ASSESSMENT OF THE CLOPIDOGREL ACTION WITH REGARD TO CYP2C19 GENE POLYMORPHISMS IN PATIENTS WITH CORONARY ARTERY DISEASE AFTER IMPLANTATION OF DES STENTS

Aim of the work to assess the impact of CYP2C19 polymorphisms, including those of CYP2C19*1, CYP2C19*2, CYP2C19*3 and CYP2C19*17 on clopidogrel response variability in patients undergoing percutaneous coronary intervention (PCI) following DES implantation

REPERFUSION THERAPY IN ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION

Aim. To compare effect of percutaneous balloon angioplasty (PCA) and a systemic thrombolysis (STL) on the central and intracardiac hemodynamics in patients with acute coronary syndrome (ACS) with ST segment elevation.Material and methods. 80 patients with ACS with ST segment elevation were included in the study. Patients were split into 2 groups depending on reperfusion strategy. PCA was performed in 55 patients (first group). 25 patients of the second group had STL with Streptokinase, i/v, 1 500 000 units per hour. Echocardiography was performed in all patients at admission and after 3 and 7 days of treatment to evaluate intracardiac hemodynamics.Results. Both reperfusion methods significantly increase of ejection fraction (EF) and maximal output speed of left ventricle (LV). Increase of LV EF in patients after PCA was higher than this in patients after STL. PCA improved LV diastolic function; STL did not change this characteristic. After PCA working diagnosis of ACS was transformed to the following final diagnosis: acute myocardial infarction (AMI) with Q, AMI without Q and unstable angina in 37,5, 30,4 and 32,1% of patients, respectively. After STL diagnosis of AMI with Q was defined in all patients.Conclusion. PCA in patients with ACS with ST segment elevation results in fast improvement of global systolic and diastolic LV function. Besides, PCA prevents AMI with Q in a half of these patients.</p

EFFECTS OF ACETYLSALICYLIC ACID AND CLOPIDOGREL ON MORPHOFUNCTIONAL STATUS OF ERYTHROCYTES IN PATIENTS WITH ACUTE CORONARY SYNDROME

Aim. In patients with acute coronary syndrome (ACS) to study an aggregation activity and morphology of erythrocytes and to assess their changes during therapy with acetylsalicylic acid, clopidogrel and combined antiplatelet therapy (acetylsalicylic acid and clopidogrel).Material and methods. 98 patients (67 men and 31 women, aged 59,6±10,8 y.o.) with ACS were included in the study. Patients were split in 3 groups depending on prescribed antiplatelets (acetylsalicylic acid; clopidogrel; acetylsalicylic acid+clopidogrel). Aggregation activity and morphofunctional status of erythrocytes were evaluated at baseline, after 3 and 7 days of treatment.Results. The highest efficacy of antiaggregant therapy was observed in patients receiving antiplatelet combination. In this group there was a maximal reduction of erythrocyte aggregation and a number of pathological erythrocytes in peripheral blood by the 3rd day of therapy. This effect was increasing by the 7th day.Conclusion. The effect of all antiplatelet drugs was significant. The antiaggregant effect of clopidogrel was more significant than this for acetylsalicylic acid. Efficacy of combined therapy was higher than these for each drug alone. </p

THE ROLE OF ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF CORONARY HEART DISEASE AND MONITORING OF TRIMETAZIDIN THERAPY IN PATIENTS WITH CORONARY HEART DISEASE

&lt;p&gt;Coronary heart disease (CHD) is one of the most common diseases with high mortality worldwide. Therefore, in order to improve the quality and increase the life expectancy of mankind, it is important to improve the methods of diagnosis, treatment and prevention of coronary heart disease. The purpose of our study is to conduct a diagnostic analysis of the heart of patients who have suffered a myocardial infarction using EchoCG and to identify the structural and functional features of coronary heart disease. In addition, using these features to analyze the therapeutic efficacy of trimetazidin after treatment of these patients. We found that after treatment of patients with coronary artery disease with trimetazidin, the results of EchoCG showed mainly positive changes in markers associated with functional features of the heart, and to a lesser extent we found structural changes.&lt;/p&gt