19 research outputs found
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠΎΠ² Π³Π΅Π½Π° CYP2C19 Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡ ΠΎΠ΄Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΈΠ½ΡΠ°ΡΠΊΡΠΎΠΌ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 12-ΠΌΠ΅ΡΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ
Β Highlights. CYP2C19 gene polymorphisms in patients with acute myocardial infarction are common in clinical practice. The article assesses the role of genetic predisposition in the development of ischemic and hemorrhagic events during dual antiplatelet therapy (aspirin and clopidogrel) within the first 12 months after revascularization for acute myocardial infarction.Aim. To evaluate the impact of CYP2C19 gene *1, *2, *3, *17 alleles polymorphism on 12-month clinical outcomes in patients who underwent coronary revascularization due to acute myocardial infarction and took clopidogrel.Methods. 363 patients with acute myocardial infarction undergoing percutaneous coronary intervention were enrolled in the prospectively study in 2010β2012. CYP2C19 gene *1, *2, *3, *17 alleles polymorphism analysis was performed in all study participants. Dual antiplatelet therapy, consisting of aspirin and clopidogrel, was prescribed for 12 months. The follow-up period was 12 months, the incidenceΒ Β of cardiovascular death, non-fatal myocardial infarction, stroke and bleeding was assessed.Results. 12 months after inclusion in the study, the incidence of composite endpoint (defined as cardiovascular death, non-fatal myocardial infarction and stroke) was observed in 18 patients (7% [5%; 11%]; 95% CI) with wild-type CYP2C19 gene and in 12 patients (11% [6%; 18%]; 95% CI) with lost-of-function *2+*3 alleles, with no statistical difference (OR = 1.6 [0.7; 3.6], 95% CI; p = 0.301). Presence of any LOF-alleles did not predict composite endpoint events (OR = 1.56 [0.71; 3.34], 95% CI, p<0.253). Multivariable logistic regression analysis revealed that CYP2C19*2 homozygotes have higher risk of composite endpoint (OR = 6.34, 95% CI [1.57; 22.23], p<0.005) and myocardial infarction (OR = 5.45, 95% CI [1.14; 19.97], p<0.016) compared to *2 heterozygotes and wild-type carriers.Β Β Β 14 patients had major bleedings, required blood transfusion or hospitalization. Patientβs age, increase in creatinine level and gain-of-function (GOF) CYP2C19*17 homozygotic carriage were identified as the predictors of major bleeding during follow-up period.Conclusion. In this study CYP2C19 LOF alleles polymorphism except the CYP2C19*2 homozygotic carriage demonstrated no impact on the incidence of ischemic events during 12-month follow-up in patients with acute MI who underwent successful revascularization. CYP2C19*17 homozygotes demonstrated increased risk of major bleeding only in young individuals with elevated blood creatinine levels.ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ. ΠΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΡ Π³Π΅Π½Π° CYP2C19 Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΡΡΡΡΠΌ ΠΈΠ½ΡΠ°ΡΠΊΡΠΎΠΌ Π²ΡΡΡΠ΅ΡΠ°ΡΡΡΡ ΡΠ°ΡΡΠΎ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. Π ΡΠ°Π±ΠΎΡΠ΅ ΠΎΡΠ΅Π½Π΅Π½Π° ΡΠΎΠ»Ρ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ΅Π΄ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ°ΠΊ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠ°ΠΊ ΠΈ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ±ΡΡΠΈΠΉ Π½Π° ΡΠΎΠ½Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°ΡΠΏΠΈΡΠΈΠ½ΠΎΠΌ ΠΈ ΠΊΠ»ΠΎΠΏΠΈΠ΄ΠΎΠ³ΡΠ΅Π»ΠΎΠΌ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠ²ΡΡ
12 ΠΌΠ΅Ρ. ΠΏΠΎΡΠ»Π΅ ΡΠ΅Π²Π°ΡΠΊΡΠ»ΡΡΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΈΠ½ΡΠ°ΡΠΊΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°.Π¦Π΅Π»Ρ. ΠΡΠ΅Π½ΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠΎΠ² Π³Π΅Π½Π° CYP2C19 (Π°Π»Π»Π΅Π»ΠΈ *1, *2, *3, *17) Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡ
ΠΎΠ΄Ρ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΡΠ»Π΅ ΡΡΠΏΠ΅ΡΠ½ΠΎΠΉ ΡΠ΅Π²Π°ΡΠΊΡΠ»ΡΡΠΈΠ·Π°ΡΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΈΠ½ΡΠ°ΡΠΊΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° (ΠΠ) Π½Π° ΡΠΎΠ½Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΊΠ»ΠΎΠΏΠΈΠ΄ΠΎΠ³ΡΠ΅Π»ΠΎΠΌ Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ 12-ΠΌΠ΅ΡΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π‘ 2011 ΠΏΠΎ 2012 Π³. Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 363 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΠΎΡΡΡΡΠΌ ΠΠ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠ΅Π³ΠΎ ΡΠ΅Π²Π°ΡΠΊΡΠ»ΡΡΠΈΠ·Π°ΡΠΈΡ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°. ΠΡΠ΅ΠΌ Π±ΠΎΠ»ΡΠ½ΡΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· Π½Π° ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΡ Π³Π΅Π½Π° CYP2C19 (Π°Π»Π»Π΅Π»ΠΈ *1, *2, *3, *17). Π ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 12 ΠΌΠ΅Ρ. ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ Π΄Π²ΠΎΠΉΠ½ΡΡ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ°ΡΠ½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ, Π²ΠΊΠ»ΡΡΠ°Π²ΡΡΡ Π°ΡΠΏΠΈΡΠΈΠ½ ΠΈ ΠΊΠ»ΠΎΠΏΠΈΠ΄ΠΎΠ³ΡΠ΅Π», ΠΏΠΎΡΠ»Π΅ ΡΠ΅Π³ΠΎ ΠΎΡΠ΅Π½Π΅Π½Π° ΡΠ°ΡΡΠΎΡΠ° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΡΠΌΠ΅ΡΡΠΈ, ΠΏΠΎΠ²ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΠ, ΠΈΠ½ΡΡΠ»ΡΡΠ° ΠΈ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π§Π΅ΡΠ΅Π· 12 ΠΌΠ΅Ρ. Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΡΠΎΠ±ΡΡΠΈΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΈ (ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠ°Ρ ΡΠΌΠ΅ΡΡΡ, ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΠΉ ΠΠ, ΠΈΠ½ΡΡΠ»ΡΡ) Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Ρ 18 (7%, 95% Π΄ΠΎΠ²Π΅ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» (ΠΠ) [5; 11]) Π±ΠΎΠ»ΡΠ½ΡΡ
Π³ΡΡΠΏΠΏΡ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π° Β«Π΄ΠΈΠΊΠΎΠ³ΠΎΒ» Π³Π΅Π½ΠΎΡΠΈΠΏΠ° ΠΈ Ρ 12 (11%, 95% ΠΠ [6; 18]) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Π³ΡΡΠΏΠΏΠ΅ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π° Π°Π»Π»Π΅Π»Π΅ΠΉ CYP2C19*2 ΠΈ CYP2C19*3. ΠΠ°Π½Π½ΡΠ΅ ΡΠΎΠ±ΡΡΠΈΡ Π½Π΅ ΠΈΠΌΠ΅Π»ΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°Π·Π»ΠΈΡΠΈΡ (ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΡΠ°Π½ΡΠΎΠ² (ΠΠ¨) 1,6, 95% ΠΠ [0,7; 3,6], p = 0,301). ΠΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²ΠΎ Π°Π»Π»Π΅Π»Π΅ΠΉ CYP2C19*2 ΠΈΠ»ΠΈ CYP2C19*3 Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Β«Π΄ΠΈΠΊΠΈΠΌΒ» ΡΠΈΠΏΠΎΠΌ Π½Π΅ ΡΠ²Π»ΡΠ»ΠΎΡΡ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠΌ Π½Π°ΡΡΡΠΏΠ»Π΅Π½ΠΈΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΈ (ΠΠ¨ 1,56, 95% ΠΠ [0,71; 3,34], p<0,253). Π Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΏΡΡΠ΅ΠΌ ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΠΌΠ½ΠΎΠ³ΠΎΡΠ°ΠΊΡΠΎΡΠ½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π³ΠΎΠΌΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΡΠΉ Π²Π°ΡΠΈΠ°Π½Ρ CYP2C19 (*2/*2) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Β«Π΄ΠΈΠΊΠΈΠΌΒ» (*1/*1) ΠΈ Π³Π΅ΡΠ΅ΡΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΡΠΌ (*1/*2) Π³Π΅Π½ΠΎΡΠΈΠΏΠ°ΠΌΠΈ ΡΠ»ΡΠΆΠΈΡ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠΌ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ (ΠΠ¨ 6,34, 95% ΠΠ [1,57; 22,23], p<0,005) ΠΈ ΠΠ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 12 ΠΌΠ΅Ρ. Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ (ΠΠ¨ 5,45, 95% ΠΠ [1,14; 19,97], p<0,016). Π£ 14 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ°Π·Π²ΠΈΠ»ΠΎΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠ΅. Π ΠΌΠ½ΠΎΠ³ΠΎΡΠ°ΠΊΡΠΎΡΠ½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΈ ΡΡΠΎΠ²Π΅Π½Ρ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°, Π²ΠΎΠ·ΡΠ°ΡΡ ΠΈ Π³ΠΎΠΌΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΠΎΠ΅ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²ΠΎ Π°Π»Π»Π΅Π»Π΅ΠΉ GOF CYP2C19*17 Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Β«Π΄ΠΈΠΊΠΈΠΌΒ» ΡΠΈΠΏΠΎΠΌ ΠΈ Π³Π΅ΡΠ΅ΡΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΡΠΌ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²ΠΎΠΌ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΠ°Π½ΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 12 ΠΌΠ΅Ρ. ΠΏΠΎΡΠ»Π΅ ΡΠ΅Π²Π°ΡΠΊΡΠ»ΡΡΠΈΠ·Π°ΡΠΈΠΈ (ΠΠ¨ 6,47, 95% ΠΠ [1,27; 26,97], p<0,013).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ°Π»ΠΈΡΠΈΠ΅ Π³ΠΎΠΌΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΠΎΠ³ΠΎ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π° CYP2C19*2 ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π° ΡΠ°ΡΡΠΎΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΡ
ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ±ΡΡΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ ΠΏΠΎΡΠ»Π΅ ΡΠ΅Π²Π°ΡΠΊΡΠ»ΡΡΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ 12 ΠΌΠ΅Ρ. Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ. ΠΠΎΠΌΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΡΠΉ Π²Π°ΡΠΈΠ°Π½Ρ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π° CYP2C19*17 ΡΠ»ΡΠΆΠΈΡ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠΌ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ Ρ Π»ΠΈΡ ΠΌΠΎΠ»ΠΎΠ΄ΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°
ΠΠΊΡΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½Π°Ρ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π½Π°Ρ ΠΎΠΊΡΠΈΠ³Π΅Π½Π°ΡΠΈΡ ΠΏΡΠΈ ΠΎΡΡΡΠΎΠΌ ΠΈΠ½ΡΠ°ΡΠΊΡΠ΅ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°, ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΠΎΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΠΎΠΌ
Cardiogenic shock is one of the main causes of death in patients with acute myocardial infarction with the mortality rates being as high as 60β80%. Extracorporeal membrane oxygenation (ECMO) is a life-saving technique in patients with cardiogenic shock. Subjects and methods. Veno-arterial ECMO was connected and the coronary arteries were stented in a 53-year-old female patient with acute myocardial infarction complicated by severe cardiogenic shock refractory to drug therapy and intra-aortic counterpulsation (IACP). ECMO was maintained at a volumetric perfusion rate of 4.5 l/min (2.5 l/min/m2). The duration of ECMO was 138.5 hours (5.8 days); that of IACP was 9 days. In the first 24 hours, there were no ECMO-related complications apart from mild bleeding from the site of cannula insertion. The patient stayed in the intensive care unit 12 days. Results. IACP is used to treat cardiogenic shock, but it is ineffective in severe cardiogenic shock. ECMO is one of the possible options for maintaining life and for stabilizing the condition. Current ECMO systems may be employed for urgent peripheral connection and coronary artery intervention. ECMO may be used for resuscitation and temporary life support, which permits as high as 50β75% of patients with refractory cardiogenic shock to be saved. Conclusion: emergency coronary stenting with ECMO support is the technique of choice for the treatment of acute myocardial infarction complicated by severe cardiogenic shock. Key words: extracorporeal membrane oxygenation, cardiogenic shock, coronary artery stenting.ΠΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΉ ΡΠΎΠΊ β ΠΎΠ΄Π½Π° ΠΈΠ· ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΏΡΠΈΡΠΈΠ½ ΡΠΌΠ΅ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΡΡΡΡΠΌ ΠΈΠ½ΡΠ°ΡΠΊΡΠΎΠΌ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° ΠΈ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΏΡΠΈ ΡΡΠΎΠΌ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 60-80%. ΠΠΠΠ β ΡΠΊΡΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½Π°Ρ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π½Π°Ρ ΠΎΠΊΡΠΈΠ³Π΅Π½Π°ΡΠΈΡ β ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΆΠΈΠ·Π½Π΅ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΠΎΠΌ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠ° 53 Π»Π΅Ρ Ρ ΠΎΡΡΡΡΠΌ ΠΈΠ½ΡΠ°ΡΠΊΡΠΎΠΌ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°, ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΡΠΌ ΡΡΠΆΠ΅Π»ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΠΎΠΌ, ΡΠ΅ΡΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠΌ ΠΊ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ Π²Π½ΡΡΡΠΈΠ°ΠΎΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π±Π°Π»Π»ΠΎΠ½Π½ΠΎΠΉ ΠΊΠΎΠ½ΡΡΠΏΡΠ»ΡΡΠ°ΡΠΈΠΈ (ΠΠΠΠ). ΠΠΎΠ»ΡΠ½ΠΎΠΉ Π±ΡΠ»Π° ΠΏΠΎΠ΄ΠΊΠ»ΡΡΠ΅Π½Π° Π²Π΅Π½ΠΎ-Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½Π°Ρ ΠΠΠΠ ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΡΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΡΡ
Π°ΡΡΠ΅ΡΠΈΠΉ. ΠΠΠΠ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΈΠ²Π°Π»Π°ΡΡ Ρ ΠΎΠ±ΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠΊΠΎΡΠΎΡΡΡΡ ΠΏΠ΅ΡΡΡΠ·ΠΈΠΈ 4,5 Π»/ΠΌΠΈΠ½ (2,5 Π»/ΠΌΠΈΠ½/ΠΌ2). ΠΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΠΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 138,5 ΡΠ°ΡΠΎΠ² (5,8 ΡΡΡ), ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΠΠΠ β 9 ΡΡΡΠΎΠΊ. ΠΠ° ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ Π½Π΅Π±ΠΎΠ»ΡΡΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Π² ΠΏΠ΅ΡΠ²ΡΠ΅ ΡΡΡΠΊΠΈ ΠΈΠ· ΠΌΠ΅ΡΡΠ° ΡΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΊΠ°Π½ΡΠ»ΠΈ, ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ ΠΠΠΠ, Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ. Π ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠ° Π½Π°Ρ
ΠΎΠ΄ΠΈΠ»Π°ΡΡ 12 ΡΡΡΠΎΠΊ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠΎΠΊΠ° ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΡΡΡ ΠΠΠΠ, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΏΡΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΠΎΠΌ ΡΠΎΠΊΠ΅ ΠΌΠ°Π»ΠΎΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π°. ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΡ
ΡΠΏΠΎΡΠΎΠ±ΠΎΠ² ΠΆΠΈΠ·Π½Π΅ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΠΠΠ. Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΡΠΈΡΡΠ΅ΠΌΡ ΠΠΠΠ ΠΌΠΎΠ³ΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡΡΡ Π΄Π»Ρ ΡΡΠ³Π΅Π½ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ΄ΠΊΠ»ΡΡΠ΅Π½ΠΈΡ ΠΈ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° Π½Π° ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΡΡ
Π°ΡΡΠ΅ΡΠΈΡΡ
. ΠΠΠΠ ΠΌΠΎΠΆΠ½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π΄Π»Ρ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΠΆΠΈΠ·Π½ΠΈ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠΏΠ°ΡΡΠΈ Π΄ΠΎ 50β75% Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ΅ΡΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΠΎΠΌ. ΠΡΠ²ΠΎΠ΄Ρ: Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΠΎΠ΅ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΠΎΠ΅ ΡΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΎΠΉ ΠΠΠΠ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΈΠ½ΡΠ°ΡΠΊΡΠ° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°, ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΠΎΠ³ΠΎ ΡΡΠΆΠ΅Π»ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΠΎΠΌ. ΠΠ»ΡΡΠ΅Π²ΡΠ΅ ΡΠ»ΠΎΠ²Π°: ΠΠΠΠ, ΠΊΠ°ΡΠ΄ΠΈΠΎΠ³Π΅Π½Π½ΡΠΉ ΡΠΎΠΊ, ΡΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΡΡ
Π°ΡΡΠ΅ΡΠΈΠΉ
Π Π°Π½Π½ΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠΌΠ΅ΡΡΠΈΡ ΠΎΡ COVID-19
261,435,768 COVID-19 infections were detected worldwide, of them 5,207,634 deaths were registered. Identifying markers of the patient severity early in the course of the disease can facilitate the assessment of the risk of adverse outcome.The objective: To compare values of laboratory parameters and their changes during treatment of patients with a complicated course of COVID-19 infection.Subjects and Methods. 56 patients were included in the study, all of them were hospitalized to COVID Hospital of the Clinic of Bashkir State Medical University, Russian Ministry of Health, from September 30, 2021 to November 15, 2021, and their complicated course of the disease necessitated transfer to the intensive care unit (ICU). The laboratory evaluation included the following: a general blood and urine counts, blood chemistry including urea and creatinine, liver transaminases, and blood coagulogram (prothrombin time (PTT), prothrombin index (PTI), thrombin time, fibrinogen, and blood clotting time).Results. In the group of patients with a fatal outcome on the day of transfer to ICU, lymphocytopenia, eosinopenia, elevated values of creatinine, total bilirubin, transaminases, C-reactive protein, D-dimer, and ferritin were noted. Also on this day, microscopic hematuria, proteinuria and cylindruria were detected in the urine tests of most patients in this group during treatment.Conclusion. Critical deviations in the results of hematological and biochemical tests were revealed. Particular attention should be paid to such parameters as the level of erythrocytes, lymphocytes, eosinophils, glucose, urea, creatinine, total bilirubin, aspartate aminotransferase, alanine aminotransferase, creatine kinase, C-reactive protein, D-dimer, and ferritin.ΠΠΎ Π΄Π°Π½Π½ΡΠΌ Π½Π° 01.12.2021 Π³., Π²ΠΎ Π²ΡΠ΅ΠΌ ΠΌΠΈΡΠ΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ 261 435 768 Π·Π°Π±ΠΎΠ»Π΅Π²ΡΠΈΡ
COVID-19, ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
5 207 634 ΡΠΌΠ΅ΡΠ»ΠΈ. ΠΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΡΠ°Π½Π½ΠΈΡ
ΡΡΠΎΠΊΠ°Ρ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΌΠΎΠΆΠ΅Ρ ΠΎΠ±Π»Π΅Π³ΡΠΈΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΡΠΈΡΠΊΠ° Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π°.Π¦Π΅Π»Ρ: ΡΡΠ°Π²Π½ΠΈΡΡ Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΈ ΠΈΡ
Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡ Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ COVID-19.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 56 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΠΊΠΎΠ²ΠΈΠ΄-Π³ΠΎΡΠΏΠΈΡΠ°Π»Ρ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΈ Π€ΠΠΠΠ£ ΠΠ Β«ΠΠΠΠ£Β» ΠΠΈΠ½Π·Π΄ΡΠ°Π²Π° Π ΠΎΡΡΠΈΠΈ Ρ 30.09.2021 Π³. ΠΏΠΎ 15.11.2021 Π³., ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΊΠΎΡΠΎΡΡΡ
Π²ΡΠ·Π²Π°Π»ΠΎ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΏΠ΅ΡΠ΅Π²ΠΎΠ΄Π° Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠ ΠΠ’). ΠΠ±ΡΠ΅ΠΌ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΠ±ΡΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ ΠΈ ΠΌΠΎΡΠΈ, Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠ²Π½Π΅ΠΉ ΠΌΠΎΡΠ΅Π²ΠΈΠ½Ρ ΠΈ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°, ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΡΡ
ΡΡΠ°Π½ΡΠ°ΠΌΠΈΠ½Π°Π·, ΠΊΠΎΠ°Π³ΡΠ»ΠΎΠ³ΡΠ°ΠΌΠΌΠ° ΠΊΡΠΎΠ²ΠΈ (ΠΏΡΠΎΡΡΠΎΠΌΠ±ΠΈΠ½ΠΎΠ²ΠΎΠ΅ Π²ΡΠ΅ΠΌΡ, ΠΏΡΠΎΡΡΠΎΠΌΠ±ΠΈΠ½ΠΎΠ²ΡΠΉ ΠΈΠ½Π΄Π΅ΠΊΡ, ΡΡΠΎΠΌΠ±ΠΈΠ½ΠΎΠ²ΠΎΠ΅ Π²ΡΠ΅ΠΌΡ, ΡΠΈΠ±ΡΠΈΠ½ΠΎΠ³Π΅Π½, Π²ΡΠ΅ΠΌΡ ΡΠ²Π΅ΡΡΡΠ²Π°Π½ΠΈΡ ΠΊΡΠΎΠ²ΠΈ).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΡΠΌ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ Π² Π΄Π΅Π½Ρ ΠΏΠ΅ΡΠ΅Π²ΠΎΠ΄Π° Π² ΠΠ ΠΠ’ ΠΎΡΠΌΠ΅ΡΠ΅Π½Ρ Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠΏΠ΅Π½ΠΈΡ, ΡΠΎΠ·ΠΈΠ½ΠΎΠΏΠ΅Π½ΠΈΡ, ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°, ΠΎΠ±ΡΠ΅Π³ΠΎ Π±ΠΈΠ»ΠΈΡΡΠ±ΠΈΠ½Π°, ΡΡΠ°Π½ΡΠ°ΠΌΠΈΠ½Π°Π·, Π‘-ΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±Π΅Π»ΠΊΠ°, D-Π΄ΠΈΠΌΠ΅ΡΠ° ΠΈ ΡΠ΅ΡΡΠΈΡΠΈΠ½Π°. Π’Π°ΠΊΠΆΠ΅ Π² ΡΡΠΎΡ Π΄Π΅Π½Ρ Π² Π°Π½Π°Π»ΠΈΠ·Π°Ρ
ΠΌΠΎΡΠΈ Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄Π°Π½Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π² Ρ
ΠΎΠ΄Π΅ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΡΠ»ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ ΠΌΠΈΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠ°Ρ Π³Π΅ΠΌΠ°ΡΡΡΠΈΡ, ΠΏΡΠΎΡΠ΅ΠΈΠ½ΡΡΠΈΡ ΠΈ ΡΠΈΠ»ΠΈΠ½Π΄ΡΡΡΠΈΡ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΡΠ²Π»Π΅Π½Ρ ΠΊΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΊΠ»ΠΎΠ½Π΅Π½ΠΈΡ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°Ρ
Π³Π΅ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
, Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π½Π°Π»ΠΈΠ·ΠΎΠ². ΠΡΠΎΠ±ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π΄ΠΎΠ»ΠΆΠ½ΠΎ Π±ΡΡΡ ΡΠ΄Π΅Π»Π΅Π½ΠΎ ΡΠ°ΠΊΠΈΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ, ΠΊΠ°ΠΊ ΡΡΠΎΠ²Π΅Π½Ρ ΡΡΠΈΡΡΠΎΡΠΈΡΠΎΠ², Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ², ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ², Π³Π»ΡΠΊΠΎΠ·Ρ, ΠΌΠΎΡΠ΅Π²ΠΈΠ½Ρ, ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΈΠ½Π°, ΠΎΠ±ΡΠ΅Π³ΠΎ Π±ΠΈΠ»ΠΈΡΡΠ±ΠΈΠ½Π°, Π°ΡΠΏΠ°ΡΡΠ°ΡΠ°ΠΌΠΈΠ½ΠΎΡΡΠ°Π½ΡΡΠ΅ΡΠ°Π·Ρ, Π°Π»Π°Π½ΠΈΠ½Π°ΠΌΠΈΠ½ΠΎΡΡΠ°Π½ΡΡΠ΅ΡΠ°Π·Ρ, ΠΊΡΠ΅Π°ΡΠΈΠ½ΠΊΠΈΠ½Π°Π·Ρ, Π‘-ΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±Π΅Π»ΠΊΠ°, D-Π΄ΠΈΠΌΠ΅ΡΠ°, ΡΠ΅ΡΡΠΈΡΠΈΠ½Π°
U-Pb (SHRIMP II) age of zircons from ash beds of the chernokamen formation, Vendian Sylvitsa group (Central Urals)
Structure and depositional history of the Vendian Sylvitsa Group in the western flank of the Central Urals
Risk Assessment of Accidents at Coal Mining Enterprises, Using the Automated System of Calculation of Fault Tree and Event
Prospective rAndomized, single-blind, mulTicenter study of sirolimus-eluting coRonary stent βCalypsoβ vs everolimus-eluting cOronary stenT βXiencePrimeβ: results of the PATRIOT trial
Aim. This trial was aimed at comparing the efficacy and safety of sirolimus-eluting coronary stent βCalypsoβ (Angioline) and everolimus-eluting coronary stent βXiencePrimeβ (Abbott Vascular) when used for treatment of ischemic heart disease patients.Methods. The trial included patients suitable for coronary revascularization with coronary stenting. They underwent a standard revascularization procedure and were randomized in 2:1 ratio to receive βCalypsoβ coronary stent (Angioline) (n = 407) or βXiencePrimeβ coronary stent (AbbottVascular) (n = 203). The follow-up period was 12 months. In order to detect restenosis (secondary endpoint), angiographic follow-up was performed in 20% of cases at 12 months. The trial protocol had no limitations regarding the length of lesions, number of target lesions and number of implanted stents. The main exclusion criterion was STEMI. The composite primary endpoint included one-year target lesion-related complications determined as cardiogenic death, target vessel myocardial infarction, clinically indicated target lesion revascularization. The primary endpoint data were evaluated by an independent committee.Results. In the trial, 55% of patients had acute coronary syndrome with ST elevation and type C lesions were detected in 46% of cases. In βCalypsoβ and βXiencePrimeβ groups, TLF occurred in 5.4% and 6.4% respectively (absolute risk difference in TLF accounted for 1%, 95% CI [---;2.1%]; p non-inferiorityΒ = 0.017). Thus, the hypothesis of non-inferiority of βCalypsoβ as compared to βXiencePrimeβ was confirmed. The incidence of stent thrombosis (definite and probable) was relatively low and had no significant differences between βCalypsoβ and βXiencePrimeβ groups (0.73% and 0%; p>0.05). Definite stent thrombosis was noted in two cases in the βCalypsoβ group (0.49%), in one case the cause of thrombosis turned out to be incomplete stent expansion after implantation.Conclusion. βCalypsoβ sirolimus eluting stent was not inferior to βXiencePrimeβ everolimus-eluting stent in treating patients with coronary heart disease.Received 7 November 2017. Revised 13 November 2017. Accepted 20 November 2017.Funding: The study was funded by βAngioline Interventional Devicesβ (Novosibirsk, Russian Federation). The supporting source had no involvement in study design; collection, analysis and interpretation of data; writing of the report; and in the decision to submit the article for publication.Conflict of interest: The authors declare no conflict of interest.</p