Publications (90)13.99 Total impact
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Article: [Clinical role of lipoprotein-associated phospholipase A2].
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ABSTRACT: Inflammation plays an important role in origin and progression of atheromatous plaque. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered a biomarker of inflammation and a predictor of vascular events. Lp-PLA2 is an enzyme secreted by leukocytes and associated with circulating lipoproteins and macrophages in atherosclerotic plaques. Lp-PLA2 hydrolizes phospholipids of oxidized low density lipoproteins and generates two proinflammatory mediators, lysophosphatidylcholine and oxidized nonesterified fatty acids, which play a major role in the development of atherosclerotic lesions, myocardial infarction and ischemic stroke. Recently the first publications appeared about selective inhibitor of phospholipase A2 - darapladib as a novel therapeutic approach for the treatment of patients with coronary artery disease. However, first results need to be confirmed by ongoing large long-term randomized clinical trials.Kardiologiia 01/2013; 53(3):59-70. · 0.20 Impact Factor -
Article: [Pleiotropic effects of nicotinic acid therapy in men with coronary heart disease and elevated lipoprotein(a) levels].
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ABSTRACT: To assess effects of niacin on risk factors of atherosclerosis in men with coronary heart disease (CHD) and high lipoprotein(a) [Lp(a)] levels. Sixty men (mean age 54+/-6 years) with angiographic evidence of CHD were randomized into two groups. Active group (n=30) received extended release nicotinic acid 1500 mg, control group consisted of remaining 30 patients. All patients received basic therapy with atorvastatin 10-40 mg qd. Blood samples were collected for total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), Lp(a), lipoprotein-associated phospholipase A2 (Lp-PL-2), high-sensitivity C-reactive protein (hsCRP), complex of tissue-type plasminogen activator with plasminogen activator inhibitor type 1 (tPA/PAI-1). Carotid intima media thickness (CIMT) was measured at baseline and after 6-months therapy. There was no statistically significant difference between the groups in the clinical and biochemical characteristics. During the study lipid profile data were within the target levels. In the active group median percent decrease of Lp(a) level was 23% (from 84+/-40 to 67+/-25 mg/dl after 6 weeks and up to 65+/-37 mg/dl after 6 months of treatment, p<0.01); LDL-C, TG, tPA/PAI-1, and Lp-PL-2 mass levels decreased by 25, 20, 25, and 32%, respectively; HDL-C increased by 16% (p<0.05 vs baseline, respectively). Nicotinic acid treatment produced statistically significant reduction nicotinic acid of the mean CIMT (right: 0.83+/-0.16 vs 0.77+/-0.17 mm, p<0.05; left: 0.88+/-0.21 vs 0.82+/-0.17, p<0.05). In control group no changes of CIMT or blood tests were observed. In men with CHD and Lp(a) excess of addition to atorvastatin results in regression of CIMT on an average of 0.06 mm in 6 months. Such rapid and significant effect on the arterial wall structure can be attributed to the complex influence of nicotinic acid on Lp(a), lipids, Lp-PL-2 and thrombogenic factors. This is the first study providing the evidence of using Lp(a) as one of therapeutic targets in patients with high Lp(a) levels for achieving beneficial effect on a surrogate marker of atherosclerosis.Kardiologiia 05/2011; 51(5):9-16. · 0.20 Impact Factor -
Article: [High level of lipoprotein (a) as a predictor of poor long-term prognosis after coronary artery bypass surgery].
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ABSTRACT: Study aim was to investigate the association of lipoprotein (a) [Lp(a)] level with the development of cardiovascular complications in long-term follow-up period after coronary artery bypass grafting (CABG). Patients with chronic ischemic heart disease (IHD) (n = 361, 88% men, mean age 55 +/- 9 years) who had had CABG were included in the study. Before surgery we assessed presence of classical risk factors, left ventricular ejection fraction, concentrations of lipids and Lp(a) in blood serum. During follow-up (from 1 to 140, mean 66 +/- 34 months) we registered cardiac deaths, nonfatal myocardial infarctions (MI), strokes, repeat procedures of revascularization, and hospitalizations due to relapse or progression of angina pectoris. Information on prognosis was obtained from 263 patients. In 109 of them we registered 142 serious events including cardiac death n = 20 (14%), nonfatal MI n = 14 (10%), myocardial revascularization (n = 35), 29 (20%) with stenting), repeat CABG n = 6 (4%), hospitalization due to angina pectoris n = 53 (37%), stroke n = 4 (3%), noncardiac outcome n = 16 (10%). In subjects with hyperlipidemia (a) [HLp(a) - Lp(a) > 30 mg/l] survival after CABG was lower (log rank p < 0.001): 11 of 93 (11.3%) and 9 of 170 (5.2%) patients died among those with Lp(a) > 30 and < 30 mg/I, respectively. Relative risk (RR) of any cardiovascular complication was 3.24 (95% confidence interval [CI] 2.18 to 4.83, p < 0.001), of death - 2.89 (95% CI 1.31 to 6.35, p < 0.01), and of MI A 1.01 (95% CI 1.00 to 1.02; p = 0.02). RR of development of MI and cardiac death in patients with HLp(a) in 5 years was 2.61 (95% CI 1.11 to 5.74; p = 0.02), in 10 years - 2.95 (95% CI 1.50 to 5.79; p < 0.001). In patients with chronic IHD high level of Lp(a) can serve as independent predictor of unfavorable events including death and nonfatal MI during 10 years after CABG.Kardiologiia 01/2011; 51(1):18-22. · 0.20 Impact Factor -
Article: [Eosinophilic cation protein and development of restenosis of drug covered stents].
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ABSTRACT: Aim of the study was to assess activation of eosinophils as well as allergic and inflammatory reactions of the body in development of restenosis after implantation of stents with drug covering. We included into the study 32 patients with ischemic heart disease (IHD) and stable angina subjected to repeat coronary angiography during first year after endovascular myocardial revascularization with the help of stents with drug covering, and 11 healthy persons. Levels of eosinophilic cation protein (ECP), immunoglobulin E (IgE), and C-reactive protein (CRP) in blood plasma of patients and healthy persons was determined by immunoenzyme assay. According to results of angiographic study patients were divided into 2 groups: the first comprised 19 patients in whom no instent restenosis was found, the second comprised 13 patients in whom formation of restenosis at least in one stent was noted. Patients in these groups did not differ by age, sex, smokers and nonsmokers ratio, presence of hyperlipidemia, and angiographical characteristics of involved arteries. In patients with restenosis of stents blood plasma ECP level was 17.7 (11.2-24.0) g/ml and significantly higher than in patients without restenosis [9.0 (6.4-12.9) g/ml; p=0.017]. Blood level of IgE in these groups of patients did not differ [58.8 (42.1-164.0) and 52.9 (12.8-76.1) mg/ml, respectively; p=0.40] and did not differ from IgE level in blood of healthy volunteers [32.0 (21.2-80.8) mg/ml; p=0.91]. CRP level in patients with IHD was higher than in healthy volunteers [0.36 (0.1-0.75) mg/ml; p=0.0008)], but did not differ significantly in groups of patients with and without restenosis [2.38 (0.30-4.08) and 1.63 (0.61-2.47) mg/ml, respectively; p=0.52]. It was found that in the group of patients with low blood level of ECP (<11 g/ml) restenoses were revealed in 19% while in the group with higher blood level of ECP (>11 g/ml) - in 62% of cases (p=0,019). In patients subjected to coronary stenting with higher level of ECP in blood we noted more frequent development of restenoses than in patients with low level of this protein. The data obtained allow to suggest presence of relationship between development of restenosis and elevated activity of eosinophilic granulocytes in patients with IHD after revascularization.Kardiologiia 01/2011; 51(6):49-54. · 0.20 Impact Factor -
Article: [Stromal progenitor cells and blood leukocytes after implantation of drug-eluting stents].
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ABSTRACT: Aim of the study was to assess participation in development of restenosis of circulating in blood progenitor cells of stromal line of differentiation and polymorphonuclear granulocytes. We compared levels of osteonectin positive progenitor cells, neutrophils, eosinophils, and basophils in blood of patients with ischemic heart disease (IHD) in whom according to data of angiographic study after endovascular myocardial revascularization with the help of stents with drug coating (Cypher, Cordis Corp, USA) restenosis was detected (n=15), in patients without restenosis (n=23), and in healthy persons (n=17). Levels of stromal progenitor cells and polymorphonuclear granulocytes in blood were measured with the help of methods of flow cytometry. In groups of patients with IHD with and without restenosis number of osteonectin positive cells in blood was higher than in healthy subjects (2.4+/-0.7 and 2.5+/-0.9 vs 1.5+/-0.5 cells/ microL, respectively, p=0.004) without significant differences between groups (p=0.59). These 2 groups of patients did not differ by numbers of leukocytes, neutrophils, and basophils in blood. At the same time we found that in patients with restenosis number of eosinophils in blood was significantly greater than in the group of patients without restenosis (262+/-68 vs 124+/-67 cells/ microL, respectively p<0.001). Moreover in patients with level of eosinophils exceeding 170 cells/ microL rate of development of restenosis was 74% against 5% in patients with number of eosinophils less than 170 cells/ microL (p<0.001). Thus level of stromal progenitor cells in blood of patients with IHD was higher than in healthy persons and remained equally high in groups with and without restenosis. Number of blood eosinophilic leukocytes in patients who had been subjected to coronary stenting in whom later restenosis developed was significantly higher than in patients without restenosis. The data obtained indicate at the presence of link between development of in - stent restenosis and elevated content of eosinophilic granulocytes in blood of patients with IHD.Kardiologiia 01/2010; 50(1):36-41. · 0.20 Impact Factor -
Article: [An experience of the use of stents with drug coating in patients with long and diffuse coronary artery lesions].
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ABSTRACT: Treatment of long and diffuse lesions of coronary arteries remains one of most complicated sections of endovascular treatment. From 2003 to 2005 treatment with the use of stents with drug coating was conducted in 198 patients with long and diffuse coronary artery lesions. This made up 26% of total number of patients subjected to percutaneous coronary intervention during this time. Mean age of patients was 58 +/- 11 years, 164 (83%) of them were men, 37 (19%) had chronic occlusions of coronary arteries, in 91 (46%) side branches went out from the damaged segment. Patients were divided in two groups: 1st (n=136) comprised patients with lesion length from 22 to 33 mm, 2nd consisted of patients in whom lesion length exceeded 33 mm. Control group comprised 54 patients with lesion length less than 23 mm subjected to endovascular treatment with the use of stents with drug coating during same period of time. Average length of stented segment was 27.3 +/- 3.6 mm in the first group, 44.5 +/- 9.8 mm in the second group and 14 +/- 3.6 in the control group. Immediate success of the procedure was somewhat lower in group II compared with group I (87 and 91%, respectively). Hemopericardium and cardiac tamponade requiring urgent surgery developed in 2 group II patients (3.2%) during first 2 hours after attempt of recanalization of long chronic occlusions of the anterior descending artery. One patient (1.6%) had small-focal myocardial infarction after procedure, in another patient (1.6%) subacute occlusion developed after stenting of venous graft to the right coronary artery which we failed to eliminate. In the first group in 2 patients (1.4%) small-focal myocardial infarction developed. There were no complications in the control group. In 8 months after procedure angiographic restenosis developed in 6 patients (5%) in the 1st group, in 4 (8%) in the second and in 1 (2%) in the control group, however differences were not significant. Rates of repeat revascularizations of the target stenosis were 3, 5 and 0%, respectively. Of 10 cases of restenosis in patients with long stenoses in 5 cases restenosis was located inside stent and was focal (length less than 10 mm), in 3 cases it was located proximal or distal to stent, and in 2 patients manifested as complete occlusion of the stented segment. Treatment of long and diffuse lesions with the use of stents with drug coating appears safe and effective. Overall rate of development of perioperative complications is higher in treatment of stenoses longer than 33 mm compared with stenoses with length 23-33 cm (6.4 vs. 1.4%). Probability of restenosis and repeat revascularization of target stenosis after 8 months is not high.Kardiologiia 02/2007; 47(9):41-6. · 0.20 Impact Factor -
Article: [Immediate results of endovascular treatment of coronary arteries in patients with ischemic heart disease].
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ABSTRACT: To assess immediate results of percutaneous coronary interventions (PCI) and finding the predictors of the successful outcomes in various subgroups of patients with coronary artery disease (CAD). Patients (n=1066, (average age 55.7+/-9.2 years, women 12%) treated with coronary artery stenting between 1999 and 2004. According to coronary angiography, 383 (36%) patients had 1-vessel, 502 (47%) - 2-vessel, and 181 (17%) - 3-vessel CAD. The endovascular treatment was made on 1694 coronary stenoses (in average 1.6 stenosis/patient), 356 stenoses (21%) was defined as type A, 745 (44%) - type capital B, and 593 (35%) - type C. PCI was performed with use of inhibitors of glycoprotein receptors IIb/IIIa in 107 (18%) patients. The complete or partial immediate procedural success of PCI (elimination of at least one coronary stenosis) was achieved in 1002 (94%) patients. The immediate success was achieved in 1575 stenoses (93%). Total rate of major adverse cardiac events (MACE) was 1.3%. There were no deaths, 11 patients (1%) had acute myocardial infarctions, 3 (0.28%) patients had an emergent coronary artery bypass grafting. The immediate procedural success was significantly lower in patients with chronic coronary occlusions (76%) than in patients without coronary occlusions (97%, p<0.0001), as well in patients with stenoses type C as compared with stenoses type A, and B (success rate 77%, 98% and 100%, accordingly, p<0.0001). By multifactorial analysis, independent predictors of procedural failure were stenosis type C (small p<0.0001) and chronic occlusion of coronary artery (p=0,03).Kardiologiia 01/2007; 47(2):15-21. · 0.20 Impact Factor -
Article: [Coronary calcium and statins therapy].
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ABSTRACT: Assessment of the dynamics of coronary calcium score (CCS) evaluated with electron-beam tomography (EBT) under the influence of statin therapy in patients with coronary heart disease (CHD) and hyperlipidemia. A total of 119 hyperlipidemic CHD patients (mean age 62.1 +/- 9.3 years, 75% males) were included in the study. 69 patients were treated with statins (the study group), 50 patients rejected statins (the control group). CCS was calculated according to Agatson. Initial study parameters in the groups were similar. Mean follow-up was 25.3 +/- 10.6 months. A mean increase of CCS in the study group was 62 +/- 84 units (27.1%) and 122 +/- 180 units (65.2%) in the control group (p = 0.044). Total plasma cholesterol (TC) in the study group decreased by 25.1% from 6.99 +/- 0.92 to 5.24 +/- 0.54 mmol/l), in the control group--by 0.5% (from 6.67 +/- 1.01 to 6.63 +/- 1.0 mmol/l). A weak but significant negative correlation was found between a fall in total cholesterol and CCS increment (r = -0.243, p = 0.008). Calcium scoring with EBT or multispiral computed tomography can be used both for pre-clinical diagnosis of coronary atherosclerosis and for monitoring of coronary atherosclerosis progression under influence of hyperlipidemic therapy.Terapevticheskii arkhiv 02/2006; 78(4):53-6. · 0.14 Impact Factor -
Article: [Effects of long acting fluvastatin on parameters of lipid metabolism in patients with type 2 diabetes and combined hyperlipidemia].
Kardiologiia 02/2004; 44(10):60-3. · 0.20 Impact Factor -
Article: [First experience of the use of sirolimus covered stents output in the treatment of ischemic heart disease].
Kardiologiia 02/2004; 44(3):9-14. · 0.20 Impact Factor -
Article: [Results of endovascular revascularization with the use of stents after coronary bypass surgery in patients with ischemic heart disease].
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ABSTRACT: To compare results of stenting in patients with and without prior coronary artery bypass grafting (CABG). In 21 patients after CABG stents were implanted both in venous grafts and native vessels (secondary revascularization) and in 25 patients without history of CABG native vessels were stented (primary revascularization). Primary revascularization: there was 1 periprocedural non Q wave myocardial infarction (4%), angina disappeared in 88% and recurred in 1 year in 24% of patients; one year restenosis rate - 18.2%. Secondary revascularization: 1 periprocedural non Q wave (4.8%) and 1 Q wave (4.8%) myocardial infarction. Angina disappeared after stenting in 90.5% and recurred in 1 year in 19% of patients; one year restenosis rate - 17.6%. Both primary and secondary revascularizations were highly effective. However secondary stenting was associated with more frequent acute complications.Kardiologiia 02/2003; 43(4):6-13. · 0.20 Impact Factor -
Article: [Combination therapy with fluvastatin and fenofibrate in ischemic heart disease patients with combined hyperlipidemia and type 2 diabetes].
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ABSTRACT: To assess efficacy of combination therapy with fluvastatin and fenofibrate in ischemic heart disease (IHD) patients with combined hyperlipidemia and type 2 diabetes. Patients with IHD and combined hyperlipidemia with (n=56)) or without type 2 diabetes (n=30). After 8-week diet period the patients were randomized to 4 weeks monotherapy with either fluvastatin (40 mg/day) or micronized fenofibrate (200 mg/day). In patients whose low-density lipoprotein cholesterol (LDL CH) remained > 2,6 mmol/1 and triglycerides (TG) > 2.3 mmol/1 combination of fluvastatin 40 mg/day and fenofibrate 200 mg/day was used for the next 12 weeks. Target levels of LDL CH and TG were achieved in 75 and 88%, respectively, of diabetics, and in 73 and 88%, respectively, of non-diabetics. The use of combination of fluvastatin and fenofibrate was more effective then monotherapy for correction of lipid abnormalities in combined hyperlipidemia both in diabetics and non-diabetics with IHD.Kardiologiia 01/2003; 43(4):30-5. · 0.20 Impact Factor -
Article: [Effect of hormone replacement therapy on blood serum lipids in postmenopausal women with type 2 diabetes].
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ABSTRACT: There are limited data concerning influence of hormone replacement therapy (HRT) on lipid profile in women with type 2 diabetes. Aim of the study was to compare changes of blood lipids during HRT in postmenopausal women with and without type 2 diabetes. Seventy seven women included in the study were assigned to 1 of 4 groups, basing on being diabetic or nondiabetic, and further subdivided into users of estrogen alone (ERT), and of estrogen plus progestin (EPRT). Effect of 6-month ERT (oral estradiol valerate 2 mg/day) and EPRT (oral estradiol valerate 2 mg/day sequentially combined with cyproterone acetate 1 mg/day) on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides and lipoprotein (a) [Lp(a)] was separately assessed. EPRT and ERT caused decrease in LDL-C by 15% and 12%, and increase in HDL-C by 12% and 13%, respectively, in patients with diabetes (p<0.05 in all cases). LDL-C decreased by 11% and 15%, respectively, in women without diabetes (p<0.05 in all cases). Lp(a) was also reduced 25% with EPRT (p<0.01) and ERT (p<0.05). HDL-C increased 10% (p<0.05) with ERT but remained unchanged with EPRT. In conclusion, changes in all lipid parameters except Lp(a) caused by ERT and EPRT were comparable in postmenopausal women with and without type 2 diabetes.Kardiologiia 02/2002; 42(7):47-52. · 0.20 Impact Factor -
Article: [Acute phase proteins and recurrence of angina after effective coronary angioplasty].
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ABSTRACT: Analysis of relationships between clinical characteristics of the patients, high concentration of acute phase proteins--fibrinogen, C-reactive protein (CRP), activity of the inhibitor of type 1 plasminogen activator (PAI-1)--and frequency of angina recurrence after successful coronary angioplasty (CA). The trial included 53 patients after successful CA for a single hemodynamically significant stenosis. Peripheral blood was examined for plasm fibrinogen, CRP, activity of PAI-1 one day before and 2 days, 3 and 6 months after CA. After 12-month follow-up the patients were divided into two groups: angina-free patients (n = 37) and with recurrent angina (n = 16). Significant differences between the above groups were in PAI-1 activity 3 and 6 months after CA, in CRP initially, on day 2, after 6 months after CA (p < 0.05) but multifactor analysis has found that only CRP level both initial and on day 2 after CA is an independent predictor of recurrent angina pectoris after successful CA. An anginal recurrence after successful CA can be predicted by the initial and postoperative day 2 levels of CRP.Terapevticheskii arkhiv 01/2002; 74(4):42-5. · 0.14 Impact Factor -
Article: [Lipoprotein (a) - an independent risk factor in atherosclerosis].
Terapevticheskii arkhiv 02/2001; 73(9):76-82. · 0.14 Impact Factor -
Article: [Association of lipoprotein(a) and apolipoprotein(a) phenotypes with coronary and carotid atherosclerosis in CHD men].
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ABSTRACT: To evaluate in a case-control cross-sectional study whether lipoprotein(a) concentration and apo(a) phenotypes are associated with the presence and severity of coronary and carotid atherosclerosis. We have examined 198 male CHD patients (mean age 53 +/- 8) years) with stenosis more than 50% at least in one main coronary artery or its major branches. Duplex scanning was performed in 168 patients to assess the degree of carotid atherosclerosis. Seventy six apparently healthy men (mean age 39 +/- 9 years) formed the control group. Lp(a) concentration was measured by ELISA, apo(a) phenotyping was performed by immunoblotting. Lp(a) level was significantly higher in cases compared to controls: 37 +/- 31 mg/dl vs. 18 +/- 27 mg/dl, p < 0.05. Patients had low-molecular weight apo(a) phenotypes more frequently than controls: 46% vs. 29%, p = 0.01. Patients aged 45 years and younger had low-molecular weight apo(a) phenotypes more frequently than older ones (65% vs. 42%, p < 0.05) and controls (65% vs. 29%, respectively, p = 0.001). High Lp(a) level and low-molecular weight apo(a) phenotypes correlated with presence and number of coronary occlusions. There was association between Lp(a) level, low-molecular weight apo(a) phenotypes and presence, severity, extension of carotid atherosclerosis. No differences in distribution of other CHD risk factors among all subgroups of patients were found.Terapevticheskii arkhiv 01/2000; 72(1):28-32. · 0.14 Impact Factor -
Article: [Urokinase receptors in human monocytes during angina].
Biulleten' eksperimental'noĭ biologii i meditsiny 03/1998; 125(2):137-9. -
Article: [Total and lipid-bound sialic acids in the blood in primary and secondary hyperlipoproteinemias].
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ABSTRACT: Total and lipid-bound sialic acids (TSA and LBSA) were measured in the blood of 219 patients with primary or secondary hyperlipoproteinemia (129 patients with ischemic heart disease and 66 patients with diabetes mellitus type II) versus 24 normolipidemic healthy subjects. TSA levels in IHD patients differed significantly from those in IHD-free and diabetic patients. LBSA quantities were the same in IHD and IHD-free patients, being significantly higher in diabetes mellitus than in IHD. These findings give no proves to diagnostic value of TSA and LBSA as markers of IHD and coronary atherosclerosis. TSA levels may be used in the test for disturbed lipoprotein metabolism.Terapevticheskii arkhiv 02/1997; 69(1):23-5. · 0.14 Impact Factor -
Article: [Degree of the reliability of single measurement of cholesterol contents (literature review)].
Klinicheskaia laboratornaia diagnostika 02/1997; -
Article: [Lipoprotein(a) as a biochemical marker of coronary atherosclerosis].
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ABSTRACT: The relation between lipoprotein Lp(a) levels, other lipids and severity of coronary atherosclerosis was studied in 281 patients (241 men and 40 women aged 24 to 68 years) with suspected or diagnosed coronary heart disease. All of them underwent coronary angiography. The angiograms were evaluated according to two scores: vessel score (0 to 3 points for 0 to 3 vessels with stenoses > 50%) and stenosis score (0 to 32 points, number and severity of coronary lesions). 224 patients with verified coronary atherosclerosis were grouped according to these scores and compared with subgroup of 57 patients with intact coronary arteries. Lp(a) levels were significantly higher in patients with 1-, 2- (p < 0.05) and 3-vessel (p < 0.01) disease and stenosis score more than 10 points (p < 0.01). LDL cholesterol (LDL-C) levels were significantly higher in patients with 2- and 3-vessel disease and stenosis score more than 10 points (p < 0.05 in all cases). There was a positive correlation between Lp(a) levels and severity of coronary atherosclerosis (p < 0.05). Lp(a) contributes < 15% of total plasma cholesterol (TC). After subtraction of Lp(a)-cholesterol from TC according to modified Friedewald formula there was no any correlation between Lp(a) and LDL-C levels.Terapevticheskii arkhiv 01/1997; 69(9):31-4. · 0.14 Impact Factor
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2010–2011
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Russian Cardiology Research and Production Complex
Moscow, Moscow, Russia
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