Fortelyzin® in comparison with metalyse® for ST-elevated myocardial infarction: One-year results and clinical outcomes of a multicenter randomized study FRIDOM1

Aim. Evaluate the one-year results and clinical outcomes of a multi-center randomized clinical trial FRIDOM1. Material and methods. The study FRIDOM1 was conducted in 11 clinical centers of the Russian Federation in the period 2014-2016. The study included 382 patients with acute ST-elevated myocardial infarction (STEMI), who were randomly divided into the Fortelyzin® and Metalyse®. Thrombolysis was accompanied by anticoagulant and dual antiplatelet therapy followed by percutaneous coronary intervention (PCI). One-year patient status, all-cause mortality, including cardiovascular diseases (CVD), hospitalization, and one-year survival were assessed by telephone contact. Results. The one-year patient status was determined in 186 out of 191 (97,4%) in the Fortelyzin® group and in 185 out of 191 (96,9%) patients in the Metalyse® group. One-year all-cause mortality was 5,9% and 6,5% in the Fortelyzin® and Metalyse® groups, respectively (p=0,83; OR 0,91; 95% CI - 0,42-1,98). One-year mortality from CVD in the Fortelyzin® group is 5,4%, in the Metalyse® group - 6,5% (p=0,67; OR 0,83; 95% CI - 0,37-1,83). All-cause mortality between 30 days and 1 year in the Fortelyzin® group was in 2,2% of patients, CVD - in 1,6%, in the group of Metalise® mortality was in 2,7% of patients (all - CVD). One-year survival was 94,1% and 93,5% in the Fortelyzin® and Metalyse® groups, respectively. Conclusion. The one-year results of the FRIDOM1 study showed the efficacy and safety of a single bolus administration of Fortelyzin® as part of a pharmaco-invasive strategy for treating patients with STEMI, as well as clinical outcomes that are comparable with Metalyse®, including high survival rates and low CVD mortality. © Russian Journal of Cardiology

Persistent dyslipidemia in statin-treated patients: Russian real-world clinical practice data (Russian part of the DYSIS Study)

The high prevalence of persistent dyslipidemia in primary and specialised care patients treated with statins justifies the need to identify its reasons and develop the recommendations on the treatment optimization. At present, Russian studies focusing on the achievement of target lipid levels remain scarce, which emphasizes the importance of the problem and its further investigation. Aim. Cross-sectional epidemiological study which assessed the prevalence of persistent dyslipidemia in statin-treated patients and analysed the predictors of the achievement of target lipid levels. Material and methods. The lipid profile parameters were analysed in 1586 statin-treated out-patients with varied levels of cardiovascular risk, taking into account the type of lipid-lowering therapy and its doses. The assessment of the cardiovascular event (CVE) risk and the definition of target levels of low-density lipoprotein cholesterol (LDL-CH), as well as normal levels of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-CH), was based on the clinical recommendations by the European Society of Cardiology (ESC 2007) and by the European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS 2011 ). Results. The analysis based on the ESC 2007 recommendations has demonstrated that the target levels of LDL-CH (<2,5 mmol/l for high-risk patients) were not achieved in 53,5% of the participants. The elevation of LDL-CH levels could be isolated or combined with the HDL-CH decrease and/or the TG increase. Low levels of HDL-CH were observed in 32,3% of the patients, while high TG levels were registered in 55,6% of the participants. The achievement of target LDL-CH levels was predicted by the higher-dose statin therapy (odds ratio 0,44). The analysis based on the ESC/EAS 2011 recommendations has shown that the prevalence of target LDL-CH levels was 12,2% in very high-risk patients (< 1,8 mmol/l), 30,3% in high-risk patients (<2,5 mmol/l), and 53,4% in moderate-risk patients (<3,0 mol/l). Conclusion. Over a half of the statin-treated patients failed to achieve target levels of LDL-CH. The lowest prevalence of target LDL-CH levels was observed in very high-risk and high-risk patients. The predictors of target LDL-CH level achievement included moderate cardiovascular risk and higher-dose statin therapy. The obtained results suggest that the correction of persistent dyslipidemia in statin-treated patients could be achieved via increasing the satin dose and combining lipid-lowering medications

Persistent dyslipidemia in statin-treated patients: Russian real-world clinical practice data (Russian part of the DYSIS Study)

The high prevalence of persistent dyslipidemia in primary and specialised care patients treated with statins justifies the need to identify its reasons and develop the recommendations on the treatment optimization. At present, Russian studies focusing on the achievement of target lipid levels remain scarce, which emphasizes the importance of the problem and its further investigation. Aim. Cross-sectional epidemiological study which assessed the prevalence of persistent dyslipidemia in statin-treated patients and analysed the predictors of the achievement of target lipid levels. Material and methods. The lipid profile parameters were analysed in 1586 statin-treated out-patients with varied levels of cardiovascular risk, taking into account the type of lipid-lowering therapy and its doses. The assessment of the cardiovascular event (CVE) risk and the definition of target levels of low-density lipoprotein cholesterol (LDL-CH), as well as normal levels of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-CH), was based on the clinical recommendations by the European Society of Cardiology (ESC 2007) and by the European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS 2011 ). Results. The analysis based on the ESC 2007 recommendations has demonstrated that the target levels of LDL-CH (<2,5 mmol/l for high-risk patients) were not achieved in 53,5% of the participants. The elevation of LDL-CH levels could be isolated or combined with the HDL-CH decrease and/or the TG increase. Low levels of HDL-CH were observed in 32,3% of the patients, while high TG levels were registered in 55,6% of the participants. The achievement of target LDL-CH levels was predicted by the higher-dose statin therapy (odds ratio 0,44). The analysis based on the ESC/EAS 2011 recommendations has shown that the prevalence of target LDL-CH levels was 12,2% in very high-risk patients (< 1,8 mmol/l), 30,3% in high-risk patients (<2,5 mmol/l), and 53,4% in moderate-risk patients (<3,0 mol/l). Conclusion. Over a half of the statin-treated patients failed to achieve target levels of LDL-CH. The lowest prevalence of target LDL-CH levels was observed in very high-risk and high-risk patients. The predictors of target LDL-CH level achievement included moderate cardiovascular risk and higher-dose statin therapy. The obtained results suggest that the correction of persistent dyslipidemia in statin-treated patients could be achieved via increasing the satin dose and combining lipid-lowering medications

The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society [Экспертное мнение по применению диуретиков при хронической сердечной недостаточности Общество специалистов по сердечной недостаточности]

The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations