Oncology disease in patients with acute myocardial infarction with nonobstructive coronary atherosclerosis

The aim of this study was to evaluate the cancer incidence among patients with myocardia

Catamnesis of children from mothers who had A(H1N1)pdm09 influenza during pregnancy

The aim of this study was to assess 5-years catamnesis of children from mothers who had A(H1N1)pdm09 influenza during pregnancy. The design of the research: cohort cross-sectional retrospective "case - control" study. The study group included 227 children of mothers who had A(H1N1)pdm09 influenza during pregnancy, and the control group was consisted of 227 children whose mothers didn't have A(H1N1)pdm09 influenza in epidemic period during pregnancy. It was shown that 11,9 % of children born to mothers with influenza infection during pregnancy vs 1,8 % of children of the control group to 5-year age formed a cohort of patients with recurrent respiratory tract infections (p < 0,001). Acute respiratory infections were complicated by pneumonia in 15,4 % of study group children vs 8,8 % of children in the comparison group (p = 0,044). We founded a significant association between maternity A(H1N1)pdm09 influenza during 1st and 2nd trimesters of gestation and increased frequency of asthma in their children

Oncology disease in patients with acute myocardial infarction with nonobstructive coronary atherosclerosis

The aim of this study was to evaluate the cancer incidence among patients with myocardia

Hemostatic gene polymorphisms in acute coronary syndrome with nonobstructive coronary atherosclerosis

The aim of the study was to investigate the prevalence of 8 haemostatic gene polymorphisms associated with thrombophilia in patients with acute coronary syndrome (ACS) with nonobstructive coronary atherosclerosis (NOCA). Material and methods: Investigation is nonrandomized, open, controlled: NCT02655718. We present the results of patients admitted to the emergency department of cardiology due to ACS in 2015-2016. Inclusion criteria comprised NOCA (normal coronary arteries/plaques A), F5 (1691 G> A), F7 (10976G> A), F13 163 G> T), F1 (-455G> A), GP Ia-IIa (807C> T), GP IIb-IIIa (1565 T> C), PAI-I (-675 5G> 4G).The genotypes were determined by polymerase chain reaction methods. Results: Among 913 patients who were hospitalized with ACS, 44 (4.8%) had NOCA. Including 19 men (66%) and 25 (57%) women, the average age of patients was 54 ± 11 years. Among 29 patients in 28 (96.6%) individuals with NOCA had at least one homozygous or heterozygous for unfavorable alleles genotype of haemostatic system. The homozygous genotype for adverse allelic variants was registered in 13 (44.8%) patients by polymorphic variants of the following genes: FXIII, GP Ia-IIa, GP IIb-IIIa, PAI-1, including 2 unfavorable homozygous genotype for variants of GP IIb-IIIa and PAI-1 genes. One patient (3.4%) had unfavorable heterozygous genotypes according to 5 studied variants predisposing to the development of thrombophilia; seven (24.1%) have heterozygous genotypes of 4 SNP, ten (34.5%) have heterozygous genotypes of 3 SNP, seven (24.1%) have 2 SNPs, two (6.9%) - 2 SNP each; Only two (6.9%) individuals did not have adverse alleles in the heterozygous state. The frequency of registration of homozygous genotypes for alleles predisposing to thromboses for all the studied polymorphic variants in the survey sample is within the limits shown for the european population, and the frequency of heterozygotes registration for variants of the FV, FVII, FXIII, FI gene, it exceeds estimates of heterozygotes prevalence in european population. Conclusion: The proportion of patients with NOCA among patients with ACS in 2015-2016 was 4.8%. The prevalence of adverse allelic variants of clotting factor genes associated with risk of thrombophilia in patients with ACS and NOCA was 96.6

Folate metabolism gene polymorphisms in patients with acute coronary syndrome with nonobstructive coronary atherosclerosis

The aim of the study was to investigate the frequency of unfavorable allelic variants of the genes associated with risk of thrombophilia of folate metabolism gene in patients with ACS in NOCA

Unfavorable variants of folate metabolism genes in patients with acute coronary syndrome in non-obstructive coronary atherosclerosis

Aim. To study the occurrence of allelic variants of folate cycle enzymes’ genes, which are unfavorable with respect to the risk of thrombophilia, to analyze the serum level of homocysteine, and to assess their impact on the development of acute coronary syndrome (ACS) in non-obstructive coronary atherosclerosis (NOCA). Material and methods. The material for the study was the results of a non- randomized, open, controlled conduct research, NCT02655718' conducted in 2015-2016 in the emergency cardiology department. The sampling included patients older than 18 years with ACS and NOCA, confirmed by invasive coronary angiography (ICAG). Patients who had previously undergone coronary artery revascularization were excluded from the study. We analyzed four polymorphic genotypes of folate cycle enzyme genes of included patients: methylene-tetra- hydro-folate-reductase MTHFR (677 C&gt;T, 1298 A&gt;C), methionine synthetase MTR (2756 A&gt;G), methionine synthetase reductase MTRR (66 A&gt;G). Determination of genotypes was performed using the methods of polymerase chain reaction and the use of a set of reagents produced by OOO “DNK-Tekhnologiya”. The level of homocysteine was determined by the enzyme immunoenzyme technique using Axis (UK) set of instruments for diagnosis and standards methods.Results. In 2015-2016 913 patients with ACS were hospitalized in emergency cardiology department; 44 (4.8%) were patients with NOKA. The mean age was 54±11 years (68% men). Mean level of homocysteine in the examined patients was 12,2 (10,8; 13,6) umol/l, in men — 12,4 umol/l (11,5; 13,6), in women — 11,3 umol/l (9,5; 13,2). Hyperhomocisteinemia (HHC) was registered in 8 (18%) individuals. The median level of homocysteine in patients with HHC was 22,8 (17,2; 25). An increase in the ultra-sensitive C-reactive protein and diagnosing of acute myocardial infarction (AMI) were more common in patients with HHC. The level of homocysteine did not differ in patients with various degrees of coronary artery stenosis; it was associated with age, hereditary background, smoking and the carriage of an unfavorable homozygous polymorphic variant of the TT genotype MTHFR gene (677 C&gt;T). The carriage of the unfavorable TT genotype MTHFR (677 C&gt;T) was statistically significantly more common in patients with AMI. The carriage of unfavorable homo- and heterozygous genotypes of the MTHFR gene (677 C&gt;T) in the group without HHC was also detected. The ancestral allele C of the rs1801133 gene was statistically significantly more common in intact coronary arteries. Conclusion. In this study 96,6% of patients with ACS and NOCA were carriers of unfavorable polymorphic variants of folate metabolism genes. The carriage frequency of unfavorable T allele of rs1801133 gene is statistically significantly more common in patients with AMI. The presence of this genotype is associated with the development of HHC, which is equivalent of literature data. However, the presence of the allelic variant of TT MTHFR (677 C&gt;T) did not always lead to the development of HHC. An increase in plasma homocysteine levels is directly proportional to age, hereditary background, smoking, and carriage of the TT rs1801133 genotype. It is also associated with an increased risk of AMI, which confirms previous studies

CASE OF PSEUDOCORONARY PRESENTATION OF MYOCARDITIS WITH ST SEGMENT ELEVATION

Clinical case demonstrates the necessity for multimodal visualization of the heart in differential diagnostics of acute coronary syndrome with ST elevation in patients with non-obstruction coronary heart disease. This made possible to be sure on the diagnosis of pseudocoronary variant of myocarditis, to prescribe etiotropic and pathogenetic treatment. On-time diagnostics of alternative causes of chest pain may help to avoid unnecessary treatments related to acute myocardial infarction

CARDIAC MAGNETIC RESONANCE IMAGING IN DIFFERENTIAL DIAGNOSTICS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH NON-OBSTRUCTION CORONARY ATHEROSCLEROSIS

Aim. To investigate on the nosological structure of acute coronary syndrome (ACS) in patients with non-obstruction coronary atherosclerosis (NOCA) before and after magnetic resonance imaging (MRI) of the heart.Material and methods. A non-randomized, open, controlled study (NCT02655718). The patients included, with ACS, older than 18 y.o., with NOCA (intact coronary arteries or stenosis ≤50%) confirmed by invasive coronary arteriography (ICAG). Patients with previous revascularization were not included.Results. In the year 2016, to emergency cardiology department (ECD) 913 ACS patients admitted. In 44 (4,8%) the NOCA was found. Mean age 54±10,4 y.o., males 68%, and the groups with ACS with ST elevation (STEACS) and none (NSTEANS) were comparable by clinical and anamnestic parameters. Intact coronary arteries were visualized in 16 (53%), non-significant coronary atherosclerosis was diagnosed in 14 (32%), slower coronary flow — 22 (73%). By MRI with contrast, performed in 11±8 days (2-43 days) from ACS beginning, myocardial oedema was found in 18 (41%), hyperemia in 13 (30%) and fibrosis in 40 (91%); there were no changes in 1 patient.Nosological structure of ACS in NOCA after MRI has been represented: by acute myocardial infarction (MI) in 24 (55%) cases, unstable angina (UA) — in 6 (14%), pseudocoronary myocarditis in 10 (23%), acute aorta dissection in 1 (2%), posttraumatic atherosclerosis in 1 (2%), congenital valve defect in 1 (2%), manifested Wolf-Parkinson-White (WPW) — in 1 (2%). In-hospital mortality was 2%. In comparison of ACS before and post MRI there was significant increase number of patients with myocarditis, by 20%.Conclusion. The prevalence of ACS in NOCA is 4,8%, that is comparable to literature data. Patients with ACS and NOCA are heterogenic group with MI, UA, myocarditis, acute aorta dissection, posttraumatic atherosclerosis, congenital defects, WPW syndrome. In-hospital mortality was 2%. Comparing the structure of the diagnoses before and after MRI, there was significant increase of myocarditis patients number. A high accuracy of MRI was found for differential diagnostics of ACS in NOCA, which was 78%