Unresolved issues of increasing physical activity after myocardial infarction

The review presents the results of studies on the problems of increasing the efficiency of rational  physical  activity  within the concept of comprehensive secondary  prevention of myocardial  infarction. The aspects of insufficient adherence of specialists and patients to rehabilitation methods were discussed; possible safe exercise modes after infarction and available monitoring methods were given. We also described the potential characteristics of physical training, taking into account the initial clinical severity  and completeness of revascularization after myocardial infarction. In addition, the need for socio-economic,  as well as informational support of the state and healthcare system has been updated

An analytical program for fermion pair production in e+e- annihilation

We describe how to use {\tt ZFITTER}, a program based on a semi-analytical approach to fermion pair production in e^+ e^- annihilation and Bhabha scattering. A flexible treatment of complete {\cal O}(\alpha) QED corrections, also including higher orders, allows for three calculational {\bf chains} with different realistic sets of restrictions in the photon phase space. {\tt ZFITTER} consists of several {\bf branches} with varying assumptions on the underlying hard scattering process. One includes complete {\cal O}(\alpha) weak loop corrections with a resummation of leading higher-order terms. Alternatively, an ansatz inspired from S-matrix theory, or several model-independent effective Born cross sections may be convoluted. The program calculates cross sections, forward-backward asymmetries, and for \tau~pair production also the final-state polarization. Various {\bf interfaces} allow fits to be performed with different sets of free parameters

DEVELOPING MEAT PRODUCTIVITY IN BULL CALVES OF DIFFERENT DGAT1 GENOTYPES

The given research aims to study the way meat productivity in special-purpose beef bull calves of different DGAT1 genotypes is developed. The scientific novelty of the research lies in the fact that an assessment of the meat productivity of Hereford and Limousin bulls of different DGAT1 genotypes was conducted for the first time. Calves were cultivated using elements of resource-saving technology. The research subject was Hereford male young stock (91 heads) and Limousin bull calves (109 heads), which were genotyped by SNP DGAT1-K232A. Live weight, average daily gains, and body size and conformation indices were analyzed. Hematological values and carcass quality of bull calves of different genotypes were studied. As a result of genotyping, young animals of both breeds had a similar distribution of genotypes (DGAT1KK>DGAT1KA>DGAT1AA) and alleles (DGAT1K>DGAT1A). There was no effect of the studied gene polymorphism on growth, body development, and hematological parameters, as bull calves of different DGAT1 genotypes did not show a significant difference between weight and linear growth, blood morphological parameters, the content of protein, and its fractions. SNP DGAT1-K232A was found to affect fat deposition. Thus, carcasses of both studied breeds of DGAT1K genotype had a significantly higher content of internal raw fat, and fat yield was (P<0.05) than carcasses of DGAT1AA genotype bull calves. Therefore, genotyping by SNP DGAT1-K232A can be used in the selection of special-purpose beef cattle as an additional criterion to produce meat of a higher energy value

Risk factors for ischemic events in residents of Kemerovo and Kemerovo region at 3-year follow-up (results of the urban rural epidemiology study)

The aim of the study was to identify risk factors for ischemic events in residents of Kemerovo and Kemerovo region at 3-year follow-up. Material and methods. The study included participants (n = 638, ages 35 to 70 years), permanently residing in Kemerovo or the Kemerovo region of the prospective epidemiological study conducted at the Research Institute for Complex Issues of Cardiovascular Diseases from 2015 to 2020. The exclusion criteria were prior myocardial infarction (MI), angina pectoris and/or diagnosed peripheral artery disease. The main socio-economic and behavioral characteristic and health status of participants were determined by means of questionnaire, data of some participants were collected from medical records (case history, patient discharge summary, results of laboratory and instrumental examinations). Food Frequency Questionnaire was used to capture an individual`s usual food consumption. International Questionnaire on Physical Activity was used to measure health-related physical activity of participants. Data regarding the end points (all-cause death or death due to cardiovascular events, de novo angina, MI, stroke) were collected at 3-year follow-up. Results. Out of 638 participants, death was reported for 22 cases (of which 4 deaths were due to cardiovascular events), 6 developed non-fatal MI, 45 had de novo angina, and 12 had a non-fatal stroke at 3-year follow-up. A composite endpoint (CE) developed in 80 study participants during 3 years of follow-up. Logistic regression analysis revealed a significant association between CE and the following factors: obesity at the beginning of the study (odds ratio (OR) 2.09, 95 % confidence interval (95 % CI) 1.03–4.26) (an adjusted OR (AOR) 2.17, 95 % CI 1.06–4.44)), regular (at least once a month) alcohol consumption at the time of the survey (OR 2.33, 95 % CI 1.23–4.42 (AOR 2.29, 95 % CI 1.21–4.34)), participants stating that they have been thinking about death during previous month (OR 3.22, 95 % CI 1.54–6.76 (AOR 3.74, 95 % CI 1.73–8.07)). The following factors had the weakest association with the risk of ischemic events at 3-year follow-up: disability due to injury and occupational diseases (OR 0.19, 95 % CI 0.07–0.51 (AOR 0.21 (0.08–0.57)), taking medication for a month (OR 0.37, 95 % CI 0.17–0.81 (AOR 0.36, 95 % CI 0.16–0.80)), in particular, antihypertensive drugs (OR 0.43, 95 % CI 0.22–0.81 (AOR 0.43, 95 % CI 0.22–0.82)) and lipid-lowering drugs as a part of primary prevention (OR 0.33, 95 % CI 0.15–0.70 (AOR 0.33, 95 % CI 0.15–0.73)). Moreover, low physical activity associated with the use of transport in daily travels (car, bicycle) proved to be conditionally protective in relation to CE (OR 0.48, 95 % CI 0.25–0.94) (AOR 0.49, 95 % CI 0.25–0.96)). Conclusions. The identification of a number of significant «non-conventional» risk factors for development of ischemic events in residents of Kemerovo and Kemerovo region without prior atherosclerotic cardiovascular diseases at 3-year follow-up allows to consider them as additional modifiable risk factors within the framework of primary prevention

Three Year Prognosis of Patients with Myocardial Infarction Depending on the Body Weight Index: Data of the Kemerovo Acute Coronary Syndrome Registry

Aim. To study the effect of body mass index (BMI) on the 3-year prognosis of patients after myocardial infarction (MI).Material and methods. The study is based on data from a 3-year observation of patients with MI from the Kemerovo registry of acute coronary syndrome (n=1366). The characteristics of patients with MI, distributed by the BMI, were determined, the outcomes were analyzed, the risk factors and predictors for the vascular events and mortality were identified.Results. Obesity was detected in 32.2% people with MI (I degree – 22.3%; II – 7.7%; III – 2.3%), lack of BMI at 0.5%, normal BMI at 20.5%, overweight at 46.9%. Patients with different BMI showed a comparable incidence of recurring MI. In patients with normal BMI, when compared with patients with obesity, unstable angina pectoris (UA), heart failure (HF) and strokes developed often. In patients with normal BMI compared with obese patients, fewer deaths from all causes were recorded within 3 years after MI. A similar pattern with respect to the group with normal BMI in terms of high overall mortality was obtained among patients with overweight who had a lower UA. Patients with obesity was favorable in relation to the development of HF, strokes and overall mortality than patients with overweight. Differences in the 3-year outcomes in the group of patients with MI and underweight were not found when compared with patients with normal and overweight, however, they had a higher of strokes compared with patients with obesity. At patients with I degree obesity within 3 years after MI UA, HF, strokes were less. Patients with III degree obesity, the maximum frequency of total mortality was recorded. The development of death from all causes during the observation period in patients with MI and obesity was associated with: male, smoking, multivessel arterial diseases, non-endovascular reperfusion, acute HF with MI, history of vascular events and angina pectoris; whereas with overweight: multifocal atherosclerosis and arterial hypertension; with a deficit of BMI: non-reperfusion; with normal BMI: heredity for cardiovascular diseases, dyslipidemia and atrial fibrillation.Conclusion. 3 years after MI patients with obesity of the I degree are less likely than patients with obesity of II-III deaths from all causes are recorded; these patients are less likely than patients with normal weight to develop strokes, HF, UA. Thus, patients with MI and the presence of I degree obesity are characterized by better survival during 3 years of observation

Intensification of lipid-lowering therapy in very high-risk patients: potential of combination with PCSK9 inhibitors

Aim. To assess the efficacy and safety of 6-month combined lipid-lowering therapy with a PCSK9 inhibitor in patients with very high cardiovascular risk (CVR).Material and methods. This prospective, open-label, single-center exploratory research study with active treatment included 5 outpatients with very high CVR. So, 80% of patients had prior coronary artery disease, 20% peripheral arterial disease, and 60% old myocardial infarction. The key inclusion criterion was the failure to achieve the target low-density lipoprotein cholesterol (LDL-C) &lt;1,4 mmol/l with high-intensity statin monotherapy at the maximal tolerated doses or combination therapy with ezetimibe. On a regular basis, all included patients took atorvastatin 40-80 mg/day or rosuvastatin 20-40 mg/day, or pitavastatin 2-4 mg/day. In addition, 2 patients received a statin in combination with ezetimibe 10 mg/day. Patients were followed up for 6 months as follows: every 2 weeks, with a lipid profile monitoring, subcutaneous injections of alirocumab at a dose of 150 mg/ml were performed. Additionally, clinical and laboratory indicators of the safety of therapy were evaluated.Results. After 6 months, with the combined lipid-lowering therapy with alirocumab, a decrease in median LDL-C from 4,3 (4,11-4,67) to 1,27 (1,06-1,47) (p=0,001) mmol/l, total cholesterol from 6,1 (6-7) to 3,7 (3,5-3,9) (p=0,018) mmol/l, atherogenic index from 3,2 (3-3,26) to 0,8% (0,8-1,5) (p=0,001). There was no significant decrease in median triglycerides and an increase in median high-density lipoprotein cholesterol. Six-month lipid-lowering therapy with a PCSK9 inhibitor had no adverse events and made it possible to achieve a maximum decrease in LDL-C by an average of 75,4% already by 4 months of treatment in actual clinical practice.Conclusion. Six-month combined lipid-lowering therapy with alirocumab 150 mg subcutaneously every 2 weeks in very high-risk patients allows the majority of patients to achieve target LDL-C values

QED corrections with partial angular integration to fermion pair production in e+e- - annihilation

Analytic formulae are derived for the complete photon energy spectrum due to QED corrections to fermion pair production in case of a limited angular acceptance for the final state fermions. After a numerical integration over the energy of non-observed photons, this corresponds to typical experimental conditions at LEP/SLC.Comment: 8 pages, Latex, text is unchanged compared to preprint and Journal-re

Clinical and biochemical markers of coronary artery calcification progression after elective coronary artery bypass grafting

Aim. To assess the relationship of various clinical and biological markers of bone metabolism with the progression of coronary artery calcification (CAC) in patients with stable coronary artery disease (CAD) within 5 years after coronary artery bypass grafting (CABG).Material and methods. This single-center prospective observational study included 111 men with CAD who were hospitalized for elective CABG. In the preoperative period, all patients underwent duplex ultrasound of extracranial arteries (ECA) and multislice computed tomography (MSCT) to assess CAC severity using the Agatston score, as well as densitometry with determination of bone mineral density in the femoral neck, lumbar spine and T-score for them, In all participants, the following bone metabolism biomarkers were studied: calcium, phosphorus, calcitonin, osteopontin, osteocalcin, osteoprotegerin (OPG), alkaline phosphatase, parathyroid hormone. Five years after CABG, ECA duplex ultrasound, MSCT coronary angiography and bone metabolism tests were repeated. Depending on CAC progression (&gt;100 Agatston units (AU)), patients were divided into two groups to identify significant biomarkers and clinical risk factors associated with CAC progression.Results. For 5 years after CABG, contact with 16 (14,4%) patients was not possible; however, their vital status was assessed (they were alive). Death was recorded in 4 (3,6%) cases (3 — due to myocardial infarction, 1 — due to stroke). In 18 (19,7%) cases, non-fatal endpoints were revealed: angina recurrence after CABG — 16 patients, myocardial infarction — 1 patient, emergency stenting for unstable angina — 1 patient. There were no differences in the incidence of events between the groups with and without CAC progression. According to MSCT 5 years after CABG (n=91 (81,9%)), CAC progression was detected in 60 (65,9%) patients. Multivariate analysis allowed to create a model for predicting the risk of CAC progression, which included following parameters: cathepsin K &lt;16,75 pmol/L (p=0,003) and bone mineral density &lt;0,95 g/cm3 according to femoral neck densitometry before CABG (p=0,016); OPG &lt;3,58 pg/ml (p=0,016) in the postoperative period 5 years after CABG.Conclusion. Within 5 years after CABG, 65,9% of male patients with stable coronary artery disease have CAC progression, the main predictors of which are low preoperative cathepsin K level (&lt;16,75 pmol/L) and low bone mineral density (&lt;0,95 g/cm3) according to femoral neck densitometry, as well as a low OPG level (&lt;3,58 pg/ml) 5 years after CABG