[Cystatin C level is independently related to risk of unfavorable outcome after acute coronary syndrome in individuals with normal or moderately reduced renal function].

We studied relation between cystatin C level and risk of unfavorable outcome (unstable angina, fatal and nonfatal myocardial infarction [MI], fatal and nonfatal stroke, and death) in patients stabilized after exacerbation of ischemic heart disease. Patients (n=272) were included on day 10 after onset of acute coronary syndrome. No relationship between studied outcomes and cystatin was found in a group as a whole. In patients with normal of slightly reduced renal function (glomerular filtration rate more or equal 60 ml/min/1.73 m2) unfavorable outcomes were independently associated with history of myocardial infarction and stroke, elevated levels of brain natriuretic peptide and cystatin. In subjects with moderately or severely reduced renal function elevation of cystatin level lost its significance. Risk of development of unfavorable outcomes among these subjects was independently related to history of MI and GFR <60 ml/min/1.73 m2 (OR 2.130, 95% CI 1.010-4,489; =0,047). Our data confirm possibility of use of cystatin C level measured early after ACS in patients with normal or slightly lowered renal function as a parameter characterizing risk of cardiovascular complications and death.

[Gender differences in the state of the system of hemostasis in patients with ischemic heart disease]. / Polovye razlichiia v sostoianii sistemy gemostaza u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Levels of fibrinogen, von Willebrand factor, d-dimer, antithrombin III, protein C, plasminogen, and plasminogen activator inhibitor were measured in 62 men and 37 women with ischemic heart disease before and after 20-min venous occlusion. Women compared with men had higher baseline levels of fibrinogen (4.046-/+0.1785 and 3.584-/+0.1591 g/l, respectively, p=0.021), von Willebrand factor (122.1-/+9.31 and 99.5-/+6.16%, respectively, p=0.035), plasminogen activator inhibitor (4.8-/+0.31 and 2.9-/+0.27 IU/l, respectively, p=0.009). Levels of antithrombin III, protein C, and plasminogen in women were higher than in men both at baseline (108.5-/+1.65 and 100.7-/+1.60 %, p=0.001; 129.1-/+2.91 and 107.2-/+3.79%, p=0.001; 113.6-/+2.13 and 104.1-/+1.89%; p=0.001, respectively) and after venous occlusion. There were no gender differences in dynamics of parameters of hemostasis during venous occlusion. Multifactorial regression analysis showed that gender was independently (of age, duration of hypertension, smoking, body mass index, and total cholesterol level) related to only antithrombin III and protein C levels.

[Role of oxidative stress as a component of critical states in the genesis of hemostatic disorders]. / Rol' okislitel'nogo stressa kak komponenta kriticheskikh sostoianii v geneze narushenii gemostaza.

The effect of oxidative stress (OS) on hemostasis parameters was studied in model systems Fe(2+)-ascorbic acid-EDTA and Fe(2+)-EDTA-H2O2. Blood recalcification time, thrombin time, activated partial thromboplastin time, prothrombin index, the content of fibrinogen, antithrombin III, soluble fibrin-monomer complexes, platelet count and aggregation activity were evaluated. Parameters characterizing the severity of OS were measured: protein concentrations of carbonyl and sulfhydryl groups and level of malonic dialdehyde. OS was found to induce changes in the hemostasis system, promoting the progress of intravascular coagulation during the formation of critical state. The authors conclude that antioxidants should be added to combined therapy of blood clotting disorders in critical patients.

[Hemostasis in pregnancy and antenatal fetal distress]. / Sistema gemostaza beremennoi i antenatalnyi distress ploda.

Study of the hemostasis system of pregnant women at risk of developing fetal distress in the third gestation trimester showed the prognostic significance of platelet aggregation test as an additional method of diagnosis of placental insufficiency. If platelet aggregation index is more than 70%, a woman should be included in the group at risk of developing ante- or intranatal fetal distress.

[Prevention and treatment of hemorrhage in obstetrical hospitals]. / Profilaktika i lechenie krovotechenii v akusherskom statsionare.

Introduction of a program of prophylactic and organizational and therapeutic measures helped reduce the incidence of massive blood loss in 741 women at various modes of delivery, including cases with obstetrical bleedings. The incidence of hemorrhages in the placental and postpartum periods reduced from 1.6 to 0.3%.

[Characteristics of the treatment of ischemic heart disease with delayed-action verapamil]. / Osobennosti lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa prolongirovannym verapamilom.

Pre- and posttreatment indices of platelet and plasma hemostasis, parameters of long-term ECG-ST monitoring were measured in 30 coronary patients on long-term verapamil regimens. ++Anti-ischemic effect of the drug was dependent on clinical pattern of the disease and initial function of the platelets. Plasma hemostasis was found unaffected. Long-term verapamil treatment is indicated in stable angina pectoris class II and III provided platelets demonstrate enhanced functional activity.

[Characteristics of nicardipine treatment of patients with ischemic heart disease]. / Osobennosti lecheniia nikardipinom bol'nykh ishemicheskoi bolezn'iu serdtsa.

The new calcium antagonist nicardipine (barizine) was tested for effects on platelet function and transient myocardial ischemia in 23 patients with coronary heart disease. Prior to the therapy, lower platelet function was more frequently encountered in patients with more severe angina pectoris and more prolonged myocardial ischemia. The efficacy of nicardipine was demonstrated to be related to the clinical course of coronary heart disease and the baseline platelet function. It is advisable to prescribe the drug to patients with Functional Class II stable angina and higher platelet functional activity.

[Plasmapheresis in dermatology]. / Plazmaferez v dermatologii.

Overall 105 patients with different dermatoses were placed under observation. The patients received plasmapheresis (PA) treatment. PA was tolerated well by the majority of the patients, with the method efficacy amounting to 96%. PA eliminated disseminated intravascular coagulation which was initially seen in the majority of the patients, led to the normalization of hemostasis and microcirculation. At the same time PA exerted an immunocorrective action which showed up by a decrease of the most parameters of humoral and cellular immunity, the level of CIC, complement activity with a simultaneous rise of the phagocytic index, which may attest to macrophagal system activation.

[Characteristics of dilzem treatment of patients with ischemic heart disease]. / Osobennosti lecheniia dilzemom bol'nykh ishemicheskoi bolezn'iu serdtsa.

In 47 patients with coronary heart disease, the function of platelet was studied and ECG ST-segment was monitored. It was found that lower platelet function was more common in patients with severe coronary heart disease if they had long episodes of transient myocardial ischemia. Following 12 days of dilzem monotherapy, the most marked ++anti-ischemic and antianginal effects were observed in patients who had had higher platelet function.

[Hemostasis in influenza and acute respiratory viral infections in the middle-aged and elderly]. / Sostoianie gemostaza pri grippe i ostrykh respiratornykh virusnykh infektsiiakh v pozhilom i starcheskom vozraste.

Hemostasis was examined over time in 168 patients with influenza and ARVI. There were 53 elderly patients, 54 senile patients and 4 long-livers. 57 patients under 60 years made up a reference group. The patients with influenza did not differ significantly from those with ARVI as regards hemostasis. The elderly persons manifested pronounced acceleration of phases I-II blood coagulation. In the acute disease period, the old men demonstrated high platelet aggregation, whereas during convalescence, activation of the plasmic component of hemostasis in the presence of relatively low antithrombin III. Analysis was also made of the age-associated changes in hemostasis depending on influenza and ARVI complications (pneumonia, exacerbation of coronary disease, bronchitis). The changes revealed dictate the necessity of hemostasis control in elderly and senile persons afflicted with influenza and ARVI.

[Platelet aggregation, hemostasis and rheological properties of arterial and venous blood in patients with acute myocardial infarction]. / Agregatsiia trombotsitov, gemostaz i reologicheskie svoistva arteria'lnoi venoznoi krovi u bo'lnykh ostrym infarktom miokarda.

Platelet aggregability, coagulant and rheologic properties of arterial and venous blood were studied in 138 patients with acute extensive myocardial infarction. Heterogeneous changes were revealed in the aforementioned parameters during this condition. There was a lower arteriovenous ratio between hemostatic potential parameters.

[Hemostatic changes in various clinical courses of influenza]. / Izmeneniia gemostaza pri razlichnom klinicheskom techenii grippa.

Data are given on the changes in the hemostatic system in 42 patients with uncomplicated influenza and in complications (pneumonia, bronchitis, aggravation of ischemic heart disease). In the acute period of the disease they were characterized by hypercoagulation which was most pronounced in patients with influenza complicated by pneumonia. In cases of aggravation of ischemic heart disease functional platelet activity during convalescence decreases but the plasma link of hemostasis remains activated and fibrinolytic blood activity inhibited. Functional platelet activity in dynamics of the disease increases which should be taken into consideration in pathogenetic therapy.

[Analysis of whole blood viscosity in patients with acute myocardial infarction using a rotation viscosimeter]. / Opredelenie viazkosti tse'lnoi krovi s pomo'shchiu rotatsionnogo viskozimetra u bo'lnykh ostrym infarktom miokarda.

Rheologic characteristics of arterial and venous blood have been examined by Rotovisco RV-100 (Haake, FRG), a present-day rotation viscosimeter. Sixty-three acute myocardial infarction cases with intravenous infusion of sodium nitroprusside are analyzed. The detected time course of the reduction of arterial and venous blood viscosity during sodium nitroprusside infusion helps specify the pattern of this drug action in patients during the acute period of myocardial infarction.