Aim.To reveal the predictors of renal dysfunction due to surgical revascularization of myocardium in stable angina patients with prediabetes. Material and methods. Totally, 48 patients with prediabetes studied, having indications for coronary bypass grafting (CBG) at the age 60±7,4 y. o. with Chd anamnesis 6±5,4 y. Multivessel disease of coronary vessels had 68,8% of patients, LCA stem stenosis >50% had 10,9% of patients. On-pump CBG was done in 87,5% of patients, off-pump -12,5%. duration of on-pump period was 95±23 min., number of distal anastomoses for one patient -2,8±0,8. Baseline, on the first and second days post-CBG, and if needed later, the creatinin concentration was measured in the blood, as glomerular filtration rate (GFR) by CKd-EPI

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ЦЕЛЬ: определить референсные значения фруктозамина и 1,5-ангидроглюцитола у людей без нарушений углеводного обмена для улучшения качества гликемического контроля у пациентов с сахарным диабетом.МАТЕРИАЛЫ И МЕТОДЫ: исследована группа людей без нарушений углеводного обмена (осуществлялся пероральный глюкозотолерантный тест с исследованием базальной и стимулированной концентрации глюкозы). Все обследования проводились после подписания добровольцами информированных согласий. Для оценки углеводного обмена определялся гликированный гемоглобин (HbA 1c ) лабораторным методом, сертифицированным в соответствии с Национальной программой стандартизации. Для оценки концентрации фруктозамина (ФА) в сыворотке крови использовался метод колориметрического химического анализа, 1,5-Ангидроглюцитола (1,5-АГ) -метод конкурентного ИФА в сыворотке крови. Материалы исследования статистически обработаны с применением пакета прикладных программ IBM SPSS Statistics (США), 26 версия.

BACKGROUND: According  to the results of the ESSE-RF study, the frequency of obesity in the population  reached 29.7%. Obesity is one of the main risk factors for the development of cardiovascular diseases. Features of the course of COVID-19 in patients with obesity is a very urgent problem.AIM: The aim of the study was a comparative investigation of clinical and laboratory-instrumental parameters in AH patients with or without obesity who had COVID-19 associated pneumonia, to identify the role of obesity as a potential predictor of post-COVID cardiovascular complications 3 months after discharge from the hospital.MATERIALS AND METHODS: Materials and methods. The study included 174 patients with COVID-19-associated pneumonia. Group 1 included 78 patients with AH without obesity, group 2 — 96 patients with AH and obesity. All patients were tested with a blood sample at the time of admission and 3 months after discharge from the hospital. We assessed parameters of general blood test, biochemistry, hemostasis, inflammation biomarkers — concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine, IL-6, etc. All patients initially underwent computed tomography  of the chest. In both groups, 24-hour blood pressure monitoring was performed using BPLaB device, according to the standard protocol; echocardiography using  an expert class ultrasound diagnostic  system Vivid S70. The study is registered with the Clinical Trials.gov database Identifier: NCT04501822.RESULTS: Results. The biomarker that significantly distinguished the both groups of patients, as well as subgroups according to the degree of obesity was the concentration of maxCRP and hs-CRP, which was significantly higher in group 2. In addition, the registered maximum values of MPO, NT-proBNP, IL-1,6, TNA-α and NRL parameters in group 2 of patients with 2–3 degrees of obesity, may indicate the highest probability of developing  delayed adverse cardiovascular complications  in this group of patients. Mean systolic blood pressure, variability of systolic and diastolic blood pressure, and heart rate at night were significantly  higher in AH patients with obesity. Numerous correlations of obesity with laboratory and instrumental parameters have been registered, which may indicate an increased likelihood of delayed unwanted cardiovascular complications in this particular group of patients. Multiple regression showed that obesity is an independent predictor of an increase in LDH, hs-CRP and right atrium.CONCLUSION: Dynamic control of the studied parameters in patients with AH and OB registered an increased concentration of CRP at the initial stage and 3 months after treatment, with a general trend towards a decrease in the increased initial structural parameters of ECHO CG. The logistic regression method showed that the presence of OB in patients with AH is an independent factor causing increased levels of immune inflammation (CRP), a marker of tissue destruction (LDH), and load on the right atrium.

The article reflects the results of studying platelet parameters in HIV-positive patients with different types of stroke.Aim. To identify changes in laboratory parameters of a complete blood count which characterize the morphofunctional features of platelets in stroke among HIV-positive patients.Materials and methods. 110 HIV-positive patients who received treatment for stroke in hospitals of the Tyumen region were examined. The study of blood parameters was carried out at the analyzer Sysmex XE2100 (Japan). Blood sampling was carried out on the day of patients admission.The number of platelets and platelet indices were analyzed: MPV – mean platelet volume, PDW – platelet distribution width, PCT – plateletcrit and P-LCR – platelet large cell ratio. The control group consisted of 117 patients. The signifcance of the differences was determined at the twotailed signifcance level of p < 0.05.Results. There was a signifcant decrease in the number of platelets (p < 0.05), in average, on 34.3% among patients with hemorrhages and HIV infection. Among patients with ischemic stroke this decrease was less pronounced (p = 0.05). A signifcant decrease in plateletcrit was established among patients with intracranial hemorrhages, while it did not change signifcantly among patients with cerebral infarction. During evaluation of other platelet parameters, no signifcant differences were found between patients in experimental and control groups. The coeffcient of giant platelets prevailed by one and a half times in patients with hemorrhages associated with HIV infection, which turned out to be beyond the statistical signifcance.Conclusion. The presence of HIV infection leads to a more pronounced, reliable decrease in the number of platelets and plateletcrit among patients that have acute phase of the development of hemorrhagic stroke than in patients with cerebral infarction. The development of intracranial hemorrhage among HIV-positive patients is characterized by an increase of blood platelets with a high volume, the level of which increased by one and a half times being beyond the statistical signifcance and having as a leading mechanism the intensifcation of platelet formation in the bone marrow.

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Aim      To determine predictors of acute kidney injury (AKI) related with surgeries for correction of acquired valvular heart disease (HD) and to evaluate the incidence of in-hospital complications in patients with postoperative AKI.Material and methods  This study included 62 patients after surgery for correction of acquired valvular HD (mean age, 61±10.9 years) with a disease duration of 11±5.3 years. NYHA functional class (FC) 1 chronic heart failure (CHF) was observed in 1.6 % of patients, FC 2 in 64.5 %, and FC 3 in 33.9 %.17.7% of patients had chronic kidney disease (CKD). Coronary lesions of ≥50 % of vascular lumen were detected in 27.4 % of patients. Surgical correction of mitral valvular disease was performed in 32 cases, aortic valvular disease in 36 cases, tricuspid valvular disease in 8 cases, and combined operations for correction of valvular disease and coronary bypass in 8 cases. Creatinine concentrations were measured according to the Jaffe method; glomerular filtration rate (GFR) was estimated with the CKD-EPI equation. AKI was diagnosed based on KDIGO (2012) criteria.Results The AKI incidence related with surgeries for correction of valvular HD was 16.1 % (8.1 % of patients had stage 1 AKI, 3.2 % had stage 2 AKI, and 4.8 % had stage 3 AKI), and 3.2% required kidney replacement therapy. AKI was associated with the presence of CKD at baseline (р=0.044), development of hemopericardium requiring drainage (р=0.012), more pronounced coronary lesions (in the AKI group: stenoses from 50 to 70 % in 20% of patients, from 70 to 90 % in 30 % of patients, and ≥90 % in 0 %; without AKI: from 50 to 70 % in 13.4 % of patients, from 70 to 90 % in 3.8 %, and ≥90 % in 5.8 % of patients, respectively; р=0.032). Probability of postoperative AKI significantly increased with the development of hemopericardium requiring drainage. Patients with postoperative AKI compared to persons without AKI had higher mortality (20 % and 0 %; р=0.001), greater incidence of decompensated CHF (40 and 9.6 %; р=0.012) and hemopericardium requiring drainage (30 and 1.9 %; р=0.012).Conclusion      The development of postoperative AKI is associated with CKD at baseline, more pronounced coronary injury, and hemopericardium requiring drainage.