[Multicenter experience of using Fortelyzin during staged reperfusion therapy of acute ischemic stroke in anterior circulation]. / Opyt mnogotsentrovogo primeneniya preparata Fortelizin pri provedenii etapnoi reperfuzionnoi terapii ostrogo ishemicheskogo insul'ta v karotidnoi sisteme.

OBJECTIVE: To evaluate the safety and efficacy of Fortelyzin in the performance of staged reperfusion therapy for acute ischemic stroke (intravenous thrombolytic therapy plus mechanical thrombectomy) in anterior circulation within the FORTA RF multicenter pilot study. MATERIAL AND METHODS: The study included 72 patients with acute ischemic stroke in anterior circulation, who underwent staged reperfusion therapy in four vascular centers of the Russian Federation from December 2019 to January 2023. RESULTS: The mean time from illness onset to hospitalization was 94.5 minutes in the Fortelyzin group and 97.2 min in the Actilyse group (p=0.78). The time from the moment of hospitalization to the admission of the patient to the X-ray operating room was significantly lower in the Fortelyzin group (p=0.002). The incidence of symptomatic hemorrhagic transformations in the Fortelyzin group was 6%, in the Actilyse group - 8% (p=0.75). A favorable functional outcome in the first group was observed in 47% of patients, in the control group in 42% (p=0.66). Mortality in both groups did not differ significantly and amounted to 22% and 25%, respectively. CONCLUSION: The first results of the FORTA RF multicenter study demonstrate the safety and efficacy of Fortelyzin in staged reperfusion therapy compared to Actilyse.

[Predictor Model of Acute Coronary Syndrome Outcomes].

Scores for assessment of risk of cardiovascular events in patients with acute coronary syndrome (ACS) became wide spread during last decade. Taking into consideration high level of ACS morbidity and mortality in Russia there is a need in creation of own national scores. Aim of this study was to investigate the value of risk factors of death and to create a multivariate model of survival of patients with ACS during hospitalization. MATERIALS AND METHODS: The non-randomized retrospective continuous study of 1000 case histories (medical records) of patients with ACS with assessment of value of risk factors was performed, and the multifactor model and computer program estimation of risk of death was created. While selecting risk factors emphasis was made on heart rhythm and presence of arrhythmia, and on anamnestic data. RESULTS: Most significant factors were age, history of myocardial infarction, atrial fibrillation, and ventricular tachycardia. The created regression model of estimation of risk of death by 51.4% was explained by these factors. Using this model, we developed a computer program "Kardiorisk" which predicts risk of death with 100% sensitivity and 80% specificity.

[The experience of organization of medical care of patients with acute coronary syndrome in multi-type hospital].

In Naberezhnye Chelny, a number of structural and technological reformations of service of emergency medical care was implemented in 2009-2012. The reformation manifested in organization of unified emergency center of medical care of patients with acute coronary syndrome; joining up of cardiological departments of two hospitals; organization of X-ray surgical department; enhancement of logistics of admission department and interaction with emergency medical care; optimization of mode of medical care rendering at pre-hospital and hospital stages. The implemented reforms permitted increasing accessibility and timeliness of reperfusion therapy under acute coronary syndrome; to implement transcutaneous coronary interventions into practice and increase their number annually; to decrease "door-balloon" index up to 30-40%. As a result, lethality of acute myocardium infarction decreased from 12 to 3 to 5.8% in 2010-2014.