Aim. To evaluate the quality of drug treatment of patients with cardiovascular diseases (CVD) at the remote stage of follow-up after hospitalization for new coronavirus infection (COronaVIrus Disease 2019, COVID-19) within the framework of the prospective TARGET-VIP registry.Material and methods. 1,130 people were included in the registry. The 473 (54.8%) patients with CVD were selected of the 863 patients discharged from the hospital with a diagnosis of COVID-19.Results. The frequency of proper prescriptions of medicines upon discharge from the hospital was 60%, after 3 years this indicator decreased to 41.4% (p<0.001). During the 3-year follow-up, a clear trend was recorded in a decrease in the frequency of intake of all drugs, while for some groups of drugs this decrease reached statistically significant differences. The frequency of taking angiotensin converting enzyme inhibitors in patients with cerebral stroke, statins in coronary heart disease and statins in patients with cerebral stroke MI did not change significantly, although the frequency of taking these drugs at all stages of follow-up was very low and did not exceed a third of the required prescriptions. New CVD were detected in 51 patients, and the average frequency of taking proper medications for CVD was higher than in patients with already known stable CVD, 74.2% and 66.2%, respectively, p=0.047. The presence of CVD did not affect the quality of therapy in the new cases of CVD, the average frequency of taking the necessary drugs in these groups was 77.8 and 63.2%, respectively, p=0.074.Conclusion. The quality of CVD therapy was insufficient at all stages of long-term follow-up: the frequency of proper prescriptions upon discharge from the hospital was 60%, after 3 years this indicator decreased to 41.4%. A clear trend was revealed in a decrease in the frequency of taking all drugs, while for some groups of drugs this decrease reached statistically significant differences. The quality of cardiovascular pharmacotherapy was higher with the appearance / development of new CVD in comparison with the group of stable patients with CVD, there was no significant improvement in the quality of therapy for previously observed CVD.

Aim. To study the long-term prognosis of patients’ life who have suffered cerebrovascular accident (CVA), and to determine the role of diabetes mellitus (DM) as a possible negative prognostic factor, according to the outpatient follow-up stage in the REGION-M registry.Material and methods. The outpatient part of the REGION-M registry included 684 patients assigned to the Moscow City Polyclinic No. 64, discharged from the hospital in the period from 01.01.2012 to 30.04.2017 with a confirmed diagnosis of CVA, of which 122 patients (17.8%) were diagnosed with DM. The polyclinic stage included three observation points: 2017, 2020, and 2022. Data on the life status of all patients were obtained by telephone survey, if it was impossible to establish contact with the patient or his relatives, a unified medical information and analytical system was used to determine the life status of patients. The study patients were observed on an outpatient basis for more than 5 years (ME 1958 (751; 2555) days), the primary endpoint was death from any cause.Results. Information about the life status was obtained for all 684 patients. By the end of the observation, 415 cohort members had died, and 269 were alive. The average age of patients with DM was significantly higher than that of patients without DM: 71.5±10.9 years vs 68.0±14.7 years (p<0.05). The proportion of women in the cohort of DM patients was significantly higher than in the cohort of patients without DM: 72.1% vs 55.2% (p<0.05). Patients with DM were statistically significantly more likely to have a history of comorbid diseases (coronary heart disease, myocardial infarction, arterial hypertension, kidney disease and chronic lung disease, chronic heart failure). Obesity occurs with the same frequency in patients with and without DM. The studied groups of patients did not differ in types of CVA (transient ischemic attack, ischemic, hemorrhagic stroke). According to Cox Proportional Hazards Regression Analysis at the outpatient stage of follow-up, no significant negative effect of DM on patients’ mortality with CVA was confirmed (relative risk =1.239 (95% CI: 0.975; 1.574), p=0.079).Conclusion. In the long-term follow-up of patients with CVA, there was no statistically significant adverse effect of DM on long-term survival.

Aim. To estimate the detection rate of heart failure (HF), using various diagnosis criteria, among patients aftr 12 months after hospital treatment for coronavirus disease 2019 (COVID-19). Material and methods . The study included 185 patients from the TARGET-VIP registry who came for a visit 12 months after hospitalization for COVID-19. To identify HF with reduced (HFrEF) and mildly reduced (HFmrEF) ejection fraction (EF), the European Society of Cardiology (ESC) criteria (2016 and 2021) were used. To identify HF with preserved EF (HFpEF), we used the ESC criteria (2016 and 2021), as well as the 2018 Russian guidelines and H2FPEF score. Results. In the analyzed group, there were no patients with EF <40%, while one patient had EF of 48% and 184 patients — ≥50%. The patient with EF of 48% was not diagnosed with HF due to the absence of HF signs and symptoms. The presence of HFpEF was confirmed in 31,4% of patients according to 2018 Russian criteria and 2021 ESC criteria (first version of the diagnosis), in 12,5% according to the 2016 ESC criteria, 11% according to ESC 2021 criteria (second version of the diagnosis) and in 2,2% on the H2FPEF score. The proportion of HF diagnosed for the first time according to the 2016 ESC criteria was 78% of the total number of HF cases. Conclusion. Among the examined patients 12 months after hospital treatment for COVID-19, there were no cases of HFrEF and HFmrEF. The proportion of HFpEF cases, depending on the diagnostic criteria used, varied significantly from 2,2 to 31,4%. The previously established diagnosis of HF was confirmed in 83% of cases at a visit 12 months after discharge from the hospital. Using the 2016 ESC criteria and the corresponding 2020 Russian Society of Cardiology guidelines, the proportion of newly diagnosed HF was 78% of all patients.

Aim. To study the two-year survival rate of patients with various types of cerebrovascular accident according to the outpatient part of the REGION-M registry. Material and methods . The outpatient part of the REGION-M registry included 684 patients assigned to the City Polyclinic № 64, discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a confirmed diagnosis of stroke or transient ischemic attack (TIA). Of these, 514 (75,1%) patients had an ischemic stroke, 52 (7,6%) — a hemorrhagic stroke, and 118 (17,2%) — a TIA. Results. The lowest two-year mortality (11%) was observed in patients who underwent TIA (p<0,001) compared with ischemic and hemorrhagic stroke. The relative risk of death for ischemic stroke was 2,0 (95% confidence interval (CI): 1,13-3,55) (p<0,05), and for hemorrhagic stroke — 2,51 (95% CI: 1, 22-5,15) (p<0,05) relative to patients with TIA. Mortality in patients with ischemic or hemorrhagic stroke did not differ significantly — 32,3 and 36,6% (p>0,05). The mean age of patients who underwent TIA was significantly less than the age of patients with hemorrhagic or ischemic stroke. With increasing age, the survival of patients significantly worsened in all types of strokes. In addition, multivariate analysis adjusted for age showed remained significant effect of the stroke type on survival as follows: the relative risk of death for ischemic and hemorrhagic stroke was 1,99 (95% CI: 1,12-3,53) (p<0,05) and 2,45 (95% CI: 1,19-5,02) (p<0,05). Conclusion. Mortality in patients with stroke was significantly lower after TIA than in any type of stroke and did not differ between subgroups of patients with ischemic and hemorrhagic stroke.

Aim . To evaluate 24-month outcomes after hospital treatment of patients with coronavirus disease 2019 (COVID-19) in a prospective registry. Material and methods . Two-year outcomes (2,2±0,5) after hospital treatment for COVID-19 were analyzed in 802 patients (mean age, 59,8±14,5 years, men, 51,0%). We assessed cases of death, non-fatal myocardial infarction (MI) and stroke, revascularization operations, hospitalizations, recurrent COVID-19, vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results. During the follow-up period, 49 (5,9%) patients died, while 7 (0,8%) patients had MI, 7 (0,8%) — stroke. In addition, 222 (26,7%) patients were hospitalized, of which 26 (3,1%) for COVID-19. Recurrent COVID-19 were revealed in 146 (17,6%) patients, while 414 (49,6%) patients were vaccinated for SARS-CoV-2. The factors of age and stay in the intensive care unit were significantly associated (p<0,001) with the risk of all-cause death (hazard ratio (HR)=1,083 per 1 year of life and HR=6,28, respectively) and composite endpoint (death, non-fatal myocardial infarction, stroke, revascularization surgery): HR=1,057 and HR=3,28, respectively. Male sex was associated with the death risk (HR=2,50, p=0,003). Of the 49 deaths, 19 (38,8%) occurred in the first 3 months, and 35 (71,4%) in the first year of follow-up. A lower (1,8 times) incidence of new cases of cardiovascular (CVD) diseases and non- CVDs were associated with initial cardiovascular pathology. Hospitalization was associated with age (odds ratio (OR)=1,027; p<0,001) and CVDs (OR=1,66; p=0,01). The risk of recurrent COVID-19 was higher with CVDs (OR=1,55; p=0,03), lower — among those vaccinated for SARS-CoV-2 (OR=0,49; p<0,001). Conclusion. Over two-year follow-up of patients after hospital treatment for COVID-19, the proportion of deaths was 5,9%: >1/3 of deaths recorded in the first 3 months and >2/3 during the first year. Factors associated with death were age, male sex, and intensive care unit treatment during the hospitalization. The readmission rate was associated with older age and CVDs. The risk of repeated cases of COVID-19 was one and a half times higher in the presence of CVDs, but 2 times lower in those vaccinated for SARS-CoV-2 in the post- COVID-19 period.

Aim. To study the two-year survival rate of patients with cerebrovascular accident (CVA) in different age groups.Material and methods. The outpatient part of the REGION-M registry included 684 patients assigned to the City Polyclinic № 64 in Moscow, discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a confirmed diagnosis of stroke or transient ischemic attack. All patients were divided into 5 age groups: group 1 — from 18 to 50 years old (n=72 (10,5%)), group 2 — from 51 to 60 years old (n=122 (17,8%)), group 3 — from 61 to 70 years old (n=156 (22,8%)), group 4 — from 71 to 80 years old (n=185 (27,0%)) and group 5 — 81 years and above (n=149 (21,8%)). Patient survival was assessed after 2 years of follow-up.Results. The mortality rate of patients during the follow-up period significantly increased with age as follows: in patients of 18-50 years old — 4%, 51-60 years old — 9,8%, 61-70 years old — 23,7%, 71-80 years old — 34%, 81-100 years old — 55% (p<0,0001). The relative death risk was 2,3 in group 2 (NA), 6,8 in group 3 (p<0,001), 9,8 in group 4 (p<0,0001) and 18,5 in group 5 (p<0,0001) compared with group 1. With increasing age in the study cohort, the proportion of women increased as follows: from 47,2% in group 1 to 77,9% in group 5 (p<0,0001). However, mortality among men and women in the groups did not differ. Patients in older age groups were more likely to have comorbidities and disability before the CVA. With increasing age, ischemic stroke was significantly more common and transient ischemic attack was less common (p<0,001).Conclusion. Mortality of patients who underwent stroke was significantly higher in older age groups and did not differ among men and women.

Aim. To assess the survival rate of patients after cerebrovascular accident (CVA), depending on the visits to the local outpatient clinic and the type of medical supervision, and in the first year after hospital discharge. Material and methods . The outpatient part of the REGION-M registry included 684 patients assigned to the City Polyclinic № 64 of Moscow, discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a confirmed diagnosis of cerebral stroke/transient ischemic attack. Results. During the first year after the CVA, 451 (65,9%) patients visited the local clinic on their own (group 1), while 166 (24,3%) patients was consulted by house call (group 2), and 67 (9,8%) did not see the physician (group 3). Patients visited by house call were more likely to have prior coronary artery disease and stroke, and the age of men was older than in other groups. Patients who did not see a doctor were less likely to have comorbidities and disabilities, and were less likely to visit the clinic before stroke. The mortality of patients in group 3 was significantly higher throughout the entire follow-up period (55,2%, 70,1% and 77,6% at stages 1, 2 and 3 (p<0,001), respectively) than in group 2 (31,2%, 55,4% (p<0,001)) and group 1 (23,7%, 37,0% and 54,3% (p<0,001)). Mortality of patients in group 1 was lower than group 2 (p<0,05-0,01). The relative risk of death in clinic visitors was 0,450 (95% confidence interval (CI), 0,333-0,608, p<0,0001), while in those visited by a doctor at home — 0,668 (95% CI, 0,482-0,927, p<0,05). In multivariate analysis and adjustment for sex and age (relative risk (RR) of death, 0,08 (95% CI, 0,048-0,133), p<0,0001 and 1,036 (95% CI, 1,031-1,042), p<0,001, respectively), the independent contribution of the factor of clinic visits was preserved. Thus, the RR of death in visitors was 0,996 (95% CI, 0,994-0,999), p<0,001 and 0,998 (95% CI, 0,995-1,0), p<0,05. Conclusion. The lower mortality among those visited the local clinic in the first year after CVA and among those who were visited by a doctor at home, compared with patients who were not observed, confirms the important role of medical supervision in the post-hospital period.

Aim. To study the long-term survival of patients with cerebrovascular accident, depending on sex and age.Material and methods. The outpatient part of the REGION-M registry (patients with cerebrovascular accident, hospitalized in a Moscow hospital) included 684 patients assigned to the City Polyclinic № 64 (Moscow), discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a diagnosis of stroke, which were divided into 5 age groups: group 1 — ≤50 years, n=72 (10,5%), group 2 — 51-60 years old, n=122 (17,8%), group 3 — 61-70 years old, n=156 (22,8%), group 4 — 71-80 years old, n=185 (27,0%) and group 5 — ≥81 years old, n=149 (21,8%). The survival of patients was assessed at the 2nd and 3rd stages after 4,2 (2,4-5,6) and 5,5 (2,4-7,0) years.Results. The mortality of patients in the long-term follow-up period significantly increased with age. There were following mortality rate for stages 2 and 3 stages: 18-50 years old — 8,3 and 22,2%, 51-60 years old — 18 and 36,9%, 61-70 years old — 41 and 56,4%, 71-80 years old — 54,1 and 73%, >81 years — 76,5 and 87,9% (p<0,0001 for all groups). At stages 2 and 3, mortality among men was higher than among women in groups 2-4, below in group 1 and did not differ in the oldest age group. In multivariate analysis, the following factors had prognostic significance: age — hazard ratio (HR) of death, 1,035 (95% confidence interval (CI): 1,029-1,041, p=0,001), sex — HR, 0,720 (95% CI: 0,43-0,123, p=0,001) and disability before stroke — HR, 0,999 (95% CI: 0,998-1,000, p=0,002).Conclusion. In long-term follow-up, the mortality of patients with cerebrovascular accident was significantly higher in older age groups, as well as among men.

Aim. To evaluate the medical treatment of patients with cardiovascular disease (CVD) during the first year of follow-up after hospitalization for coronavirus disease 2019 (COVID-19) in a prospective registry. Material and methods. The material for the study was obtained from the database of the TARGET-VIP inhospital registry. The registry included 1130 people. Of 863 patients discharged from the hospital with a diagnosis of COVID-19, 473 (548%) patients with CVD were selected, and 31 (40,8%) patients were selected from 76 patients in whom the diagnosis of COVID-19 was not confirmed with CVD. Results. At the stage of discharge from the hospital, the quality of therapy for CVD was insufficient on average, the frequency of proper prescriptions was 59,5%. During the first year, there was a significant trend towards a decrease in the prevalence of antihypertensive therapy for hypertension (p=0,018), anticoagulants for atrial fibrillation (p<0,001) and an increase in prescribing angiotensinconverting enzyme inhibitors/angiotensin receptor blockers for heart failure (p=0,037). The average prevalence of prescribing proper cardiovascular pharmacotherapy after 30-60 days and 6 months of follow-up was significantly less than at discharge from the hospital. In both groups of patients, when comparing the average frequency of compliance with proper prescriptions at all follow-up periods, as well as when comparing these indicators between groups, no significant differences were found, with the exception of the stage of 30-60 days after discharge from the hospital (p=0,009). Conclusion. In the TARGET-VIP registry after discharge from the hospital, the prevalence of proper appointments for CVD was insufficient. During the first year of observation, patients with CVD showed a significant decrease in the frequency of proper prescription of antihypertensive therapy for hypertension and anticoagulants for atrial fibrillation. When comparing groups of patients with confirmed and non-confirmed COVID-19, a higher average rate of adherence to proper prescriptions was found in patients with confirmed COVID-19. However, significant differences were found only 30-60 days after discharge.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить двухлетнюю выживаемость больных, перенесших острое нарушение мозгового кровообращения (ОНМК) или транзиторную ишемическую атаку, в зависимости от наличия или отсутствия хронической сердечной недостаточности (ХСН) и выявить факторы, влияющие на уровень данного показателя. МАТЕРИАЛ И МЕТОДЫ В амбулаторную часть регистра РЕГИОН-М включены 684 пациента, прикрепленных к ГБУЗ «ГП №218 ДЗМ», выписанных из ГБУЗ Москвы «Городская клиническая больница им. Ф.И. Иноземцева Департамента здравоохранения Москвы» в период с 01.01.12 по 30.04.17 с подтвержденным диагнозом ОНМК (мозговой инсульт/транзиторная ишемическая атака). Из них 103 (15,1%) пациентам ранее установлен диагноз ХСН, о чем есть записи в амбулаторных картах. РЕЗУЛЬТАТЫ Пациенты с ХСН были статистически значимо старше, чаще болели артериальной гипертензией, ишемической болезнью сердца, имели в анамнезе перенесенный инфаркт миокарда, фибрилляцию предсердий, инсульт, сахарный диабет, заболевания легких, почек, анемию и инвалидность. Эти пациенты статистически значимо чаще находились под врачебным наблюдением в поликлинике в течение 12 мес после выписки из стационара (93,2%), чем пациенты без ХСН (82,6%), p<0,05. За 22 мес наблюдения не выявлены статистически значимые различия в уровне смертности среди лиц с ХСН (29,6%) и без ХСН (24,3%). При этом у пациентов (21,8%), обращавшихся в поликлинику как минимум 1 раз после выписки, смертность была в 2,4 раза ниже, чем у пациентов (57,4%), не обратившихся после выписки ни разу (p<0,05). При многофакторном анализе с учетом наблюдения в поликлинике после ОНМК положительное влияние посещения поликлиники после выписки из стационара сохраняло свою статистическую значимость (p<0,001). ЗАКЛЮЧЕНИЕ Смертность пациентов с хронической сердечной недостаточностью и без данной патологии, перенесших острое нарушение мозгового кровообращения, статистически значимо не различалась. Объяснением может быть более частое врачебное наблюдение и лечение в постгоспитальном периоде перенесших острое нарушение мозгового кровообращения пациентов с хронической сердечной недостаточностью.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить приверженность последующей вакцинации против SARS-CoV-2 пациентов, перенесших COVID-19, и их иммунный статус по результатам длительного наблюдения (через 12 мес и более после выписки из стационара). МАТЕРИАЛ И МЕТОДЫ В рамках регистра ТАРГЕТ-ВИП 775 пациентов (возраст 57,5±1,4 года; 50,6% мужчин) с установленным в стационаре диагнозом COVID-19 наблюдались после выписки в течение 13,7±3,0 мес. Группы сравнения: 190 (24,5%) вакцинированных за период наблюдения против SARS-CoV-2 и 585 (75,5%) невакцинированных. Иммунный статус оценен в репрезентативной выборке из 283 (36,5%) пациентов (возраст 56,9±12,7 года; 44,9% мужчин), пришедших на амбулаторный прием через 14,6±4,1 мес после выписки из стационара, в том числе у 97 (34,3%) вакцинированных против SARS-CoV-2 и 186 (65,7%) невакцинированных. РЕЗУЛЬТАТЫ Между группами вакцинированных и не вакцинированных против SARS-CoV-2 не выявлено статистически значимых различий в возрасте, гендерных характеристиках, в доле случаев сердечно-сосудистых заболеваний, хронических некардиальных заболеваний, в доле курящих. В группе невакцинированных была больше доля пациентов с анамнезом лечения в отделении реанимации по поводу COVID-19 и/или поражения легких 3—4-й степени по данным компьютерной томографии: 55,0% по сравнению с 46,8% (p=0,048). Доля курящих была незначимо меньше среди вакцинированных против SARS-CoV-2: 3,7% по сравнению с 6,0% (p=0,22). Среди пациентов, пришедших на прием, титр антител IgG типа N был повышен в 50,4% случаев, титр антител IgG типа S (количественно) — в 98,6% случаев. Через 14,6±4,1 мес наблюдения после перенесенной инфекции COVID-19 в группе вакцинированных против вируса SARS-CoV-2 (через 12,3±2,7 мес после выписки из стационара и за 2,0±2,5 мес до амбулаторного визита) по сравнению с невакцинированными пациентами был выше уровень антител IgG типа S (505±103 против 376±171 BAU/мл; p<0,001) и не было статистически значимых различий титров антител IgG типа N и IgM. В группе вакцинированных против SARS-CoV-2 по сравнению с невакцинированными была статистически значимо выше частота вакцинации против гриппа как до COVID-19 (34,8% против 21,9%; p=0,0004), так и после референсной госпитализации по поводу COVID-19 (37,0% по сравнению с 15,0%; p<0,0001). После COVID-19 по сравнению с периодом до госпитализации в группе вакцинированных против SARS-CoV-2 возросла доля привитых против гриппа (с 34,8% до 37,0%; p=0,65), при этом в группе не вакцинированных против SARS-CoV-2 доля привитых против гриппа снизилась (с 21,9% до 15,0%; p=0,003). ЗАКЛЮЧЕНИЕ В исследовании показано, что лишь 24,5% лиц, перенесших COVID-19, затем были вакцинированы против SARS-CoV-2 (за период наблюдения 13,7±3,0 мес). Через год после выписки из стационара у 50,4% пациентов сохранялся повышенный титр антител IgG типа N, у 98,6% пациентов — высокий титр антител IgG типа S, который был статистически значимо выше у вакцинированных. Приверженность вакцинации против гриппа после госпитализации по поводу COVID-19 возросла у пациентов, впоследствии вакцинированных против SARS-CoV-2, и снизилась у невакцинированных.

Aim. According to hospital-based registry, to evaluate the age characteristics and prevalence of concomitant cardiovascular and non-сardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave.Material and methods. The TARGET-VIP register included 1130 patients aged 57,5+12,8 years (men, 51,2%) hospitalized at the Pirogov National Medical and Surgical Center from April 6, 2020 to June 22, 2020 with COVID-19. Cardiovascular diseases (CVDs) were diagnosed in 51,6% of patients, non-сardiovascular chronic diseases — in 48,6%, while CVDs and/or non-сardiovascular chronic diseases — in 65,8% of patients.Results. The average age of patients significantly increased by an average of 0,77 years per week (p<0,001), while the difference between the 1st week (52,8 years) and 11th week (62,2 years) was 9,4 years; the proportion of men did not change significantly. The proportion of patients with CVDs increased significantly — from 34,2% to 66,7%, on average by 3,7% per week (p<0,001; Incidence Risk Ratio (IRR)=1,037; 95% confidence interval (CI), 1,017-1,058), with chronic non-cardiovascular diseases — from 32,5% to 43,2%, on average by 2,5% per week (p<0,001; IRR=1,025; 95% CI, 1,002-1,049), as well as those with CVDs and/or chronic non-cardiovascular diseases — from 47,5% to 75,3%, on average by 3,2% per week (p<0,001; IRR=1,032; 95% CI, 1,017-1,048). Over the entire period, the proportion of people with hypertension (HTN) was 47,0%, with coronary artery disease (CAD) — 15,4%, with heart failure (HF) — 4,0%, and with atrial fibrillation (AF) — 10,1%. The proportion of patients with HTN increased by 9,5% (p<0,001; OR=1,095; 95% CI, 1,047-1,144), with СAD — by 9,4% (p=0,01; OR=1,094; 95% CI, 1,022-1,172) and with AF — by 9,4% (p<0,001; OR=1,094; 95% CI, 1,023-1,170) per week. The proportion of patients with diabetes was 16,5%, with respiratory diseases — 11,4%, with chronic kidney disease (CKD) — 12,6%, with digestive diseases — 22,5%, with obesity — 6,1%. During the epidemic wave, the most pronounced increase in the proportion of patients with CKD was by 6,2% (p=0,036; OR=1,062; 95% CI, 1,004-1,124) and with digestive diseases — by 6,0% (p=0,01; OR=1,060; 95% CI, 1,014-1,109) per week.Conclusion. According to the 11-week TARGET-VIP registry, the age of patients increased by 9,4 years, CVD cases — by 1,9 times (mainly HTN, CAD, AF), and chronic non­сardiovascular pathology — by 1,3 times (mainly CKD and digestive diseases). These trends in hospital practice corresponded to a weekly increase in the proportion of patients with a higher risk of fatal and non-fatal complications, which is the basis for further research in order to develop a system for a comprehensive prognostic assessment of the degree and rate of increase in the load on hospitals during COVID-19 epidemic wave.

Aim. To study the frequency of detection of hyperuricemia (HU) in patients with high and very high cardiovascular risk and the frequency of prescribing drugs that lower serum uric acid (sUA) levels in real clinical practice.Material and methods: The general information of the study was based on the data of 2457 patients who were consistently included in the «PROFILE» registry until November 30, 2020: 1250 men (50.9%) and 1207 (49.1%) women. All patients with HU were selected (UA level ≥360 pmol/l in women, ≥420 pmol/l in men). At the stage of inclusion of the patient, data on MC indicators were available in 1777 (72.3%), upon re-examination - only 262 (33.2%) out of 790 patients who returned to the appointment.Results: The most common study of the level of sUA was performed in patients with gout (65.2%), with arterial hypertension (AH) and dyslipemia in 29.1% of cases, with diabetes mellitus (DM) - 30.1%, with impaired tolerance to glucose (IGT) - 40.2%, with other diseases, the proportion of patients with a known UA was even less. A positive relationship was found between the presence of AH and IGT with the frequency of UA control (p<0.001). In patients with AH, an increase in the level of sUA was detected significantly more often than in patients without AH (p<0.001), and less frequently in patients with DM and IGT (p<0.001 and p<0.01, respectively). The frequency of allopurinol prescribing was low: 49 (2%) patients received therapy, while of the 284 patients with HU, only 20 (7%) were prescribed allopurinol.Conclusion: in real clinical practice, only 29.1% of patients with AH and 20-25% of patients with other CVDs were monitored for sUA levels, every third patient had data on sUA levels at a repeat visit. In the presence of gout, the proportion of patients with current UA was higher (65%). For those with AH and IGT, positive correlations were found between the presence of the disease and control of sUA levels. A low frequency of prescribing drugs for the correction of HU was revealed.

Aim. To study two-year survival and factors affecting it in patients with cerebrovascular accident (CVA) with prior coronary artery disease (CAD).Material and methods. The outpatient stage of the REGION-M registry included 684 patients assigned to the Moscow City Polyclinic № 64, discharged from the F.I. Inozemtsev City Clinical Hospital in the period from January 1, 2012 to April 30, 2017 with a verified diagnosis of stroke or transient ischemic attack. Of these, 423 (61,8%) patients had a diagnosis of CAD in the outpatient records.Results. Patients with CAD were significantly older, more often had comorbidities, disability, and were monitored in the polyclinic before the stroke and after hospital discharge than patients without CAD. During the follow-up period, mortality among patients with CAD (34,3%) was significantly higher than without CAD (19,9%) (p< 0,01), At the same time, mortality in CAD was 2,6 times lower among patients who applied to the polyclinic at least once after discharge (28%) than those who never applied after discharge — 72,9% (p< 0,001), Multivariate analysis confirmed this positive effect (relative risk, 0,998; confidence interval: 0,983-0,992, p< 0,0001).Conclusion. Mortality in patients with stroke and CAD was significantly higher than in those without CAD, while it was significantly lower among patients monitored in the polyclinic in the post-hospital period of stroke.

Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry. Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 – in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards – from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0±1.5 months. Results. The age of post-COVID patients with CVMM was 73.7±9.6 years, without CVD – 49.4±12.4 years (p<0.001), the proportion of men was 53.9% and 58.4% (p=0.34). In the group with CVMM the majority of patients had AH (92.3-93.3%), CHD (90.4-91.4%), and minority – CHF (42.7-46.0%) and AF (42.9-43.4%). The combination of 3-4 CVDs prevailed (58.9-60.3%). The proportion of cases of chronic non-cardiac pathologies was higher in the CVMM group (80.9%) compared to the group without CVD (36.7%; p<0.001). The frequency of proper cardiovascular pharmacotherapy during the follow-up period decreased from 56.8% to 51.3% (p for trend = 0.18). The frequency of anticoagulant therapy in AF decreased significantly: from 89.1% at the discharge from the hospital to 56.4% after 30-60 days (p=0.001), 57.1% and 53.6% after 6 and 12 months of monitoring (p for a trend <0.001). There were no other significant changes in the frequency of other kinds of the proper cardiovascular pharmacotherapy (p>0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p<0.001) as well as rates of hospitalization (34.7% and 9.9%, p<0.001) and non-fatal myocardial infarction (MI) – 2.5% vs 0.5% (p=0.048). The proportion of new cases of CVD in the groups with CVMM and without CVD was 5.5% and 3.7% (p=0.33). The incidence of acute respiratory viral infection (ARVI)/influenza was higher in the group without CVD – 28.3% vs 19.0% (p=0.02). The proportion of cases of recurrent COVID-19 in groups with CVMM and without CVD was 3.7 % and 1.8% (p=0.19). Conclusion. Post COVID-19 patients with CVMM were older and had the bigger number of chronic non-cardiac diseases than patients without CVD. The quality of cardiovascular pharmacotherapy in patients with CVMM was insufficient at the discharge from the hospital with following non-significant decrease during 12 months of follow-up. The frequency of anticoagulant therapy in AF decreased by 1.6 times after 30-60 days and by 1.7 times during the year of follow-up. The proportion of new cases of CVD was 5.5% and 3.7% with no significant differences between compared groups. The rate of all-cause mortality, hospitalizations and non-fatal MI was significantly higher in patients with CVMM, but the frequency of ARVI/influenza was significantly higher in patients without CVD. Recurrent COVID-19 was registered in 3.7% and 1.8% of cases, there were no significant differences between compared groups.

Aim. To assess long-term outcomes within 12 months after hospital treatment of patients with coronavirus disease 2019 (COVID-19) as part of a prospective registry.Material and methods. Outcomes in the posthospital period were assessed in 827 patients diagnosed with COVID-19 (age, 58,0±14,8 years; men, 51,3%). For periods of 30-60 days, 6 and 12 months after discharge from the hospital, cases of death, nonfatal myocardial infarction (MI) and stroke, hospitalization, acute respiratory viral infections/influenza were assessed. The follow-up period was 13,0±1,5 months.Results. During the follow-up period, 35 (4,2%) patients died, 6 (0,73%) and 4 (0,48%) cases of MI and stroke were registered. In addition, 142 (17%) patients were hospitalized, while 217 (26,2%) patients had acute respiratory viral infections/ influenza. Factors of age and length of intensive care unit stay were significantly associated (p<0,001) with the risk of all-cause death (hazard ratio (HR)=1,085 per 1 year of life and HR=6,98, respectively), with the risk of composite endpoint (death, non-fatal MI and stroke): HR=1,081 per 1 year of life and HP=4,47. Of the 35 deaths, 11 (31%) were within the first 30 days of follow-up, and 19 (54%) — 90 days after discharge from the hospital. A higher probability of hospitalization was associated with older age (odds ratio (OR)=1,038; p<0,001), while a higher probability of acute respiratory viral infections/influenza was associated with younger age (OR=0,976 per 1 year of life; p<0,001) and female sex (OR=1,414; p=0,03).Conclusion. A prospective follow-up of 827 patients in the TARGET-VIP registry revealed that 12-month mortality was 4,2%, while more than half of the deaths (54%) were registered in the first 90 days, including 31% — for the first month after discharge from the hospital. The most common events were hospitalizations (17,0%) and acute respiratory viral infections/influenza (26,2%), while the rarest were myocardial infarction (0,73%) and stroke (0,48%). The key factors associated with 12-month mortality in the post-COVID-19 period were older age and intensive care unit stay during the reference hospitalization. A higher readmission rate during the follow-up period was associated with older age, and the prevalence of acute respiratory viral infections /influenza during the follow-up period was associated with younger patients and female sex.

Aim . Based on the data from the register of patients with COVID-19 and community-acquired pneumonia (CAP), analyze the duration of the prehospital period, cardiovascular comorbidity and the quality of prehospital pharmacotherapy of concomitant cardiovascular diseases (CVD). Material and methods . Patients were included to the study which admitted to the FSBI "NMHC named after N.I. Pirogov" of the Ministry of Health of the Russian Federation with a suspected or confirmed diagnosis of COVID-19 and/or CAP. The data for prehospital therapy, information from medical histories and a patients’survey in the hospital or by telephone contact 1-2 weeks after discharge were study. The duration of the prehospital stage was determined from the date of the appearance of clinical symptoms of coronavirus infection to the date of hospitalization. Results . The average age of the patients (n=1130; 579 [51.2%] men and 551 [48.8%] women) was 57.5±12.8 years. The prehospital stage was 7 (5,0; 10,0) days and did not differ significantly in patients with the presence and absence of CVD, but was significantly less in the deceased than in the surviving patients, as well as in those who required artificial lung ventilation (ALV). 583 (51.6%) patients had at least one CVD. Cardiovascular comorbidity was registered in 222 (42.7%) patients with hypertension, 210 (95.5%) patients with coronary heart disease (CHD), 104 (91.2%) patients with atrial fibrillation (AF). The inclusion of non-cardiac chronic diseases in the analysis led to an increase in the total proportion of patients with concomitant diseases to 65.8%. Approximately a quarter of hypertensive patients did not receive antihypertensive therapy, a low proportion of patients receiving antiplatelet agents and statins for CHD was revealed – 53% and 31.8%, respectively, anticoagulants for AF – 50.9%. Conclusion . The period from the onset of symptoms to hospitalization was significantly shorter in the deceased than in the surviving patients, as well as in those who required ALV. The proportion of people with a history of at least one CVD was about half of the entire cohort of patients. In patients with CVD before COVID-19 disease, a low frequencies of prescribing antihypertensive drugs, statins, antiplatelet agents and anticoagulants (in patients with AF) were recorded at the prehospital stage.