on the maturation of high density lipoproteins, the discoidal complexes of apoA-I, phosphatidylcholine and cholesteryl ester (CE) were prepared. Saturated dipalmitoylphosphatidylcholine (DPPC) and unsaturated palmitoyllinoleoylphosphatidylcholine (PLPC), palmitoyloleoylphosphatidylcholine (POPC), and fluorescent probe cholesteryl 1-pyrenedecanoate (CPD) that forms in a diffusion- and concentration-dependent manner short-lived dimer of unexcited and excited molecules (excimer) were used. The apoA-I/DPPC/CPD complexes were heterogeneous by size, composition and probe location.

Capillary isotachophoresis study of lipoprotein network sensitive to apolipoprotein E phenotype. 2. ApoE and apoC-III relations in triglyceride clearance.

The plasma (P), VLDL (V) triglyceride and apoB (B) clearance rates were measured both as 'mass' clearance (k (1)) and 'within the particle' clearance in three patient groups (E33, E23 and E34 phenotypes) at heparin-induced lipolysis in vivo. The lipid (C)- and apoE (E)-specific lipoprotein profiles both before and after heparin were followed by capillary isotachophoresis. The displacement of apoE by exogenous apoC-III at plasma titration in vitro was measured as well.

Capillary isotachophoresis study of lipoprotein network sensitive to apolipoprotein E phenotype. 1. ApoE distribution between lipoproteins.

Sixteen patients differing widely in plasma triglyceride content were divided into three groups by their apolipoprotein E (apoE) phenotype-E33 homozygotes, E23, and E34 heterozygotes. The plasma lipid and apoE distribution between individual lipoproteins was followed by capillary isotachophoresis (CITP) of plasma samples pre-stained with lipid fluorescent probe NBD-C6-ceramide and by fluorescein-labeled apoE, respectively. Among 12 peaks visualized by ceramide staining, an individual peak with very low density lipoproteins (VLDL) was identified.

Statins as effectors of key activities involved in apoE-dependent VLDL metabolism: review and hypothesis.

Statins influence the major reactions of TG and HDL metabolism controlled, in part, by apoE level and its isoforms on the transcriptional, translational and post-translational levels. The existing unexplained maximal and minimal lipid responses (lowering TG and rising HDL-C) for varepsilon2 and varepsilon4 APOE alleles, respectively, following statin therapy may be completely described by the minimal set of the effects that follow: (i) the lowest and the highest efficiency of the binding of apoE2 and apoE4, respectively, to the LDL receptor; (ii) the increased competition of apoE4-containing VLDL with LDL for the LDL receptor; (iii) the isoform-independent induction by statin of the LDL receptor expression; (iv) the highest inhibition of hepatic lipase and the highest activation of lipoprotein lipase-directed lipolytic pathways for varepsilon2-bearing patients by statins; and (v) the increased clearance of large apoE-containing HDL, specifically with apoE4, at highest statin doses. These effects may be modulated additionally by apoE-controlled TG secretion.

Time-dependent lipid response on fluvastatin therapy of patients with hypercholesterolemia sensitive to apoE phenotype.

Sixty-seven male patients with hypercholesterolemia, divided into three groups according to apolipoprotein E phenotype (33 with apoE3/ 3 phenotype, E3 group; 23 with 2/2 or 2/3, E2+ group; 11 with 4/4 or 4/3, E4+ group), received daily 20-40 mg of fluvastatin for 12 weeks. The levels of triglyceride (TG), cholesterol (Chol), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured after 0, 4, 8 and 12 weeks on fluvastatin and after 4 weeks washout period. Lipid percentage changes (delta) were not associated with apoE phenotype for any treatment time.