Dabigatran, rivaroxaban, apixaban, and edoxaban are direct oral anticoagulants (DOACs) that are increasingly used worldwide. Taking into account their widespread use for the prevention of thromboembolism in cardiology, neurology, orthopedics, and coronavirus disease 2019 (COVID 19) as well as their different pharmacokinetics and pharmacogenetics dependence, it is critical to explore new opportunities for DOACs administration and predict their dosage when used as monotherapy or in combination with other drugs. In this review, we describe the details of the relative pharmacogenetics on the pharmacokinetics of DOACs as well as new data concerning the clinical characteristics that predetermine the needed dosage and the risk of adverse drug reactions (ADRs). The usefulness of genetic information before and shortly after the initiation of DOACs is also discussed. The reasons for particular attention to these issues are not only new genetic knowledge and genotyping possibilities, but also the risk of serious ADRs (primarily, gastrointestinal bleeding). Taking into account the effect of the carriership of single nucleotide variants (SNVs) of genes encoding biotransformation enzymes and DOACs metabolism, the use of these measures is important to predict changes in pharmacokinetics and the risk of ADRs in patients with a high risk of thromboembolism who receive anticoagulant therapy.

Background. This work is a review of preclinical and clinical studies of the role of telomeres and telomerase in the development and progression of coronary heart disease (CHD). Materials and methods. A search for full-text publications (articles, reviews, meta-analyses, Cochrane reviews, and clinical cases) in English and Russian was carried out in the databases PubMed, Oxford University Press, Scopus, Web of Science, Springer, and E-library electronic library using keywords and their combinations. The search depth is 11 years (2010–2021). Results. The review suggests that the relative leukocyte telomere length (LTL) is associated with the development of socially significant and widespread cardiovascular diseases such as CHD and essential hypertension. At the same time, the interests of researchers are mainly focused on the study of the relative LTL in CHD. Conclusions. Despite the scientific and clinical significance of the analyzed studies of the relative length of human LTL as a biological marker of cardiovascular diseases, their implementation in real clinical practice is difficult due to differences in the design and methodology of the analyzed studies, as well as differences in the samples by gender, age, race, and ethnicity. The authors believe that clinical studies of the role of the relative length of leukocyte telomeres in adult patients with coronary heart disease are the most promising and require large multicenter studies with a unified design and methodology.

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This review was described in detail the mechanisms of endothelial dysfunction development in patients with essential hypertension, lists the risk factors leading to endothelial dysfunction, diagnostic markers of endothelial dysfunction, and gives an idea of endothelial progenitor cells that can regenerate damaged endothelium. The data of the authors’ own studies were presented evaluating the severity of endothelial dysfunction with the help of such markers as sPECAM-1. The authors were conducted studies of endothelial progenitor cells in patients with different stages and degrees of arterial hypertension.

The clinical case of essential hypertension patient pharmacotherapy using the combination of olmesartan with lercanidipine was described in the article. The authors evaluated the effect of this combination not only on the degree of lowering blood pressure, but also on the levels of markers of endothelial dysfunction such as sPECAM-1 and copeptin. Pharmacotherapy with this combination of medicines was carried out for 28 weeks. It was found that in this patient the combination of olmesartan with lercanidipine led to the achievement of the blood pressure target level and decrease the level of sPECAM-1 by 2.5 times, and the level of copeptin by 5 times compared with the initial levels before treatment. Thus, the authors concluded that the combination of olmesartan and lercanidipine not only leads to the normalization of blood pressure, but also reduces the severity of endothelial dysfunction, which underlies the pathogenesis of essential hypertension.