Aim. To study the relationship of gut microbiota (GM) composition with clinical and paraclinical characteristics of patients with coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF).

Material and methods. The study included 64 patients (men, 71,9%) with CAD, 33 (men, 87,9%) with HFrEF and 38 (men, 63,2%) with various cardiovascular risk factors (control group). GM composition was assessed using real-time polymerase chain reaction and next- generation sequencing. To identify correlations of GM composition with clinical and paraclinical characteristics, the Spearman rank correlation coefficient (ρ) was calculated. Generalized linear models (QuasiPoisson, overdispersion) with covariates (age, body mass index) were used to compare groups by phylotype.

Results. The relative abundance of Bacillota phylotypes is significantly higher in patients with CAD and HFrEF compared to controls (p<0,001). The Bacillota/Bacteroidota dysbiosis ratio was also significantly higher in patients with CAD and HFrEF than in the control group (p<0,001). According to correlation analysis, the relative representation of methanogenic archaea Methanomassiliicoccaceae, Methanomethylophilaceae (ρ=0,49, p<0,0003) directly correlated with ventricular arrhythmias in patients with HFrEF.

Conclusion. Patients with CAD and HFrEF differ significantly from the control group in GM composition at the phylotype level. In the study groups, Bacillota/Bacteroidota dysbiosis ratio was also significantly higher than in the control group. The relative abundance of the archaea Methanomassiliicoccaceae and Methanomethylophilaceae is associated with episodes of ventricular tachycardia/ventricular fibrillation.

Aim. To study the relationship of biomarkers of collagen metabolism and systemic inflammation with left ventricular (LV) remodeling in patients with stable coronary artery disease (CAD) and obstructive sleep apnea (OSA).

Material and methods. The study included 195 patients with stable CAD, of which 63 without OSA and 132 patients with combination of CAD and OSA. The mean age of patients was 63,4±3,7 years. Biomarkers of collagen metabolism and systemic inflammation were assessed by determining the concentration of matrix metalloproteinase (MMP)-9, tissue inhibitor of matrix metalloproteinase-1, monocyte chemoattractant protein-1 (MCP-1) and calculating the neutrophil-to-lymphocyte (NLR) and platelet-tolymphocyte ratio (PLR). Echocardiography was performed according to a standard protocol.

Results. There were no significant differences in systemic inflammation parameters (MCP-1, NLR, PLR) between the group of patients with CAD and CAD with mild OSA and a significantly higher level of MCP-1, NLR, PLR in more severe OSA. In patients with CAD and severe OSA, the eccentric LV remodeling was diagnosed in 75% of individuals, while the concentric type was diagnosed in only 25%.

Conclusion. In patients with stable CAD, the more severe the OSA, the more pronounced systemic inflammation (MCP-1, NLR, PLR), and there are higher proportion of eccentric LV hypertrophy, which may be associated with an imbalance of fibrosis markers (high concentration of MMP-9 with an almost unchanged level of tissue inhibitor of MMP-1).

Aim. To analyze availability and affordability of alcoholic beverages in Russian cities.

Material and methods. We assessed the actual state of urban infrastructure in the Arkhangelsk, Tver and Sverdlovsk regions. Data were collected in three districts of Arkhangelsk, three districts of Tver, three districts of Yekaterinburg and Revda, where participants of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study (2021) lived. The study objects were elements of the city infrastructure where alcoholic beverages were sold. To assess the infrastructure, special software was developed to collect and analyze the necessary data using Open Street Maps. Data were collected from January to March 2022.

Results. In total, 1180 alcohol-selling outlets were identified in the study areas: in Arkhangelsk — 450, in Yekaterinburg and Revda — 444, and in Tver — 286. Mainly alcoholic beverages in Sverdlovsk and Tver regions can be purchased in the alcohol section of a grocery store (n=260, 58,6% and n=185, 41,4%, respectively), and in the Arkhangelsk region — in a specialized liquor stores (n=263, 58,4%). The median number of alcohol stores located within a radius of 1000 m from the place of residence of the ESSE-RF3 participant was 33, and within a radius of 400 meters — 8. In Arkhangelsk, the alcohol was sold in a grocery store located in the same building as the college branch. In the Sverdlovsk region, the nearest alcohol store was located at a distance of 50 m from the kindergarten, in the Tver region — 44 m from the college. A 0,5 liter bottle of vodka was sold below the price floor in 55,1% of specialized liquor stores in the Sverdlovsk region and in 66,8% of such liquor stores in the Tver region.

Conclusion. As a result of the study, availability and affordability of alcoholic beverages in Arkhangelsk, Tver, Yekaterinburg and Revda was assessed. The findings reflect the high availability of alcohol and indicate the need for interventions at both the national and local government levels. The used method of collecting and analyzing data demonstrated sufficient research effectiveness and can be recommended for wider use.

Aim. To study the relationship of the density and proximity of tobacco products (TPs) and electronic nicotine delivery systems (ENDS) with increased levels of depression, anxiety and stress among the population in 3 constituent entities of the Russian Federation.

Material and methods. The work used data from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study in 3 Russian regions (Arkhangelsk, Sverdlovsk and Tver regions) among the population aged 35-64 years (n=1674), who signed a consent to participate in the study. We analyzed data on the status of smoking and consumption of ENDS, passive smoking, attempts to quit smoking, as well as the presence of depression, anxiety (Hospital Anxiety and Depression Scale (HADS) score ≥8) and stress (Perceived Stress Scale (PSS) >21). Elements of urban infrastructure (data collection: January-March 2022) selling TPs and ENDS were assessed using aт OpenStreetMap-based program. Associations were established using logistic regression analysis.

Results. With a twofold increase in the distance of TP and ENDS outlets from the place of residence, the depression probability was reduced by 13% (odds ratio (OR) 0,87; 95% confidence interval (CI): 0,79-0,96) and by 12% (OR 0,88; 95% CI: 0,78-0,99), respectively. With increase in distance from of TP outlets, the anxiety decreased probability by 12% (OR 0,88; 95% CI: 0,81-0,97). With an increase in the number of TP outlets within a radius of 1000 m from the place of residence, there were an increase in the probability of depression (OR 1,18; 95% CI: 1,031,36), anxiety (OR 1,12; 95% CI: 1-1,26) and stress (OR 1,24; 95% CI: 1,05-1,46). A greater number of ENDS outlets within a radius of 1000 m and 400 m was associated with a high likelihood of depression (OR 1,17; 95% CI: 1,02-1,34 and OR 1,25; 95% CI: 1,04-1,47, respectively). An increased depression probability was found in those exposed to tobacco smoke at home (OR 1,88; 95% CI: 1,27-2,73) and at work (OR 1,67; 95% CI: 1,14-2,41). An increase in the number of attempts to quit smoking doubles the odds of depression (OR 2,40; 95% CI: 1,35-4,23) and anxiety (OR 2,00; 95% CI: 1,18-3,38).

Conclusion. Unfavorable environmental factors, including the proximity and density of TP and ENDS outlets, can increase the probability of depression, anxiety and stress among the population living in these areas.

Aim. To study genetic causes of decreased low-density lipoprotein cholesterol (LDL-C) in Russian patients.

Material and methods. The study included the following Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) participants: individuals with LDL-C<5th percentile, taking into account sex and age (n=52), who underwent targeted sequencing of protein-coding regions of 6 genes (APOB, PCSK9, MTTP, ANGPTL3, SAR1B, APOC3) and determination of the genetic risk score (GRS) for hypercholesterolemia; and a representative sample of the Ivanovo region population (ESSEIvanovo, n=1667), for which only GRS was determined. Genetic testing was performed using next generation sequencing.

Results. In 10 (19,2%) of 52 participants with decreased LDL-C levels, the following rare variants potentially associated with hypocholesterolemia were identified: 8 — leading to a premature termination codon in the APOB gene, 1 — leading to a premature termination codon in the APOC3 gene and 1 missense variant in the PCSK9 gene. Of the 10 identified variants, 6 are described by us for the first time. GRS in the LDL-C group (0,27±0,25) was significantly lower than in the ESSE-Ivanovo population sample (0,43±0,27) (p=4,7×10-06).

Conclusion. Genetic reasons explain decreased LDL-C levels (<5th percentile) in 32,7% of patients, of which only monogenic variants were identified in 13,5%, a combination of monogenic and polygenic hypocholesterolemia — in 5,7%, and polygenic hypocholesterolemia — in 13,5%.

Aim. To validate and evaluate the accuracy of 4 genetic risk scores (GRSs) for hypertension (HTN), previously created on European samples, on a population sample of the Ivanovo Oblast.

Material and methods. For genetic analysis, targeted next-generation sequencing was used on a sample of the Central Russia (n=1682) based on the biobank collection. Four GRSs associated with HTN, previously developed for the European population, were selected for validation. The coefficient of determination and the area under the ROC curve were used as quality metrics for regression models. Additional validation was carried out to include all nucleotide sequence variants, regardless of linkage disequilibrium level. A combined GRS was compiled based on coefficients from individual GRSs using the clumping + thresholding (C+T) method.

Results. The study demonstrated that the predictive value of previously developed GRSs when used for Central Russian population is lower than in the original studies. The proportion of explained variance was 0,5-0,8%. The best predictive ability (proportion of explained variance — 2,5%) was demonstrated using previously developed GRSs (Evangelou E, et al., 2018), which includes the largest number of nucleotide sequence variants (n=852).

Conclusion. GRSs for HTN, developed on European samples, is not recommended for Russian population without preliminary validation. To create original GRSs, combining statistical parameters (β-coefficients and p-value) from different GRS is not recommended.

Aim. To analyze socio-demographic characteristics and the prevalence of behavioral risk factors in the adult population of the Vladimir region, taking into account sex characteristics.

Material and methods. This cross-sectional population-based study was organized in 5 cities of the Vladimir region (Vladimir, Kovrov, Murom, Yuryev-Polsky and Vyazniki) from May 2018 to March 2020. The study included 1350 men and women aged 30-69 years. The response rate was 87%. A total of 1174 people completed the study, of whom 424 (36.1%) were men and 750 (63.9%) were women. A total of 1174 people completed the study. Of these, 424 (36,1%) were men and 750 (63,9%) women. Respondents were surveyed using a standard questionnaire prepared by the National Medical Research Center for Therapy and Preventive Medicine, which included socio-demographic characteristics, behavioral risk factors, data on somatic diseases and medications taken.

Results. Smoking prevalence among men was 38,4%, which was 4 times higher than in women (p=0,001). Walking <30 min/day, as a sign of a sedentary lifestyle, was detected in 41,3% of men, and among women in every third (33,2%, p=0,007). Every second man and woman during the survey reported insufficient consumption of vegetables and fruits. Adding salt to food was detected in 34,4% of men and 21,7% of women (p=0,001). Alcohol abuse rate among men was 12,5, while among women it was 2 times lower and amounted to 5,6% (p=0,001). The variability of these disorders was noted in different Vladimir region cities.

Conclusion. In the analyzed random sample of adults from the Vladimir region, every second man and woman does not consume enough vegetables and fruits, while every third person leads a sedentary lifestyle. At the same time, there are 4 times more male smokers and 2 times more male alcohol abusers than females.

Aim. To assess the prevalence of major noncommunicable diseases (NCDs) taking into account gender characteristics in a random sample of adults in 5 cities of the Vladimir region.

Material and methods. This cross-sectional population-based study (May 2018 — March 2020) included 1350 people (men and women aged 30-69 years) from 5 cities of the Vladimir region. The response rate was 87%. A total of 1174 people completed the study. Of these, 424 (36,1%) were men and 750 (63,9%) women. Respondents were surveyed using a standard questionnaire prepared by the National Medical Research Center for Therapy and Preventive Medicine, which included socio-demographic characteristics, behavioral risk factors, data on somatic diseases and medications taken.

Results. The prevalence of coronary artery disease among men was 14,1%, among women — 9,5% (p=0,016). In men, the second most common disease is chronic obstructive pulmonary disease (COPD), which was 2,5 times more common than in women — 10,6 and 4,5%, respectively (p=0,001). Among women, the second most common disease was type 2 diabetes (T2D), accounting for 7,6%. Cerebrovascular diseases occupy fourth place in the NCD structure. Their prevalence was 6,1% among men and 4,4% among women. Cancer diseases were less common than other chronic diseases without sex differences — 2,8 and 3,1%, respectively. In certain cities, the prevalence of NCDs varied. Every third man and fourth women had a positive family history for cardiovascular diseases (CVDs) (p=0,005). About 20% of men reported a positive family history for COPD, while among women this figure was 2 times lower (p=0,001). Men and women were comparable in terms a family history for T2D — 10,4 and 12,5%, respectively. A positive family history for tumors of various locations was recorded in ~5%.

Conclusion. In the adult working-age population of the Vladimir region, atherosclerosis-related CVDs was identified in 17% of cases. The incidence of T2D and COPD in the adult population was approximately the same and amounted to >7%. The prevalence of cancer was 3%. Sex differences were identified in the prevalence of coronary artery disease and COPD.

High salt intake is a risk factor for the development of hypertension, most cardiovascular diseases and their complications.

Aim. To study the characteristics of high salt intake in Russian and Moscow populations according to epidemiological studies.

Material and methods. Data from representative samples of adult population aged 25-64 years (n=21922, 8372 men and 13550 women) from Russian 13 regions and persons aged >18 years (n=4063, 1662 men and 2401 women) from Moscow were used. A combination of 2 out of 3 items was taken as excess salt intake: daily consumption of meat and sausage products and pickles and/or adding salt to the finished dish. The results are presented as frequencies and odds ratios (OR).

Results. The prevalence of high salt intake in the Russian population was 49,3% (53% among men and 47% among women); in the Moscow sample — 49,6% (60,3% for men and 41,9% for women). The habit of adding salt to a finished dish is widespread in the Russian Federation — 40,5% (47% among men and 34,7% among women); among Muscovites it is less pronounced — 25,8% (31,6% among men and 21,7% among women). Positive associations of high salt intake were noted with male sex (OR=1,1), education level (OR=1,5 and OR=1,3 for primary and secondary education, respectively), smoking (OR=1,74), alcohol consumption (OR=1,3, OR=1,4 and OR=1,5 — for moderate, high and very high alcohol consumption, respectively), rural place of residence (OR=1,34), anxiety (OR=1,27), depression (OR=1,36) and abdominal obesity (OR=1,1), and negative — with thyroid disease (OR=0,9), previous cerebral stroke (OR=0,8) and type 2 diabetes (OR=0,87). The prevalence of high salt intake in the all-Russian sample is not associated with income level and age, but was noted among Muscovites.

Conclusion. In the Russian population, a high prevalence of high salt intake was revealed, which is more pronounced among smokers, alcohol drinkers, those with primary and secondary education levels, rural residents, as well as those with anxiety and depression.

Vaccination is an effective tool to control infectious diseases at the population level. There is an increase in the proportion of the adult population vulnerable to controlled infections, which is confirmed by the emergence of disease outbreaks involving population aged >18 years. Qualitative research methods are used to explore factors influencing vaccination behavior.

Aim. To develop and present a qualitative study design to study barriers and drivers for vaccination in adults.

Material and methods. The World Health Organization (WHO) approach of Tailoring Immunization Programs (TIP), Capability-Opportunity-Motivation-Behavior (COM-B) tool, developed by the WHO and adapted in several countries to study vaccination issues, and the Rapid Assessment Process method were chosen and adapted for conducting a study in three Russian regions. The qualitative methods selected are focus groups and in-depth personal interviews in two target groups of adults and medical workers. A purposive sampling method will be used to select population participants aged ≥18 years.

Results. A qualitative research design was developed, including the following steps: selecting target populations, developing a discussion plan, training the analytical group, testing the methodology and questions in the target groups, collecting and analyzing data, developing recommendations and interventions.

Conclusion. Qualitative research methods are preferable for identifying vaccination barriers and drivers. Based on the results obtained, an educational program for health workers will be developed, including communicating approaches to be used with patients when discussing vaccination matters.The qualitative research design developed and presented can be used by researchers, public health professionals, and decision-makers to study vaccination behavior among adults.

The article discusses the effectiveness and safety of homologous and heterologous revaccination for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in people of different age groups.

Aim. The study the severity and duration of immune response in people of different age groups after SARS-CoV-2 revaccination.

Material and methods. The study was carried out as part of the prospective registry Saturn, which included persons who received various SARS-CoV-2 revaccination regimens (homoand heterologous) based on the combination of two vaccines: Gam-COVID-Vac and Covivac. Group I (n=106) included persons who received a homologous revaccination with Gam-COVID-Vac, while group II (n=54) — heterologous revaccination with Gam-COVID-Vac and Covivac, group III (n=40) — homologous Covivac revaccination. In addition, all participants in the study were divided into two age categories: ≥60 years (n=33) and <60 years, (n=167). In all participants, the medical history was collected. At each visit, we assessed the quantitative level of specific IgG SARS-CoV-2 S-protein antibodies and plasma coagulation using the thrombodynamics method. At visits 1, 3 and 5, blood was collected to assess T-cell immunity activity (T-Spot.COVID test, Oxford Immunotec) to the SARS-CoV-2 virus.

Results. Revaccination in persons ≥60 years of age ensures the intensity of humoral (quantitative level of specific IgG SARS-CoV-2 S-protein antibodies) and cellular immunity (quantitative assessment of SARS-CoV-2 spike protein-specific (panel A) and nucleocapsid-specific T-lymphocytes) comparable to that in younger individuals (<60 years). Revaccination did not increase the plasma thrombogenic potential in vaccinated people, regardless of age.

Conclusion. In the group of vaccinated people ≥60 years old, an adequate humoral and cellular immune response was developed, which persisted for a year after revaccination, and even more intense cellular immunity was demonstrated compared to vaccinated people <60 years old. The plasma thrombogenic potential did not increase during vaccination and revaccination, regardless of age.

Aim. To evaluate the information content of genetic risk scores (GRSs) for coronary artery disease (CAD), previously developed on European populations, in representatives of the Russian population.

Material and methods. The work involved 1685 people from the ESSE-Ivanovo epidemiological study. CAD was verified in 3,1% of individuals. The coronary composite endpoint was assessed annually during 8-year follow-up. Next generation sequencing was performed using a targeted panel. Logistic regression analysis and area under the ROC curve (AUC) were used. Age, sex, and smoking status were taken into account in the multivariate model.

Results. Of the 16 GRSs included in the analysis, only 2 GRSs demonstrated significance in the univariate analysis of association with CAD (highest AUC — 0,577). In a multivariate model, with an increase by 1 standard deviation (SD) for the 6 studied GRSs, a significant association with CAD was obtained — the odds ratio varied in the range of 1,31-1,47. The two GRSs demonstrated significant differences in the incidence of CAD between the groups corresponding to the upper and lower quintiles. Forty-five endpoints were registered. The risk ratio for the end point with an increase in GRS by 1 SD, taking into account cofactors, exceeded statistical significance for the 9 analyzed GRS and was in the range of 1,36-1,54.

Conclusion. For the first time in Russia, 16 CAD GRSs, previously developed on European samples, was validated. The results were reproduced only for a few of the studied CAD SGRs.

Hypertrophic cardiomyopathy (HCM) at the cellular level is characterized by hypertrophy, cardiomyocyte disorganization and myocardial fibrosis areas. The leading death cause in HCM remains sudden cardiac death (SCD). Despite the existing risk scores for SCD in HCM, there are still patients with uncertain SCD risk. In addition, SCD cases are also recorded among low-risk patients. From the above, search for novel markers for a more accurate risk assessment should be continued. Fibrosis is currently suspected to be a substrate of potentially life-threatening ventricular arrhythmias. Despite the increasingly widespread use of cardiac magnetic resonance imaging in the diagnosis of myocardial fibrosis and stratification of patients at high SCD risk, the determination of myocardial fibrosis biomarkers remains a relevant and promising area. The article presents the results of studies proving the diagnostic significance and relationship with the risk of life-threatening cardiac arrhythmias of the following markers: C-propeptide of type I procollagen, matrix metalloproteinase proteins, tissue inhibitor of metalloproteinases 1, microRNA family, soluble suppression of tumorigenicity 2, galectin-3, apelin. Evaluation of these biomarkers can be used to improve risk stratification of patients with HCM.

Coronavirus disease 2019 (COVID-19) pandemic was not only a serious challenge for the healthcare system around the world, but also an incentive for intensive research and development for the introduction of innovative technologies and drugs, in particular vaccines against the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The first vaccination campaigns provided significant protection against severe disease course and hospitalization. However, new SARS-COV-2 variants require further comprehensive research and the introduction of booster vaccination. Booster vaccination is the most important tool for immunostimulation and increase of protection duration against the severe disease course. The study of booster vaccines, including BioNTech/Pfizer, Moderna, Oxford AstraZeneca, Sputnik V, Sinopharm и Covaxin vaccines, sheds light on their unique action mechanisms and contribution to long-term immunity. The analysis of clinical data demonstrates their effectiveness and safety. The review summarizes modern knowledge about booster vaccinations against the COVID-19 with focus on action mechanisms and efficiency. In addition, the immune system function in response to COVID-19 is considered, while the role of memory cells, antibody and cellular immunity reactions are emphasized.

An important condition for providing quality and safe care is to understand the differences between men and women in epidemiology, pathophysiology, risk factors, clinical performance of diseases, response to treatment and use of medical care. The first part of the review was devoted to the evolutionary mechanisms of differences in life expectancy and potential strategies for increasing life expectancy in men. The second part of the review examines sex and gender differences using the example of 3 groups of diseases, which, according to the World Health Organization, are the main causes of death in the European Region, in the programming of health and disease, as well as the reasons for the male-female health-survival paradox.

Liver transplantation (LT) requires not only a carefully organized system for monitoring the condition of patients in the early postoperative period, but also reliable coordination of the actions of doctors of different specialties in the long-term period. This is due to improved survival of liver transplant recipients and a shift in the mortality structure towards cardiovascular diseases and the need to correct metabolic complications that often occur in recipients, in particular hyperlipidemia. Treatment of lipid metabolism disorders after LT includes lifestyle changes, immunosuppressive and lipid-lowering therapy (LLT), which reduces cardiovascular risk. The use of LLT in patients after LT is limited by potential side effects caused by drug interactions, in particular myopathy up to rhabdomyolysis. According to current clinical guidelines, the safest treatment for patients after LT is pravastatin and fluvastatin, the use of which is limited by low availability and low efficacy. It seems promisingto improve LLT in patients after LT through the use of ezetimibe, which has a potentially favorable tolerability profile when combined with immunosuppressants, as well as pitavastatin, which is metabolized through cytochrome P-450 isoenzymes not involved in the metabolism of immunosuppressants, and metabolically neutral PCSK9 inhibitors.

Aim. To search associations for lipid profile parameters (lowand highdensity lipoprotein cholesterol levels, triglycerides and total cholesterol) in population samples from two Russian regions and make a replication analysis of a previously published genome-wide association study (GWA study, GWAS) for residents of three other Russian regions.

Material and methods. The study included representative samples from the Vologda (n=689) and Ivanovo (n=1675) regions collected for the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. We assessed lipid profile parameters and performed a targeted sequencing. A linear regression model adjusted for sex, age, and statin use was used to assess the associations of genomic variants with lipid profiles. The work replicated the results of a study by Usoltsev D, et al., 2023, carried out on population samples of individuals from St.Petersburg, Orenburg and Samara regions.

Results. We identified variants for which associations with lipid parameters had previously been identified in a Russian sample. The proportion of replicated variants was 89% and 92% for the samples from the Vologda and Ivanovo regions, respectively. The directions of effects of all replicated variants in the previously published study (samples from the Orenburg and Samara regions and St. Petersburg) and in both studied samples (samples from the Ivanovo and Vologda regions) coincide.

Conclusion. The results of the search for associations with lipid parameters in different Russian samples are consistent with each other.

Aim. To study the effect of multimorbidity on the risk of cardiovascular events (CVEs) in men with chronic coronary artery disease (CAD) after myocardial infarction (MI) and percutaneous coronary intervention (PCI).

Material and methods. A total of 101 men with chronic CAD after MI and PCI were included in the study (mean age 60,5±6,1 years). Of these, taking into account the non-inclusion criteria and consent to examination, 2 following groups were formed: first (n=39) — men without CVEs; 2^nd (n=39) — men with CVEs. In both groups, we studied the detection rate of grade I hypertension (HTN), class I obesity, hypercholesterolemia (HCE), and type 2 diabetes (T2D). The influence of HTN, obesity, HCE, and T2D on the risk of cardiovascular events was analyzed based on the calculation of contingency tables and Pearson's χ², as well as odds ratios (OR) with 95,0% confidence intervals (CI). The follow-up period for patients averaged 3,6±0,5 years.

Results. In men of group 2, compared with group 1 patients, grade I HTN, class I obesity, HCE were diagnosed more often in 1,3 (p=0,044), 1,4 (p=0,047), 1,2 (p=0,059) times, respectively. An increase in the risk of CVEs in men with chronic CAD, who underwent MI and PCI was associated with the detection of grade I HTN, class I obesity, HCE — OR 2,44 (CI: 1,88-6,75), OR 1,78 (CI: 1,56-4,62), OR 1,37 (CI: 1,11-4,17), respectively.

Conclusion. Thus, the detection rate of grade I HTN, class I obesity and HCE in men with chronic CAD and CVEs at long-term follow-up after MI and PCI was significantly higher compared to patients with chronic CAD without CVEs after PCI. At the same time, the detection of grade I HTN, class I obesity and HCE were associated with an increased risk of cardiovascular events.

Superior vena cava syndrome (SVCS) is due to impaired venous outflow from the head, neck, limbs and upper half of the body into the right atrium due to stenosis or complete obstruction of the superior vena cava (SVC). Increased venous pressure in the SVC and lack of timely treatment leads not only to serious complications, but also to death. In recent years, the etiology of SVCS has changed dramatically, mainly due to an increase in the number of implanted intravascular devices (central venous catheters, pacemakers, defibrillators, and other devices). Endovascular methods have become widely used in the treatment of patients with SVCS. This was primarily due to the minimally invasive nature of the intervention, the high technical success of the operation and the rapid onset of clinical improvement. Patients who develop SVCS after device implantation are predominantly younger and have a longer life expectancy. When choosing a treatment method, it is extremely important to take these factors into account and give preference to methods providing a long-term effect with the fewest possible complications. The article presents a case of endovascular treatment of a patient with SVCS occlusion, which developed 9 years after pacemaker implantation, using intravascular imaging methods.

Aim. In patients with acute thrombophlebitis of the great saphenous vein and/or large tributaries, compare the effectiveness and safety of 1,5-month fondaparinux sodium therapy and endovenous laser ablation in the area of the saphenofemoral junction in combination with shortterm anticoagulation or without anticoagulant therapy.

Material and methods. This prospective, single-center, randomized, open-label clinical trial included 105 patients with acute great saphenous vein thrombophlebitis at a distance of at least 5 cm from the saphenofemoral junction. Thirty-four patients were randomized into the group of endovenous laser ablation in the area of the saphenofemoral junction without the anticoagulant therapy. The group of endovenous laser ablation in combination with 7-day fondaparinux sodium included 35 patients, while the group of 1,5-month treatment with fondaparinux sodium — 36. In all cases, class 2 compression stockings were used for 1,5 months. Clinical manifestations of venous thrombosis and its prevalence according to compression ultrasonography were assessed in the first 45±2 days from the start of treatment.

Results. The mean age of patients was 49,1±13,7 years. There were more women (73,3%). The prevalence of risk factors for the occurrence and progression of venous thrombosis was low. Previous episodes of thrombophlebitis were observed in 3 (2,9%) patients. External factors that could provoke venous thrombosis were identified in 21 (20,0%) patients. Thrombosis was located in the great saphenous vein in 97,1% of patients, while large tributaries were involved in 25,7% of cases. The median distance from the proximal thrombus to the saphenofemoral junction was 45,2 cm. Patients randomized to the pharmacotherapy group were significantly older (mean age 49,1±13,7, 45,9±13,3 and 53,8±13,2 years, respectively; p=0,032), had slightly less pain and swelling. In all patients, after endovascular laser obliteration, a stable flow cessation at the intervention site was achieved. There were no cases of progression of venous thrombosis. After 7±2 days, in all groups there was a significant decrease in the proportion of patients with clinical manifestations of venous thrombosis, as well as the severity of persistent clinical manifestations. After 45±2 days, clinical manifestations were observed in a few patients and their severity was minimal. However, in the drug treatment group, a more frequent persistence of edema was noted both after 7±2 days (26,5, 20,0 and 47,7%, respectively; p=0,036) and after 45±2 days, (0, 2,9 and 16,7%, respectively; p=0,01). Hematomas and bruises were exclusive hemorrhagic complications. Hematomas were revealed in groups with endovenous laser ablation only. All hemorrhagic complication were minor according to World Society of Thrombosis and Hemostasis (ISTH) and type 1 according to Academic Research Consortium (BARC) classifications.

Conclusion. In outpatients with low risk of recurrence and mainly distal localization of acute thrombophlebitis of the great saphenous vein and/ or large inflows, endovenous laser ablation close to saphenous vein junction without anticoagulation or with 7 days of anticoagulation and medical treatment with 1,5-month anticoagulation had comparable efficacy and invasive treatment was sufficiently safe.