[Lornoxicam for prevention of myocardial injury during acute ST-elevation myocardial infarction].

10% of patients with acute ST-elevation myocardial infarction (STEMI) treated with reperfusion therapy fail to develop an enzyme rise, but do exhibit transient ECG changes, which are consistent with an aborted myocardial infarction. Following reperfusion by primary PCI in STEMI, oxidative stress and an inflammatory response are induced immediately. Inflammation is a critical component of STEMI. Both COX isoforms are involved in reperfusion and ischemic myocardial injury. To evaluate the effectiveness of lornoxicam - nonselective NSAID, in decrease of myocardial injury during acute ST-elevation myocardial infarction. We analyzed 22 patients with STEMI, 14 of them received 16 mg and 8 mg lornoxicam after 20 min and 8 hours, respectively, after arrival to hospital. 12 f them received alteplase, 10 patients with cardiac pain up to 24 hours from the beginning, did not receive reperfusion therapy. All patients received anticoagulants, antiplatlet therapy, -blockers. The primary end point was all-cause mortality by the day 30 and hospitalization due to congestive heart failure by the 1st year. There was no difference in mortality and heart failure by the 30 day and 1st year respectively, between the patients with STEMI treated with lornoxicam or placebo. Randomized controlled trials are needed to explore potential cardioprotective effects of lornoxicam in patients with acute STEMI.

[Protective effect of lornoxicam on development of myocardial infarction in rats under conditions of ischemia and ischemia-reperfusion].

Activation of inflammation and enzyme cyclooxygenase with formation of proinflammatory prostaglandins is a key element of development of myocardial infarction in patients with acute coronary syndrome. Basing on literature data and own experience we suggested that single intravenous injection of 230 mg/kg of nonselective inhibitor of type 1 and 2 cyclooxygenase lornaxicam in the phase of initialization of inflammation 20 min after onset of ischemia would lead to reduction of myocardial infarction volume in rats in irreversible ischemia and ischemia with subsequent reperfusion. The conducted study allowed to reveal that administration of lornoxicam in recommended for human use dose lowered mortality of animals and increased number of capillaries per one cardiomyocyte in case of irreversible coronary artery occlusion. In ischemia-reperfusion as in irreversible myocardial ischemia lornoxicam reduced volume of necrosis and degree of thinning of left ventricular wall in the region of infarction, and lowered volume of connective tissue in periinfarction zone of the myocardium in remote period.

[Long-term prognosis in patients with rheumatoid arthritis depending on baseline variability of cardiac rhythm].

AIM: The study of outcomes of rheumatoid arthritis (RA) depending on cardiac rhythm variability (CRV). MATERIAL AND METHODS: A total of 78 patients with RA of I--III degree of activity aged 38-83 years (mean age 60.3 +/- 10.8 years) were examined using 24-h AP and ECG monitoring. Follow-up was 2-4 years. RESULTS: A clear correlation was seen between RA activity and CRV. CONCLUSION: In patients with high activity of RA, CRV decline reflect severity of inflammation. In low RA activity, low CRV may point to the presence of IHD. Low CRV in RA activity of degree I-II may indicate high risk of sudden cardiac death and acute myocardial infarction within 2-4 years.

[What is the reason for low heart rhythm variability during bicycle exercise?].

AIM: To characterize a reduction in heart rhythm variability (HRV) in patients with coronary heart disease (CHD), essential hypertension (EH) and in healthy controls during bicycle exercise test (BET). MATERIAL AND METHODS: BET was made in 21 CHD patients, 23 EH patients and 22 healthy controls (mean age 47.8 years, standard deviation 14 years). HRV was analysed before, during and after BET under continuous ECG monitoring (Cardiotens-01, Meditech, Hungary). Also, this device measured arterial pressure before and after exercise. BET (3 minutes of exercise plus 2 minute rest) was stepwise: the initial stage load was 25 W, at each subsequent stage the load was raised by 25 W RESULTS: In BET, lowering of HRV low-frequency power in CHD patients occurs at lower heart rate (HR) and load than in healthy controls and EH patients, it comes prior to ST wave depression. The individual index of exercise tolerance HRLF < 40/HRsubmax reflecting the ratio of HR at which LF < 40 ms2 is reached to submaximal HR in CHD patients is < 75%, in healthy controls > 80% irrespective of age or gender. CONCLUSION: CHD patients show lowering of HRV at lower HR than EH patients and healthy controls. The index HRLF < 40/HRsubmax under 75% can be used as an additional criterion of positive results of BET.

[Parameters of heart rate variability during bicycle ergometry test]. / Pokazateli variabel'nosti ritma serdtsa vo vremia veloérgometricheskoi proby.

Short-term (5 min) heart rate variability (HRV) was studied before and during submaximal bicycle exercise tests in 27 patients with ischemic heart disease, 23 patients with hypertension and 9 healthy subjects. Low-frequency (0.04 to 0.15 Hz) and high-frequency (0.15 to 0.40 Hz) power components of HRV were significantly decreased during submaximal exercise. The level of load at which abrupt decrease of low-frequency components below 40 ms(2) occurred possibly reflected individual exercise tolerance. Episodes of myocardial ischemia were associated with pronounced decreases of low - frequency HRV components.

[Clinical efficacy of xefocam and its effect on arterial pressure and heart rhythm variability in patients with rheumatoid arthritis in combination with arterial hypertension]. / Otsenka klinicheskoi éffektivnosti ksefokama i ego vliianiia na arterial'noe davlenie i variabel'nost' serdechnogo ritma u bol'nykh revmatoidnym artritom v sochetanii s arterial'noi gipertenziei.

AIM: To try clinical response to xefocam, its safety, effects on arterial pressure and heart rhythm variability in rheumatoid arthritis (RA) patients with arterial hypertension (HT). MATERIAL AND METHODS: Xefocam (lornoxicam), a new non-steroid antiinflammatory drug, was given for 12 weeks in a daily dose 12 mg/day to 44 RA patients (mean age 54.5 +/- 7.3 years). 24-h arterial pressure monitoring was made with Cardiotens-01 device. RESULTS: Xefocam in a dose 12 mg/day has shown good tolerance, a high analgetic and antiinflammatory effect as indicated by a positive response of articular syndrome, a significant fall of systolic arterial pressure, decreased heart rate, better heart rhythm variability. CONCLUSION: In hypertensive RA patients xefocam in a dose 12 mg/day proved effective and safe.