Obesity is not associated with increased risk of adverse postprocedural in-hospital outcomes. These findings, however, do not discount the need for sustained efforts in secondary prevention of obesity and its consequences.

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Objective. The Canadian Tofacitinib for Rheumatoid Arthritis Observational (CANTORAL) is the first Canadian prospective, observational study assessing tofacitinib. The objective was to assess effectiveness and safety for moderate to severe rheumatoid arthritis (RA). Coprimary and secondary outcomes are reported from an interim analysis.Methods. Patients initiating tofacitinib from October 2017 to July 2020 were enrolled from 45 Canadian sites. Coprimary outcomes (month 6) included the Clinical Disease Activity Index (CDAI)-defined low disease activity (LDA) and remission. Secondary outcomes (to month 18) included the CDAI and the 4-variable Disease Activity Score in 28 joints (DAS28) using the erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) level to define LDA and remission; the proportions of patients achieving mild pain (visual analog scale <20 mm), and moderate (≥30%) and substantial (≥50%) pain improvements; and the proportions of patients achieving a Health Assessment Questionnaire disability index (HAQ DI) score greater or equal to normative values (≤0.25) and a HAQ DI score greater or equal to minimum clinically important difference (MCID) (≥0.22). Safety was assessed to month 36.Results. Of 504 patients initiating tofacitinib, 44.4% received concomitant methotrexate. At month 6, 52.9% and 15.4% of patients were in CDAI-defined LDA and remission, respectively; a similar proportion of patients achieved outcomes by month 3 (first post-baseline assessment). By month 3, 27.2% and 41.7% of patients, respectively, were in DAS28-ESRdefined LDA and DAS28-CRP <3.2; 14.7% and 25.8% achieved DAS28-ESR remission and DAS28-CRP <2.6. By month 3, mild pain and moderate and substantial pain improvements occurred in 29.6%, 55.6%, and 42.9% of patients, respectively; 19.9% and 53.7% of patients achieved a HAQ DI score greater than or equal to normative values and a HAQ DI score greater than or equal to MCID, respectively. Outcomes were generally maintained to month 18. Incidence rates (events per 100 patientyears) for treatment-emergent adverse events (AEs), serious AEs, and discontinuations due to AEs were 126.8, 11.9, and 14.5, respectively, and AEs of special interest were infrequent.Conclusion. Tofacitinib was associated with early and sustained improvement in RA signs and symptoms in realworld patients. Effectiveness and safety were consistent with the established tofacitinib clinical profile.

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1 Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Россия 2 Государственное образовательное учреждение высшего профессионального обучения «Кемеровская государственная медицинская академия» Министерства здравоохранения Российской Федерации, Кемерово, Россия Сердечно-сосудистые заболевания, в первую очередь ишемическая болезнь сердца (ИБС), остаются главной причиной смертности как в России, так и в других индустриально развитых странах. К наиболее эффективному методу лечения ИБС относит-ся коронарное шунтирование (КШ). Несмотря на усовершенствования техники кардиохирургических операций, в послеоперацион-ных осложнениях одно из лидирующих мест занимают бронхолегочные осложнения, увеличивая пребывание пациента в стацио-наре, стоимость их лечения, повышая смертность. В обзоре представлен методологический подход к подготовке пациентов с ИБС к КШ, а также предложены методы, направленные на снижение послеоперационных респираторных осложнений.Ключевые слова: ишемическая болезнь сердца, коронарное шунтирование, респираторные осложнения, реабилитация, предоперационная подготовка. Cardiovascular diseases especially coronary artery disease (CAd) remains the major cause of death both in Russian and in other industrialized countries. the most effective method of CAd treatment is a coronary artery bypass grafting (CABG). despite the technological improvement of cardiac surgery operations, one of the leading position in postoperative complications are taken by bronchopulmonary complications which lengthen a subject's hospital stay, increasing treatment cost and mortality rate. A review provides a methodological approach to the preparation of CAd subjects for CABG, as well as proposes the methods aimed at reducing the postoperative respiratory complications. PREVENTION OF RESPIRAOTRY COMPLICATIONS IN SUBJECTS WITH CORONARY ARTERY DISEASE WHEN PERFORMING PLANNED CORONARY ARTERY BYPASS GRAFTING