Stable angina with intermedium coronary artery stenosis: the most typical clinical phenotypes

Aim of the study was to investigate the most typical phenotypes and to study cardiovascular risk factors and assess of the clinical angiographic picture in stable angina patients with intermedium coronary artery stenosis. Material and methods. 236 stable angina functional class I–III patients (190 men) aged 49–59 with intermedium (40–70 %) coronary artery stenosis were examined. A general clinical examination, ultrasound examination and coronary angiography were performed. Study design – non-randomized descriptive study of four parallel groups. Differences in the compared parameters were considered statistically significant at p < 0.05. Results. The prevailing phenotypes in stable angina patients with intermedium coronary artery stenosis turned out to be coronary artery disease (CAD) without a previous myocardial infarction (MI); CAD with previous MI less than a 6 months ago; CAD with metabolically unhealthy obesity phenotype (MUOP) without diabetes mellitus (DM), and CAD with DM type 2. Patients of different phenotypes did not significantly differ in the frequency of past MI. CAD and MUOP patients with previous MI were characterized by the earliest age of its occurrence. Despite the 100 % availability of hypertension in different phenotypes groups, in CAD and DM type 2 patients were largest left ventricle myocardium mass values. They also had the most frequently recorded multivessel lesion during the coronary angiography study. Despite ongoing outpatient treatment for one year, the values of lipid and inflammation indices (content of low-density cholesterol, triglyceride, C-reactive protein) were high in all phenotypes patients as well as number of people with insufficient blood pressure control. Conclusions. In stable angina patients with intermedium coronary artery stenosis despite the absence of obstructive coronary artery lesion, the cardiovascular complications risk is due to the presence of 100 % arterial hypertension, high body mass index, significant frequency of obesity, dyslipidemia, carbohydrates metabolism disorders. That is why such patients represent a rather serious group in terms of prognosis. The clinical and angiographic picture, as well as residual risk levels, vary depending on the clinical phenotype

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Features of genetic manifestations in patients with abdominal obesity during atrial fibrillation in combination with arterial hypertension

Aim. To study the significance of the rs1378942 polymorphisms of the CSK gene and rs2200733 (chromosome 4q25) in the progression of AF in men with AH and AO. Materials and methods. In an observational cohort study, 116 men aged 4565 years were followed. Of these, 57 patients with AF, AH and AO and a control group including 59 patients with AF, AH and without AO. Testing of polymorphism rs1378942 of the CSK gene and rs2200733 of chromosome 4q25 using polymerase chain reaction with restriction fragment length polymorphism. All statistical calculations were performed using the Rstudio program (version 0.99.879 20092016 RStudio, Inc., USA). Results. The average age of all studied patients was 53.37.1 years. When dividing patients with AF and AH into groups based on the presence/absence of AO, it turned out that in the subgroups of carriers of different genotypes of the rs1378942 polymorphism of the CSK gene there are significant differences in BMI: in the group with BMI, there is an increase in the indicator in the series of CC, AC, AA genotypes. The highest BMI value in carriers of the CC genotype (p0.03) was in the group with AO. In the subgroups of carriers of different rs2200733 genotypes of chromosome 4q25, CC has the highest BMI (p0.05). It was proved that in the group with AO, the progression of AF occurred 2.57 times more often than in the group without AO (p0.003). Conclusion. In men with AF and AH, single nucleotide polymorphisms rs1378942 of the CSK gene and rs2200733 of chromosome 4q25 are associated with BMI. The heterozygous genotype AC rs1378942 in the CSK gene is significantly more common in patients, regardless of the presence of AO. In the group with AO, the progression of AF occurred 2.57 times more often than in the group without AO