Parameters of complete blood count, lipid profile and their ratios in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Aim. To evaluate the predictive potential of the parameters of complete blood count (CBC), lipid profile and their ratios for predicting obstructive coronary artery disease (oCAD) in patients with non-ST elevation acute coronary syndrome (NSTEACS).Material and methods. The study included 600 patients with NSTE-ACS with a median age of 62 years who underwent invasive coronary angiography (CA). Two groups were formed, the first of which consisted of 360 (60%) patients with oCAD (stenosis ≥50%), and the second — 240 (40%) with coronary stenosis <50%. The clinical and functional status of patients before CAG was assessed by 33 parameters, including parameters of CBC, lipid profile and their ratio. For statistical processing and data analysis, the Mann-Whitney, Fisher, chi-squared tests, univariate logistic regression (LR) were used, while for the creation of predictive models, multivariate LR (MLR) was used. The quality was assessed by 4 metrics: area under the ROC curve (AUC), sensitivity (Se), specificity (Sp), and accuracy (Ac).Results. CBC and lipid profile analysis made it possible to identify factors that are linearly and non-linearly associated with oCAD. Univariate LR revealed their threshold values with the highest predictive potential. The quality metrics of the best prognostic model developed using MLR were as follows: AUC — 0,80, Sp — 0,79, Ac — 0,76, Se — 0,78. Its predictors were 8 following categorical parameters: age >55 years in men and >65 years in women, lymphocyte count (LYM) <19%, hematocrit >49%, immune-inflammation index >1000, high density lipoprotein cholesterol (HDL-C) to low density lipoprotein cholesterol (LDL-C) ratio <0,3, monocyte (MON)-to-HDL-C ratio >0,8, neutrophil (NEUT)-to-HDL-C ratio >5,7 and NEUT/LYM >3. The relative contribution of individual predictors to the development of end point was determined.Conclusion. The predictive algorithm (model 9), developed on the basis of MLR, showed a better quality metrics ratio than other models. The following 3 factors had the dominant influence on the oCAD risk: HDL-C/LDL-C (38%), age of patients (31%), and MON/HDL-C (14%). The influence of other factors on the oCAD risk was less noticeable

Electrocardiographic, echocardiographic and lipid parameters in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Aim. To assess the predictive potential of electrocardiographic (ECG), echocardiographic, and lipid parameters for predicting obstructive coronary artery disease (oCAD) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) prior to invasive coronary angiography (CA).Material and methods. This prospective observational cohort study included 525 patients with NSTE-ACS with a median age of 62 years who underwent invasive coronary angiography. Two groups were distinguished, the first of which consisted of 351 (67%) patients with oCAD (stenosis 50%), and the second — 174 (33%) without oCAD (<50%). Clinical and functional status of patients before CAG was assessed by 40 indicators. Mann-Whitney, Fisher, chi-squared, univariate logistic regression (LR) methods were used for data processing and analysis, while miltivariate LR (MLR), gradient boosting (XGBoost) and artificial neural networks (ANN) were used to develop predictive models. The quality of the models was assessed using 4 following metrics: area under the ROC curve (AUC), sensitivity (Se), specificity (Sp), and accuracy (Ac).Results. A comprehensive analysis of ECG, echocardiography and lipid profile parameters made it possible to identify factors that had linear and non-linear association with oCAD. LR were used to determine their weight coefficients and threshold values with the highest predictive potential. The quality metrics of the best predictive algorithm based on MLR were 0,81 for AUC, 0,74 for Sp and Ac, and 0,75 for Se. The predictors of this model were 4 categorical parameters (left ventricular (LV) ejection fraction of 42-60%, global LV longitudinal systolic strain <19%, low-density lipoprotein cholesterol >3,5 mmol/l, age >55 years in men and >65 years for women).Conclusion. The prognostic model developed on the basis of MLR made it possible to verify oCAD with high accuracy in patients with NSTE-ACS before invasive CA. Models based on XGBoost and ANN had less predictive value

Intracardiac and pulmonary hemodynamics and arterial blood gases in patients with chronic stable angina pectoris associated with chronic obstructive pulmonary disease

Aim. To study intracardiac and pulmonary hemodynamics and arterial blood gases in patients with chronic stable angina pectoris associated with chronic obstructive pulmonary disease (COPD). Material and methods. The study included 103 patients: 49 people with Functional Class II chronic stable angina pectoris and COPD, plus 54 individuals with COPD only. Arterial blood gases, left and right ventricular (LV, RV) diastolic function (echocardiography with colour Doppler ultrasound), and right heart pressure levels (right heart and pulmonary artery (PA) catheterisation) were assessed. Results. The patients with chronic stable angina pectoris associated with COPD were characterised by progressing RV and LV diastolic dysfunction. In contrast to patients with isolated COPD, RV diastolic dysfunction was more pronounced in participants with combined pathology. In both groups, pulmonary hemodynamics was characterised by equivalent increases in systolic, diastolic, and mean PA pressure (Stage I). The manifestations of this increase were determined by the COPD stage. Conclusion. Combined cardio-respiratory pathology was characterised by progressing RV andLV diastolic dysfunction. In both groups, the factors with the strongest correlation with pulmonary hypertension included arterial hypoxemia, hypercapnia, and RV diastolic dysfunction

ESTIMATION OF TOXIC EFFECTS OF MEDICINAL PREPARATION OF CABAZITAXEL

A study of the toxic properties of the drug cabazitaxel was carried out on outbred rats with intravenous administration. The toxicity was assessed with a single and repeated weekly administration of the drug. It was noted that the toxic and lethal effects were delayed. In an acute experiment, the mean lethal dose was calculated, which for animals of both sexes was 4.2 mg/kg. With repeated administration, the maximum tolerated dose was 1.5 mg/kg, lethal - 2.5 mg/kg. The clinical picture of intoxication was characterized by depressed behavior, decreased response to external stimuli and tonus of skeletal muscles, tachypnea and diarrhea. A decrease in feed intake and body weight of animals was detected. Target organs of toxic effect of cabazitaxel: gastrointestinal tract, liver, bone marrow, reproductive system of male rats