ABSTRACT
AIM: To evaluate the results of two-year use of alirokumab in Karelia Republic. MATERIALS AND METHODS: The observation group consisted of 27 patients (17 patients with familial hypercholesterolemia, 10 patients with the history of myocardial infarction), mean age 53.4±4.3 years, 70.3% men, follow-up duration from one year to 2.5 years, 18 (66.6%) patients received therapy for more than 2 years. 19 patients received alirocumab at a dose of 75 mg/ml once every 2 weeks, eight - at a dose of 150 mg/ml once every 2 weeks. Before the start of therapy, the majority received maximally tolerated statin therapy, 10 patients received statin therapy in combination with ezetemibe, 3 patients received ezetemibe monotherapy due to statin intolerance. The target levels of LDL cholesterol were considered for very high risk patients less than 1.4 mmol/L, high risk - less than 1.8 mmol/L, extreme risk - less than 1 mmol/L. RESULTS: The reduction of LDL on therapy with alirocumab was 58%; target levels of LDL were achieved in 77.8%. The level of decrease in LDL cholesterol less than 50% was noted only in 7.4% of cases. Patients requiring a large dose of the drug were classified as very high risk, had higher cholesterol and LDL-C levels. The level of Lp(a) decrease on 29.7% by 6-12 months. No destabilization of coronary heart disease, new cases of stroke were registered. CONCLUSION: The inclusion of alirocumab in the treatment regimen contributed to the stable course of atherosclerosis-associated diseases, the achievement of LDL cholesterol targets in 77.8% of patients, was not accompanied by side effects during 2.5 years therapy.
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypercholesterolemia , Male , Humans , Middle Aged , Female , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Cholesterol, LDL , Antibodies, Monoclonal, Humanized/adverse effects , Hypercholesterolemia/drug therapy , Treatment Outcome , Double-Blind MethodABSTRACT
AIM: Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection. MATERIALS AND METHODS: The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home. CLINICALTRIALS: gov ID NCT04492384. RESULTS: Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively. CONCLUSION: Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.
Subject(s)
COVID-19 , Cardiovascular Diseases , Coronary Disease , Diabetes Mellitus , Heart Failure , Hypertension , Noncommunicable Diseases , Adult , Female , Humans , Male , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Chronic Disease , COVID-19/diagnosis , COVID-19/epidemiology , Hypertension/diagnosis , Hypertension/epidemiology , Prognosis , Registries , SARS-CoV-2ABSTRACT
AIM: to analyze parameters of vascular stiffness and augmentation index in patients with familial hypercholesterolemia (FH). MATERIALS AND METHODS: We compared parameters of vascular stiffness of 88 normotensive FH patients (mean age 41.95±1.43 years, 43 men [48.9 %]) and 68 subjects with normal blood lipid spectrum (mean age 37.58±1.02 years, 21 men [30.9 %]). FH was diagnosed according to the criteria of the Dutch Lipid Clinic Network. Examination included lipid profile, 24hour blood pressure (BP) monitoring with assessment of arterial stiffness. RESULTS: Normotensive FH patients had higher pulse wave velocity (PWV) (7.99±0.17 m/s) in comparison with patients with normal lipid spectrum (6.87±0.10 m/s), p.
Subject(s)
Hyperlipoproteinemia Type II , Hypertension , Vascular Stiffness , Adult , Blood Pressure , Female , Humans , Lipids , Male , Pulse Wave AnalysisABSTRACT
Following the analysis of the results of quantum chemical simulation of interaction between a GSH molecule and oxygen radicals âOH and âOO-, it was found that it takes place through the acid-base mechanism, where GSH acts as a base towards âOH, and as an acid towards âOO-. The results of quantum chemical calculations (electron density redistribution, energy characteristics) were correlated at the time of interaction of a GSH molecule with âOH and âOO- with a change of macroscopic parameters ofthe process of free oxygen, radical electroreduction in the presence of GSH (potential and maximum current of reduction waves), which is a direct experimental macroscale, evidence of results ofthe conducted nanoscale theoretical simulation.
