CLINICAL IMPLICATIONS OF NT PROBNP LEVEL IN PATIENTS WITH MYOCARDIAL INFARCTION COMPLICATED BY ATRIAL FIBRILLATION

Our aim was to study the predictive value of NT proBNP regarding the risk of AF and clinical features in acute phase of ST-segment elevation MI (STEMI). Methods. We examined 56 patients with STEMI and AF who did undergo the primary PCI. 35 (62.5 %) of patients had the new-onset AF (group 1), 21 (37.5 %) had pre-existing AF (group 2). Control group consisted of 60 patients with STEMI without AF (group 3). Results. Group 3 patients were more likely to be smokers than patients in group 2. They had lower admission heart rate and glycemia, lower NT proBNP, higher hemoglobin and ejection fraction. Patients in group 1 were more likely to have anterior MI, left anterior descending artery as an infarction-related artery (IRA) and adverse cardiac events (MACEs). Patients in group 2 had higher left atrium end-systolic diameter and were more likely to have three-vessel injury. NT proBNP correlated positively with age, admission glycemia, mean PA pressure and negatively – with GFR. ROC analysis had shown the cut-off point of NT proBNP level for prediction of AF was >1050 pg/ml. Cut-off point for prediction of the risk of MACE in STEMI complicated with AF was >2189 pg/ml. Discussion. It was shown that NT proBNP is higher in STEMI patients who have AF. Increased NT proBNP is associated with the risk of adverse events in acute STEMI phase. NT proBNP level can be utilized as AF predictor in STEMI patients and as predictor of MACEs in patients with STEMI and AF

ВПРОВАДЖЕННЯ ОЧИСНОЇ УСТАНОВКИ ДЛЯ ТЕРМІЧНОЇ ДЕМЕРКУРІЗАЦІЇ

There are currently ways and means demercurization have significant drawbacks, not safe and effective. The analysis of the dynamics of the production of non-radioactive waste at the South Ukrainian nuclear power plant for the 2013-2015 biennium. Proposed to establish production facilities in South Ukrainian nuclear power plant in order to reduce the volume of waste hazard class I, because of mercury used fluorescent lamps, sewage treatment plants for thermal demercurization. Also calculated environmental and economic benefits in the process of implementing the installation for thermal demercurization.Известные  способы и средства демеркуризации имеют значительные недостатки, недостаточно безопасны и эффективны. Выполнен анализ динамики производства нерадиоактивных отходов на Южно-Украинской АЭС в 2013-2015 гг. В целях уменьшения объема образования отходов I класса опасности, в результате использованных ртутных люминесцентных ламп, предложено установить в производственных помещениях ЮУАЭС очистительную установку для термической демеркуризации. Также, в процессе работы рассчитан эколого-экономический эффект от внедрения установки для термической демеркуризации.Відомі на сьогодні способи та засоби демеркуризації мають значні недоліки, недостатньо безпечні та ефективні. Виконано аналіз динаміки виробництва нерадіоактивних відходів на Южно-Українській АЕС за 2013-2015 рр. В цілях зменшення обсягу утворення відходів I класу небезпеки, внаслідок  використаних ртутних люмінесцентних ламп, запропоновано встановити у виробничих приміщеннях ЮУАЕС очисну установку для термічної демеркуризації. Також, в процесі роботи розраховано еколого-економічний ефект від впровадження установки для термічної демеркуризації

Evinacumab for Homozygous Familial Hypercholesterolemia

BACKGROUND Homozygous familial hypercholesterolemia is characterized by premature cardiovascular disease caused by markedly elevated levels of low-density lipoprotein (LDL) cholesterol. This disorder is associated with genetic variants that result in virtually absent (null–null) or impaired (non-null) LDL-receptor activity. Loss-offunction variants in the gene encoding angiopoietin-like 3 (ANGPTL3) are associated with hypolipidemia and protection against atherosclerotic cardiovascular disease. Evinacumab, a monoclonal antibody against ANGPTL3, has shown potential benefit in patients with homozygous familial hypercholesterolemia. METHODS In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned in a 2:1 ratio 65 patients with homozygous familial hypercholesterolemia who were receiving stable lipid-lowering therapy to receive an intravenous infusion of evinacumab (at a dose of 15 mg per kilogram of body weight) every 4 weeks or placebo. The primary outcome was the percent change from baseline in the LDL cholesterol level at week 24. RESULTS The mean baseline LDL cholesterol level in the two groups was 255.1 mg per deciliter, despite the receipt of maximum doses of background lipid-lowering therapy. At week 24, patients in the evinacumab group had a relative reduction from baseline in the LDL cholesterol level of 47.1%, as compared with an increase of 1.9% in the placebo group, for a between-group least-squares mean difference of –49.0 percentage points (95% confidence interval [CI], –65.0 to –33.1; P 0.001); the between-group least-squares mean absolute difference in the LDL cholesterol level was –132.1 mg per deciliter (95% CI, –175.3 to –88.9; P 0.001). The LDL cholesterol level was lower in the evinacumab group than in the placebo group in patients with null–null variants (–43.4% vs. +16.2%) and in those with non-null variants (–49.1% vs. –3.8%). Adverse events were similar in the two groups. CONCLUSIONS In patients with homozygous familial hypercholesterolemia receiving maximum doses of lipid-lowering therapy, the reduction from baseline in the LDL cholesterol level in the evinacumab group, as compared with the small increase in the placebo group, resulted in a between-group difference of 49.0 percentage points at 24 weeks. (Funded by Regeneron Pharmaceuticals; ELIPSE HoFH ClinicalTrials.gov number, NCT03399786.