[Comparative effectiveness of intracoronary and systemic thrombolytic therapy of acute myocardial infarction]. / Sravnite'lnaia otsenka éffektivnosti intrakoronarnoi i sistemnoi tromboliticheskoi terapii ostrogo infarkta miokarda.

Systemic thrombolytic therapy with streptodekase was shown to produce the same effects as intracoronary thrombolytic therapy with avelysine. The blood flow in the coronary vessels could be restored in 72.7% with intracoronary therapy and in 66.7% with systemic thrombolytic therapy. Death rates were 9.1 and 8.9%, respectively, and in 3.1 and 3.3% with reperfusion. A difference was found in the frequency of myocardial infarction-associated complications, depending on the modality of thrombolytic therapy. In the authors' opinion, in clinical institutions where operations on coronary vessels are not supposed to be made after thrombolytic therapy, the systemic thrombolytic therapy with streptodekase should be preferred as it is simplier, safer and easier to apply.

[Factors contributing to the success of intracoronary thrombolytic therapy]. / Faktory, vliiaiushchie na uspekh intrakoronarnoi tromboliticheskoi terapii.

Intracoronary thrombolytic therapy (ICT) was used in 36 patients with acute transmural myocardial infarction. Recanalization of an infarction-dependent artery was achieved in 26 (72.2%) patients. Factors affecting the success of ICT were analysed, using Bayes' theorem. The ejection fraction (EF) is shown to have the highest predictive value as an indicator of left-ventricular pump function. The anticipated probability of ICT success is 84.9% in patients with acute myocardial infarction and a 35% EF baseline, and 25.7% in those with a 35% EF. In the absence of severe left-ventricular pumping and contractility disorders, the success of ICT is affected by patient's age, history of myocardial infarction and the site of thrombotic occlusion.

[6-year trial of a program for predicting the potential occurrence of myocardial infarct]. / Shestiletniaia aprobatsiia programmy prognozirovaniia vozmozhnosti vozniknoveniia infarkta miokarda.

A six-year prospective study of 3775 individuals, first examined in 1978, using an original mathematical program of myocardial infarction risk prognosis, is reported. The program is based on an integral assessment of 19 risk factors, each having 4 degrees of severity. The subjects were allocated to one of 3 groups, depending on the prognostic risk score. In the low coronary risk group (2068 people), there was 1 (0.048%) myocardial infarction over 6 years. There were 12 (0.76%) infarctions in the medium risk group (1569 people), and 62 (44.92%) infarctions in the high risk group (138 people). Therefore, the program is capable of identifying a limited (about 4%) population that is going to develop 80% of all myocardial infarctions within the next 5 or 6 years.

[Effect of various doses of aspirin after a single and long-term administration on platelet aggregation in patients with ischemic heart disease]. / Vliianie razlichnykh doz aspirina pri odnokratnom i dlitel'nom ego primenenii na agregatsiiu trombotsitov u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A study of 169 patients with coronary heart disease has shown that the duration and intensity of the inhibition of platelet aggregation following the single administration of 0.5, 1 and 1.5 g of aspirin is largely determined by the dose used. It has been established that in individuals sensitive to aspirin, the intake of 0.5 g of the drug causes a marked inhibition of platelet aggregation lasting for over 24 hours. A year-long follow-up of patients with myocardial infarction receiving 0.5 g of aspirin daily has demonstrated that platelet aggregation is consistently depressed throughout the entire period of observation.

[Effect of lipoproteins of different classes on platelet aggregation]. / Vliianie lipoproteidov razlichnykh klassov na agregatsiiu trombotsitov.

The influence of high-, low- and very-low-density lipoproteins on platelet aggregation was examined in coronary patients and normal subjects. Preincubation with high-density lipoproteins was shown to drastically inhibit platelet aggregation capacity both in normal subjects and coronary patients. Preincubation with a mixture of low- and very-low-density lipoproteins had no significant effect on platelet aggregation. The suppression of platelet aggregation by high-density lipoproteins was the most obvious in washed platelets.

[Results of prospective studies of a group of persons with high risk of myocardial infarction]. / Rezul'taty prospektivnogo nabliudeniia za gruppoi lits s vysokim riskom vozniknoveniia infarkta miokarda.

The results of three years' observation of a coronary high risk population identified through a mathematical prognosis of myocardial infarction based on 19 risk factors are reported. Out of 154 subjects (about 4% of the screened population), 40 (26%) developed myocardial infarction within the next three years. None of the risk factors alone could be regarded as having a prevailing effect on the development of myocardial infarction. The mathematical procedure employed can also be used for predicting new anginal episodes, although the method specificity would be lower than the one obtained with the prognosis of myocardial infarction.

[Experience with the clinical study of cordaron]. / Opyt klinicheskogo izucheniia kordarona.

Complex examination including continuous long-term observation by means of a computer showed that because of a wide spectrum of action cordaron is among the effective agents for the treatment of ischemic heart disease. The capacity of cordaron to reduce the zone of myocardial damage makes its use expedient in the acute period of myocardial infarction. Long-term treatment of patients suffering from chronic ischemic disease of the heart with cordaron raises the tolerance to physical exercise and improves myocardial nutrition. The coronarolytic effect of cordaron is evidently associated to a definite measure with the action of the agent on adenosine metabolism, which is manifested in an increase in its production and inhibition of its inactivation.

[Interrelationship of lipid metabolic disorders and hemostasis in arteriosclerosis]. / Vzaimosviaz' narushenii lipidnogo obmena i gemostaza pri ateroskleroze

Proceeding from the obtained data, the authors conclude that two factors are of paramount importance in the pathogenesis of atherosclerosis: 1) lipid infiltration, 2) fibrin and platelets deposits on the vascular wall. It seems hardly proper to oppose the lipid-infiltrationab of pathogenesis of atherosclerosis to the thrombogenic one, since they do not necessarily exclude one another. Moreover, they seem to present two aspects of a single process: on the one hand, lipids increase platelet adhesion and aggregation on the vascular wall; on the other hand, platelets during aggregation help the penetration of beta-lipoproteins into the arterial wall by increasing the permeability of the endothelium and by adsorbing cholesterol-rich beta-lipoproteins on their own surface. A vicious circle occurs that must underly one of the mechanisms of the atherosclerosis development.

[Comparative evaluation of different programs of physical rehabilitation in acute myocardial infarct]. / Sravnitel'naia otsenka razlichnykh programm fizicheskoi reabilitatsii bol'nykh ostrym infarktom miokarda

The conducted randomized comparative study of 305 patients with acute myocardial infarction included into different programmes of physical rehabilitation has demonstrated that better results are achieved with fast rehabilitation in those with a relatively mild and moderate course of the disease, and with comparatively slower rehabilitation--in those with severe lesions. The regimen of motor activity has to be recommended on an individual basis to the infarction patients, with due regard of the severity of their state and its prognosis. A programme of rehabilitation is presented that prescribes the scope and tempo of motor activity extension depending on the severity and prognosis of the lesion determined mathematically on the basis of the described original technique.