The aim: Is to determine the levels of markers of endothelial dysfunction in young men with myocardial infarction and their changes during the treatment with beta-blockers with different pharmacological properties. Materials and methods: 112 male patients of Caucasian race of the Ukrainian population under the age of 50 with MI. Group I received Nebivolol, group II – bisoprolol. Results: During the 6-month follow-up, positive dynamics of NOS-2 and ET-1 was observed. The level of NOS-2 in groups I – II was 4272.3±162.7, 4629.7±161.2 pg/mL, respectively (p<0.05). The dynamics of ET-1 showed significant decrease of its level in all groups Conclusions: Significant changes in markers of endothelial dysfunction, namely NOS3/eNOS, NOS2/iNOS and ET-1, are observed in young male patients of the Ukrainian population with MI. During 6 months of treatment, positive changes were observed in the form of an increase in NOS-3 levels and a significant decrease in ET-1 and NOS-2 levels. The inclusion of Nebivolol in the basic therapy for this group of patients is associated with an additional positive effect on the normalization of levels NO synthase and the reduction of ET-1.

The aim: To identify clinical and angiographic factors, associated with fractional flow reserve (FFR), in stable coronary artery disease (CAD) patients. Materials and methods: The study consecutively enrolled 68 patients with stable CAD (mean age (63±8,0) ys) and angiographically intermediate coronary lesions (diameter stenosis 50-90 %), with FFR assessment. Stable angina of CCS classes II and III was diagnosed in 42 (62 %) and 15 (22 %) patients, respectively; left ventricular hypertrophy (LVH) – 27 (40 %); severe coronary stenosis (SCS) (70-90 %) – 46 (68 %). The overall CAD complexity was assessed by SYNTAX score. FFR «negative» group (FFRNEG) included the patients with non-significant FFRs (>0,80) (n=28 [41 %]). In case of at least one significant FFR (≤0,80), a patient was assigned to FFR «positive» group (FFRPOS) (n=40 [59 %]). Results: FFRPOS (vs. FFRNEG, respectively) was characterized by the higher frequency of angina class III (32 % vs. 7 %; p<0,001), LVH (53 % vs. 21 %; p=0,010) and SCS (98 % vs. 25 %; p<0,001). The SYNTAX score was strongly associated with FFR ≤0,70 and ≤0,65, and moderately – with FFR ≤0,65. Conclusions: In patients with stable CAD and intermediate coronary artery stenosis, the presence of at least one functionally significant lesion (FFR ≤0,80) was associated with the higher prevalence of angina class III, LVH and more advanced coronary stenosis (≥70 %). The greater overall CAD complexity increased the probability for the angiographically significant coronary lesions to be more functionally compromised.

The aim: To carry out an evaluation of comorbidities in CCS patients having undergone PCI for stable coronary artery diseases (planned) or PCI in myocardial infarction (urgent) with the aim of justifying the best management strategies. Materials and methods: We carried out an analysis of comorbid pathology spreading and the evaluation of multiple comorbidities using of Combined Age Charlson Comorbidity Index (CA-CCI) – in 138 patients below 75 yrs having undergone urgent and planned PCI. These patients were divided into two groups; the Ist one included 60 patients with urgent PCI (angioplasty with stent), the 2nd group – 78 patients with planned PCI. Results: We found a high prevalence of comorbidity in CCS patients: the mean number of diseases in patients of the 1st and 2nd groups were 8.2±0.3 and 9.3±0.4, and the CACCI values – 7.3±0.3 and 7.5±0.2, respectively (p>0.05). Ten and more diseases were found in (28.3±5.8%) patients from the 1st group and in (43.6±5.6%) patients from the 2nd group (p=0.06). The most frequent comorbidities were arterial hypertension, cerebrovascular diseases, peripheral arterial disease, type 2 diabetes mellitus, and impaired glucose metabolism. Conclusions: Comprehensive assessment and management of patients with CCS who undergo PCI remains a current problem in modern medicine, given the high prevalence of comorbid pathology.

Purpose: to study the association of blood pressure (BP) visit-to-visit variability (VVV) with non-valvular atrial fibrillation (AF) in rural dwellers with arterial hypertension (HTN). Material and methods. The cross-sectional study retrospectively analyzed complex data from consecutive 160 males with primary HTN (mean age 50 ± 6 years). Patients with major HTN complication were excluded. We analyzed the office systolic BP (SBP) and diastolic BP (DBP) levels, obtained at four consecutive doctor`s visits. As a metric of BP VVV, we used standard deviation (SD) and coefficient of variation (CV) values. The criteria for high BP VVV were Patients were ascertained to have high BP VVV in case of SD (SBP) ≥15 mm Hg and/or SD (DBP) ≥14 mm Hg. Totally, high BP VVV status was in 82 (51,3 %) patients. Paroxysmal AF was detected in 29 (18,1 %) patients. Results. HTN with AF group (vs. HTN alone) was characterized by higher average values of BB VVV metrics (median, interquartile range): SD (SBP) (16,7 (15,9-17,5) vs. 8,7 (4,6-15,2) mm Hg, respectively); SD (DBP) (11,5 (8,9-14,6) vs. 5,7 (3,9-8,9) mm Hg, respectively); CV (SBP) (10,1 (9,6-10,7) vs. 5,6 (2,9-9,2) %, respectively); and CV (DBP) (12,9 (9,3-15,5) vs. 6,3 (4,1-9,7) %, respectively) (р<0,001 in all the comparisons). Additionally, HTN with AF group associated with worse kidney filtration function (estimated glomerular filtration rate (eGFR): 57 (53-59) vs. 67 (62-77) ml/mim/1,73 m2, respectively) and more pronounced albuminuria (urine albumin/creatinine ratio (A/Cu): 36,1 (32,3-40,6) vs. 10,3 (6,5-26,9) mg/mmol, respectively) (р<0,001 in both comparisons). While integral assessment of eGFR and A/Cu values, we determined higher frequency of patients with high and very high cardiovascular and renal adverse events risk (AER) in HTN with AF group. Moreover, patients with HTN and AF presented with higher left atrial antero-posterior dimension (LAD) (4,3 (4,2-4,6) сm vs. 3,9 (3,6-4,1) cm, respectively; р<0,001), as well as with more advanced left ventricular remodeling. At multivariable analysis, SD (SBP) ≥15 mm Hg and SD (DBP) ≥14 mm Hg, along with AER and LAD, were the most significant factors independently associated with AF. Conclusion. In rural males with HTN, the presence of high BP VVV is one of the factors associated with non-valvular AF risk increase. High BP VVV could be proposed as an additional modified AF risk factor in patients with HTN.

Aim: to provide a literature review of the presently available data on the risk of thromboembolic events and current options for antithrombotic prophylaxis in patients with myeloproliferative neoplasms (MPN) patients with concomitant coronavirus disease 2019 (COVID-19). Material and methods. The thematic scientific papers, published predominantly during the last decade (including the references regarding SARS-CoV-2 infection (COVID-19) of the last three years), constituted the study material. The research methodology involved bibliosemantic method and structural and logical analysis. Results and discussion. MPN and SARS-CoV-2 infection (COVID-19) are both conditions with inherently enhanced susceptibility to thromboembolic events (venous and arterial). Along with the specific pathophysiological pathways, MPN and COVID-19, in case of their constellation, share overlapping pathomechanisms of hypercoagulability. As of today, the antithrombotic prophylaxis in MPN/COVID-19 patients (primary and secondary) is carried out according to the guidelines and algorithms, including those regarding general principles of the use of anticoagulants (oral or parenteral) and antiplatelet agents, and those specifically addressed to MPN or SARS-CoV-2 infection. These documents are constantly updating as the results of ongoing trials become available. Considering the relatively low prevalence of MPN, and the absence of specific guidelines, devoted to MPN in tandem with SARS-CoV-2 infection, the conduction of global registry studies is of crucial importance, aiming to provide a continuous and thorough collection and analysis of the data, related to the characteristics of this particular patients` population, pathological background and clinical features of thromboembolic complications, as well as short- and long-term outcomes. Conclusion. The comprehensive study of basic, epidemiological and clinical data regarding various aspects of thrombosis/thromboembolism in case of MPN/COVID-19 constellation, is a multidisciplinary task, which should be performed with an ultimate goal to improve already implemented and develop novel approaches to antithrombotic management of such patients.