Aim. To comparison standardized mortality rates (SMRs) among men and women from acute types of coronary artery disease (CAD) and their regional variability in Russia in 2015 and 2019.

Material and methods. The Federal State Statistics Service (Rosstat) data on the population and the number of deaths from CAD based on the brief nomenclature of death causes using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) in 2015 and 2019 in 82 Russian subjects are presented. For each sex, SMR was calculated for acute (primary) and recurrent myocardial infarction (MI) (I21-I22), for other types of acute CAD (I20, I24.1-9), as well as average regional SMRs, coefficient of variation (CV).

Results. The average regional SMR for each of the acute CAD types among men was significantly higher than among women both in 2015 (p<0,0001) and in 2019 (p<0,0001). For the period of 2015-2019 in men, SMR from all acute CAD types decreased by 22,5%, from acute MI — by 7,4%, from recurrent MI — by 22,2% and from other acute CAD types — by 25,8%, while in women, these figures were 11,8, 8,8, 19,0 and 29,7%, respectively. The men-to-women SMR ratio in 2015 and 2019 were 2,79/2,72 for all acute CAD types, 2,58/2,55 for all MI cases, and 3,36/4,18 for other acute CAD types. The minimum CV values (41,9% among men in 2019 and 44,7% among women in 2015) were recorded for acute MI, while the maximum CV values (129,3% among men and 158,6% among women in 2019) for other acute CAD types.

Conclusion. Over the period of 2015-2019, the average regional SMR from acute CAD types in men and women decreased in Russia, with a more noticeable decrease for men. Greater regional variability in mortality, especially for other acute CAD types, poses the problem of finding organizational, methodological and strategic solutions to clarify the criteria for coding and refine the logistics schemes for providing healthcare for doubtful or uncertain diagnostic signs of acute CAD.

The ongoing pandemic of coronavirus disease 2019 makes it important to study the immunogenicity, the duration of immune response, and the safety of existing vaccines.

Aim. As part of a prospective observational study, to assess associations between levels of anti-Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) S protein IgG antibodies and thrombodynamics parameters in individuals vaccinated with Gam-COVID-Vac and CoviVac vaccines.

Material and methods. The study included 137 people who completed the first 3 visits: 30 people received the Gam-COVID-Vac, 107 people — CoviVac. The study participants underwent venous blood sampling before the introduction of the 1st and 2nd vaccine doses, as well as 42 days after the administration of 1st dose in order to quantify the level of IgG antibodies. At each visit, plasma hemostasis parameters were analyzed using a thrombodynamics test.

Results. During the follow-up period, there was a clear increase in the level of anti-SARS-CoV-2 S protein IgG antibodies in both groups. At the same time, this increase over time was significantly greater in Gam-COVID-Vac group. There was no correlation detected between thrombodynamics test results and the levels of anti-SARS-CoV-2 S protein IgG antibodies.

Conclusion. The data obtained demonstrate the ability of both vaccines to stimulate the production of anti-SARS-CoV-2 antibodies. However, immune response to Gam-COVID-Vac is much higher. The lack of correlation between thrombodynamics and the level of specific antibodies suggests that vaccination for COVID-19 with Gam-COVIDVac and CoviVac does not cause changes in plasma hemostasis and does not increase the risk of thrombosis.

Aim. To study the dynamics and pattern of publications in Russian on post-COVID-19 syndrome (PCS) in order to assess the completeness of information and identify medical specialties with its most active investigation in Russia.

Material and methods. The search for publications was carried out in the database of the largest digital scientific library in Russia Elibrary.ru from February 1, 2021 to February 1, 2022. The study included publicly available medical publications on the consequences of coronavirus disease 2019 (COVID-19) in Russian. Publications were classified according to subject matter, study design, and evidence hierarchy. The data obtained is reflected using integers, percentages and graphs.

Results. The study included 478 publications, of which 196 (41%) presented data from original studies, while 269 (56,3%) reflected the results of existing sources. Expert community documents accounted for 2,7%. In terms of study design, most of original studies described case series (37,2%) and individual case reports (22,4%). Casecontrol studies accounted for 20,4%, cross-sectional studies — 8,7%, prospective cohort studies — 3,6%, randomized clinical trials — 1,5%, and systematic reviews — 1%. In addition, 5,1% of publications were devoted to preclinical studies, mathematical models and various methodological aspects. By topic, the largest number of publications noted cardiovascular (12,2%) and neurological manifestations of PCS (12,2%). Furthermore, 23,5% of publications described the course of PCS in specific groups of patients, particular issues of COVID-19 consequences, and healthcare management problems. We also revealed that 11,7% of publications were devoted to general rehabilitation, 71% — to imaging diagnostics, 5,6% — to herd immunity to the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARSCoV-2), and 5,6% — to PCS features in children. The smallest number of publications considered mental (5,1%), gastroenterological (4,6%), pharmacological (4,6%), rheumatological (4%) and pulmonological aspects of PCS.

Conclusion. The dynamics and pattern of publications on COVID-19 in Russian are generally consistent with global trends and reflect the natural consequences of the pandemic. This analysis of publications on PCS showed that the most in-demand specializations in this filed are cardiology, neurology, and rehabilitation.

Aim. To study the advantages of using a portable electrocardiographic (ECG) monitor in outpatients with paroxysmal atrial fibrillation (AF).

Material and methods. We examined 88 patients (26 men, 62 women, mean age, 63 [57;68] years) with paroxysmal AF with an average frequency of arrhythmia episodes of 1,0 [0.3;3.75] per month. Forty three (49%) patients were included in the remote monitoring (RM) group using the ECG Dongle monitor, and 45 (51%) patients were included in the conventional monitoring (CM) group. Patients underwent scheduled examinations 2, 6 and 12 months after the start of therapy. Unscheduled consultations were carried out in case of AF recurrence. Patients from the RM group, using portable cardiac monitor, additionally self-registered ECG 1 time per week and in case of symptoms suggestive of AF. ECG strips were sent to the clinical investigator for analysis.

Results. With the help of portable cardiac monitor, 2477 ECG strips were collected and analyzed: 2159 (87,2%) — sinus rhythm, 318 (12,8%) — AF and atypical atrial flutter. Forty four episodes of AF in 3 patients were asymptomatic. In addition, 211 (8,5%) sinus rhythm ECG strips were recorded by 13 patients with symptoms suggestive of AF. In the RM group, 7 (16%) patients were hospitalized due to recurrent AF, while in the CM group, 20 (44%) patients (p=0,004). The total number of emergency hospitalizations was 8 and 29 in the RM and CM groups, respectively. The number of patients who called an ambulance was significantly lower in the RM group: in the CM group, 37 calls for an ambulance were made by 22 patients, while in the RM group — 12 patients made 15 calls (p=0,044). The proportion of calls followed by hospitalization (40 vs 70%, p=0,043) was significantly lower in the RM group.

Conclusion. Remote ECG monitoring using the ECG Dongle system is a useful way to monitor patients with paroxysmal AF, which make it possible to register asymptomatic AF episodes, differentiate the causes of palpitations, and significantly reduce the frequency of emergency calls and hospitalizations.

Aim. To analyze the results of remote monitoring of patients with decompensated heart failure (HF) based on the assessment of quality of life (QOL), self-care ability and adherence to treatment 3 and 6 months after discharge from the hospital.

Material and methods. The first group (experimental) consisted of 70 patients who, along with the approved healthcare standard, underwent measures according to the developed model for managing HF patients, including remote monitoring. The second group (control) included 65 patients who received care according to generally accepted algorithms for managing HF patients. In the study group, there were 46% men (69,6±9,4 years) and 54% women (71,7±9,9 years). The control group also included 46% men (70,6±9,1 years) and 54% women (73,0±10,3 years). Class I HF in the first group had 4%, while in the second — 3%; class II HF in both groups occurred in 11%; class III in the first group — 43%, in the second group — 54%, class IV HF in the first group — 41%, in the second group — 32% of patients. We conducted a standard clinical examination, assessed QOL, self-care ability, and adherence to treatment.

Results. In the first group, after 3 months, compared with the baseline, the average Minnesota Satisfaction Questionnaire (MSQ) score was lower by 37 (p=0,037), while after 6 months — by 33,6 (p=0,026). After 3 months according to the MSQ, the QOL in the second group was higher by 7,9 points (p=0,0001); according to the Morisky-Green test — lower by 1,2 points (p=0,0003); according to the self-care questionnaire — higher by 4,7 points (p=0,0001) than in the first group. After 6 months, MSQ score in the second group was higher by 10,4 points (p=0,0001), according to the Morisky-Green test — lower by 1,8 points (p=0,0003); according to the self-care questionnaire  — higher by 5,6 points (p=0,0001) than in the study group.

Conclusion. The developed model for managing HF patients using remote monitoring, in comparison with the generally accepted standards, has led to an increase in QOL, adherence to treatment and self-care ability of patients.

One of the effective approaches to the prevention of noncommunicable diseases and the extension of labor potential is the introduction of workplace wellbeing programs (WWPs). The implementation of WWPs and the formation of health promotion working conditions contribute to improvement of the wellbeing and quality of life of employees, reduce presenteeism, absenteeism and improve the economic performance of the company.

Aim. To assess the experience of implementing the WWPs among employers in Russia using the ATRIA electronic platform.

Material and methods. Experts from the National Medical Research Center for Therapy and Preventive Medicine have developed a set of tools (a questionnaire for employers and employees) to assist in the development and implementation of WWPs. A link to an ATRIA electronic platform was sent to the chief external specialists in preventive medicine to ensure a wide coverage of the country’s population. The survey was conducted from April 2020 to October 2021.

Results. The survey involved 181 employers and 7500 employees (women, 63,2%, n=4735), but not every respondent answered all questions. The companies related to education, science and culture (23,8%, n=43), metallurgy/mining (19,9%, n=36) and chemical/ petrochemical industry (11,6%, n=21). The majority of employers (73%; n=73) consider it necessary to develop and implement WWPs, while the majority of them (66,9%, n=121) were not familiar with such programs. Companies mainly implement health examinations (79,4%, n=100), vaccination (78,6%, n=99), measures aimed at increasing the physical activity (73,8%, n=93). Only 50% of employers evaluate the effectiveness of WWPs: according to a survey of employees — 41,2% (n=47), according to temporary disability rate  — 27,2% (n=31), according to staff turnover — 13,2% (n=15). Through the implementation of the WWPs, employers expect to improve employee health (94,4%, n=171), employee satisfaction (81,2%, n=147), morale (77,3%, n=140) and workforce productivity (75,1%, n=136).

Conclusion. The prevalence of WWPs in Russia varies depending on the industry, the entities involved in its implementation, the nature of work and the number of employees, which creates health inequalities and justifies the need to develop targeted interventions and measures to implement WWPs.

Aim. To present first results of the study on the assessment of municipal infrastructure using specialized software in a pilot subject of the Russian Federation (Sverdlovsk Oblast).

Material and methods. The following infrastructure elements of four municipalities of the Sverdlovsk Oblast have been assessed in the period from January to March 2022: sports facilities, grocery stores, fairs/markets with fresh vegetables and fruits, alcoholic drinks in shops and supermarkets, special liquor stores, tobacco outlets, fast food restaurants). The assessment was made with specialized software developed using Open Street Map (OSM) that allows real-time recording of objects for interactive map data visualization.

Results. The density of sales outlets for tobacco, alcohol, fresh vegetables and fruits was 2,3, 3,4 and 2,4 per 1 km², respectively; the density of sports facilities, fast food and restaurants — 1,3, 0,9 and 0,5, respectively. The number of sales outlets for tobacco, alcohol, fresh vegetables and fruits per 100 thousand people was 111,6, 167,7 and 116,5, respectively, while the number of sports facilities, fast food and restaurants — 63,5, 44,1, 25,0, respectively.

Conclusion. Creation and implementation of integrated system for assessing a unified preventive environment for promoting health and maintaining a healthy lifestyle at the municipal level using a combination of objective (GIS technologies, paraclinical tests) and subjective assessment methods (personal survey), as well as the introduction of interactive maps of municipal infrastructure, will make possible use of evidence to make decisions on the development and implementation of programs for the prevention of cardiovascular diseases and health promotion, as well as their management at the regional/municipal level.

Aim. To conduct a comparative analysis of the effect of long-term pharmacotherapy (12 months) using a β-blocker (nebivolol) and its combination with eplerenone in patients after ST-segment elevation acute coronary syndrome (STE-ACS) with heart failure with mildly reduced ejection fraction (EF) (HFmrEF) on the structural and functional cardiac parameters.

Material and methods. We examined 130 patients with STE-ACS and HFmrEF after successful myocardial revascularization by percutaneous coronary intervention. The mean age of patients was 53,6 [46;57] years. Ten patients withdrew from the study due to personal reasons. Subsequently, patients were randomly divided into 2 treatment groups as follows: 60 patients received nebivolol; 60 patients received nebivolol and eplerenone. Patients were examined at two stages: 1st day of the disease before PCI and 12 months later. All patients underwent a clinical examination, echocardiography, followed by assessment of left ventricular (LV) EF, LV end-diastolic volume index (EDVI), LV endsystolic volume index (ESVI), LV myocardial index (LVMI), LV wall motion score index (WMSI), the ratio of peak early diastolic flow over peak late diastolic flow (E/A), the ratio of early diastolic transmitral flow velocity to the mitral annular velocity (E/e´).

Results. Twelve-month pharmacotherapy with nebivolol in patients after STE-ACS showed an increase in LVEF by 7,2% (p<0,05), a decrease in WMSI by 13,0% (p<0,05), an increase in the E/A ratio by 11,1% (р<0,05), decrease in the E/e’ ratio by 7,2% (р<0,05). LV EDVI increased by 4,6% (p>0,05). Twelve-month combined pharmacotherapy with nebivolol and eplerenone showed an increase in LVEF by 16,0% (p<0,01), a decrease in LV ESVI by 17,9% (p<0,05), and a decrease in WMSI by 26,7% (p<0,01), LVMI — by 23,8% (р<0,01). At the same time, LV EDVI decreased by 0,7% (p>0,05). The E/A ratio increased significantly by 22,2% (<0,01), E/e’ decreased by 29,6% (р<0,01). Comparative analysis also found that combination therapy had a more pronounced positive effect on LVEF (p<0,05), ESVI (p<0,05), WMSI (p<0,05), LVMI (p<0,01), as well as diastolic function in the form of a significant increase in E/A (p<0,05) and E/e’ (p<0,01), which recovered to normal values.

Conclusion. The advantages of long-term combination pharmacotherapy of nebivolol and eplerenone in HFmrEF patients after STE-ACS on both structural and functional cardiac parameters were established.

Cardiac rehabilitation (CR) is one of the effective healthcare types for cardiovascular patients. At the same time, the choice of the most effective CR methods for a particular patient remains a problem. An increasing number of studies are devoted to the application of genetic methods for studying human health. Particular attention is drawn to determining the telomere length. The review purpose was to analyze the literature on various studies on the significance of assessing the chromosome telomeres for characterizing human health and choosing effective CR methods. The article discusses issues related to the relationship between the telomere length and cardiovascular risk factors, dietary pattern, and psychological status of a person. We also assessed the effectiveness of various exercise types at the genetic level. In preparing the review, publications over the past 14 years were searched in the MEDLINE/PubMed, Scopus, Cochrane Library, PEDro, eLIBRARY, and Google Scholar databases. The presented facts indicate the need for further study and effective use of one of the genetic factors protecting chromosome telomeres in CR.

Despite the decrease in the incidence rate, today the problem of a coronavirus disease 2019 (COVID-19) remains relevant on a global scale. Among the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) variants, the Omicron is currently dominant. The differentiating properties of the Omicron variant are a shorter incubation period (1-5 days), high contagiousness, and a relatively mild course of the disease, which is associated with the highest number of genome mutations among all SARS-CoV-2 variants. The new variant is characterized by upper respiratory tract symptoms: rhinorrhea, severe sore throat, sneezing, less commonly cough, headache, and weakness. Oral antiviral drugs Paxlovid and Molnupiravir are effective for treating mild to moderate COVID-19, including in outpatients. While corticosteroids and interleukin-6 receptor antagonists are still effective in treating patients with moderate to severe COVID-19, the effectiveness of anti-SARS-CoV-2 monoclonal antibodies has not yet been fully proven. Vaccination, especially booster doses, against SARS-CoV-2 is the most effective method of preventing COVID-19. The review purpose was to analyze the literature to determine the key aspects of prevention, clinical picture and treatment of a new SARSCoV-2 Omicron variant. The work used publications for the period from November 2021 to February 25, 2022, dedicated to the prevention, diagnosis and treatment of COVID-19 caused by the Omicron variant from the following databases: PubMed, eLibrary, MedRxiv, Google Scholar. The following key words were used: “Omicron”, “SARS CoV-2”, “COVID-19”, “Omicron treatment”. The analysis showed that COVID-19 caused by the Omicron variant is characterized by a relatively mild course. However, due to high contagiousness, this variant poses a significant problem due to the excessive load on outpatient and inpatient healthcare, including intensive care units.

This literature review reflects modern ideas about the combination of heart failure (HF) and osteoporosis, common risk factors for these diseases, and pathophysiological mechanisms of metabolic bone diseases in HF. Despite a growing number of studies on the combined cardiovascular and skeletal system pathology, the relationship between a decrease in bone mineral density and HF risk remains poorly understood. Both conditions are common causes of disability, death, prolonged hospitalizations and a significant reduction in quality of life, while its combination exacerbates their course and increases the incidence of adverse outcomes, which is a heavy burden for a patient and health care in general. Keywords: heart failure, osteoporosis, bone mineral density, bone metabolism.

Improvement of the treatment and diagnosis of hypertension and heart failure (HF) contributes to an increase in life expectancy of the population and, accordingly, its aging. The problem of diagnosing and predicting HF with preserved ejection fraction (HFpEF) is currently one of the urgent problems. The role of left atrial function in the development and course prediction of HF are the subject of scientific study. This review provides an analysis of recent studies on left atrial function in HF patients.