[Efficacy of Mexidol in combination with cerebral revascularization in the treatment of ischemic stroke]. / Effektivnost' primeneniya Meksidola v kombinatsii s revaskulyarizatsiei golovnogo mozga v terapii ishemicheskogo insul'ta.

Stroke is an acute life-threatening condition; its outcome is determined by the degree of damage to brain tissue, the quality and speed of medical care in the first minutes and hours after its occurrence. The main mechanism of brain tissue damage during both ischemia and reperfusion is oxidative stress. The review covers adverse influence oxidative stress at the cerebral ischemia and reperfusion periodes of ischemic stroke. The results of preclinical studies demonstrating the ability of Mexidol to neutralize the effects of free radicals and activate antioxidant protection are presented. Data from clinical studies of the use of Mexidol in combination with thrombolysis in patients with ischemic stroke are reviewed.

[Efficacy and safety of non-immunogenic staphylokinase in the ischemic stroke in real-world clinical practice in the Sverdlovsk region]. / Effektivnost' i bezopasnost' primeneniya neimmunogennoi stafilokinazy v terapii patsientov s ishemicheskim insul'tom v usloviyakh real'noi klinicheskoi praktiki v Sverdlovskoi oblasti.

OBJECTIVE: To compare the efficacy and safety of non-immunogenic staphylokinase (Fortelysine) and alteplase in patients with ischemic stroke (IS) in real-world clinical practice. MATERIAL AND METHODS: A retrospective, observational, non-interventional study of data the register of the Territorial Compulsory Health Insurance Fund was conducted. The proportion of patients with a favorable outcome, the degree of disability at discharge from the hospital, the duration of hospitalization, the proportion of lethal outcome in the groups of Fortelysine and alteplase were evaluated. The effect of the Rankin scale points at the hospitalization, the choice of a medical organization, the month of hospitalization, the choice of a thrombolytic on achieving a favorable outcome was determined. RESULTS: The data of 1238 patients from 26 hospitals of the Sverdlovsk region were included. There were no statistically significant differences in the proportion of a favorable outcome between the groups of Fortelysine and alteplase (26% and 25% respectively, p=0.845). Mediana of duration of hospitalization in the Fortelysine group was one day less, which is statistically significant compared to the alteplase group (9 [7;12] and 10 [7;13] respectively, p<0.001). There were no differences in the frequency of mortality (11% and 13% respectively, p=0.331). The hospital, the year and month of hospitalization, the level of disability at the baseline have a statistically significant effect on the outcome of hospitalization. The choice of a thrombolytic drug did not have a statistically significant effect on the frequency of favorable outcome. CONCLUSIONS: The comparable efficacy and safety of Fortelysine and alteplase in IS has been proven in clinical study and confirmed by real-world clinical practice.

[Efficacy and Safety of Combined Treament with Ivabradine and Metoprolol in Patients with Stable Angina Pectoris - a Systematic Review].

This article presents results of a systematic review, which was designed for evaluating the effect of combination treatment with ivabradine and metoprolol on heart rate, frequency of angina attacks, frequency of using short-acting nitrates, and angina severity. The analysis included data from three large observational studies on efficacy of the ivabradine and metoprolol tartrate combination in patients with chronic angina. Results of the analysis supported the efficacy of the metoprolol and ivabradine combination in clinical practice, which provided effective decreases in the heart rate, frequency of angina attacks, requirement for short-acting nitrates, and alleviation of angina severity. The studies demonstrated good tolerability of this treatment.

[Left Bundle Branch Block in Unstable Angina. Mortality and Rate of Myocardial Infarction].

AIM: to study mortality and adverse outcomes in patients with unstable angina (UA) and left bundle branch block (LBBB). MATERIAL AND METHODS: We included in this study UA patients with (n=56) and without LBBB (n=310). Period of observation was 14 days (from admission to discharge). The following events were considered as adverse outcomes: death, myocardial infarction, carcinogenic shock, and stroke. RESULTS: Combination of UA with LBBB was associated with increases of risk of death (3.4-fold) and myocardial infarction (2.6-fold), shortening of in-hospital mean duration of life and survival time by 1 day.

[THE FEATURES OF STRUCTURE-FUNCTIONAL HEART CONDITION IN OLDER PATIENTS WITH UNSTABLE ANGINA AND LEFT BUNDLE BRANCH BLOCK].

The structural and functional parameters of echocardiography in 56 older patients with UA and LBBB were analyzed in comparison with these parameters in 186 patients with UA without LBBB. The median age of patients with UA and LBBB was 75 (67-81) years, without LBBB - 74 (65-80) years. The procedure was carried out in the first day of hospitalization in cardiology department on the UA. LBBB in patients with unstable angina is associated with remodeling of the heart with an increase the diameter of the aorta, the LVID (s) and (d), thickening of the IST and PWT and increasing the RWT, as well as a decrease of LP and RV cavities. We revealed the signs of left ventricular dysfunction without evidence valvular obstruction in the patients with UA and LBBB. The hemodynamic of patients with UA and LBBB was characterized by large LV DV and SV, as well as by decrease FS, FJ, MFS and gradients MV, AV, PV, and TV than at UA without LBBB. The echocardiographic symptoms of diastolic dysfunction with delayed relaxation were found in patients with UA and LBBB. The mitral regurgitation occurred more frequently in 2,4 times more in patients with UA without LBBB.