A new dosage form of lappaconitine hydrobromide has been created – the long-acting drug Allaforte®, which has fewer side effects compared to the traditional dosage form (Allapinin®). Objective. To evaluate the effectiveness, safety and tolerability of Allaforte® therapy in comparison with the drug Rytmonorm® in patients with paroxysmal atrial fibrillation (AF). Material and methods. Patients who met the inclusion criteria and those who did not meet the non-inclusion criteria were randomized into 2 groups: 1st (n=50) – patients received Allaforte® 25 mg 3 times a day with an increase in dose to 50 mg 2 times a day when detected attack of AF; 2nd (n=50) – patients received Rytmonorm® 150 mg 3 times a day with an increase in dose to 300 mg 2 times a day if an attack of AF was detected. Results. The average time from the first dose of the drug to the development of AF paroxysm in the 1st group (Allaforte®) was 98.877±6.022 days, in the 2nd group (Rytmonorm®) – 98.808±5.876 days, the average time from the first dose of the drug to the completion of the study – 105.740±5.032 and 103.732±5.353 days, respectively. The drugs Allaforte® and Rytmonorm® equally improved the quality of life of patients. A comparative analysis in groups according to the severity of adverse events and their cause-and-effect relationship with the drug did not show significant differences. Conclusion. The study drugs showed comparable effectiveness in preventing attacks of AF with similar safety and tolerability.

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used,  of representative  selection  of non-organized  male and  female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol  (TC), cholesterol  of lipoproteids low and high density were measured at SSRCPM and RSPCC. Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased  level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached  of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively. Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment  of the persons with high and very high cardiovascular  risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity  of development  and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used, of representative selection of non-organized male and female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol (TC), cholesterol of lipoproteids low and high density were measured at SSRCPM and RSPCC.Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively.Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment of the persons with high and very high cardiovascular risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity of development and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Aim. To study the relation of emotional status with negative tendencies in food preference style in Russian population, including regional specifics of Saint-Petersburg, Samara and Orenburg. Material and methods. The study is the part of ESSE-RF (Epidemiology of Cardiovascular diseases in different regions of Russian Federation). Totally 1941 men and 2859 women studied at the age 25-64 y.o. — citizens of Saint-Petersburg, Samara and Orenburg. The socio- demographic data assessed, as absence/presence of cardiovascular disorders, diabetes and gastrointestinal disorders (by self-report), some parameters of the food preference style and emotional status using the Hospital Score of depression and anxiety.Results. The preference of animal fats was registered in 4,8%, daily intake of sausages in 22,4%, confectionery — in 48,4%, >6 tea spoons of sugar — in 36,5% respondents. The risk factors for pernicious habits were male gender, younger age, lower income, and tendency to spend most part of the income for food. In 51,3% of participants there were increased values on anxiety score and in 30,3% — increased depression scores. Probability of animal fats preference — odds ratio (OR)=1,89, confidence interval (CI) 95%=1,40-2,57 (p<0,001), and regular intake of sausages and meat plucks — OR=1,67, CI 95%=1,41-1,96 (p<0,01), was higher in persons with depressive states; at the same time the probability of daily intake of confectioneries and sweets was significantly lowered — OR=0,83, CI 95%=0,72-0,96 (p=0,01). Inhabitants of Orenburg and Samara had much more probably prefer sausages and animal fats comparing to Saint-Petersburg citizens, and the risk of depression was significantly variable in regions: being maximum in Orenburg — 43,9% vs 20,6% in Saint-Petersburg and 26,3% in Samara (p<0,001) without significant differences by anxiety levels. Conclusion. There is an interdependence of emotional status and food preference of a person. Emotional state, at the most related to an actualization of "pernicious" eating habits, reflects the depression. Presence of depression signs is linked with more common intake of animal fats and sausages, but less common intake of confectioneries and sweets. Interregional differences in the eating style and risks of the health disorders might probably be defined with the differences in life quality of the people.

Aim. To study the relationship of NT-proBNP level with metabolic sindrome (MS) components and values of diastolic and systolic functions of the LV in patients with MS. Material and methods. Totally 148 patients studied. The main group consisted of 100 persons with MS, controls were 48 persons without MS. The participants underwent anthropometry, BP measurement, glucose level measurement, lipid spectrum, NT-proBNP levels and also ECG and EchoCG recording. MS and its components were evaluated according to IDF (2005).Results. MS patients had higher level of NT-proBNP than controls (246,5±35,3 pg/ml vs 24,33±4,7 pg/ml, p<0,0001). It was shown that the diameter of LA (P=0,766, p=0,001), IVST (P=0,29, p=0,04), ОТ (Р=-0,217, p=0,039) and level of TG (P=-0,22, p=0,04) are independent factors related to NT-proBNP. With anincrease of diastolic dysfunction LV severity the level of NT-proBNP alsoincreased.Conclusion. NT-proBNP reveals the patients with early cardial disorders amongpersons with MS.

Objective. The article presents the analysis of social, demographic and clinical risk factors, perioperative examination parameters, therapy and outcome data in patients with stable coronary artery coronary disease after coronary artery bypass grafting surgery (CABG) in three regions inRussian Federation during 2012 year in the context of Ricochet program. The other aim was to establish a correspondence of the findings to international myocardial revascularization guidelines. Design and methods. Altogether 300 patients (100 in each region) were chosen according to the inclusion/exclusion criteria, and all participants were given individual numbers. All data were registered in a special database “A registry of patients with stable coronary artery disease after coronary artery bypass grafting surgery”. Phone visits or office visits when necessary were scheduled in 12 months. Response rate was almost 100 %. Results. It was shown that males dominated among patients. The female CABG rate was three times lower, though the most of them (90 %) had myocardial infarction in past in comparison with 73 % of patients among male group. The average patient age was 60–64 years and 43 % of them were invalids. Work-status analysis of pre- and postoperative periods showed no significant difference. Indications for surgery correspond to current guidelines, however, the preoperative stress test rate was only 36 %. Conclusions. The majority of patients were treated with evidence-based medicine drugs. A significant number of patients with recurrent angina after CABG, including high functional class, was found. These data indicate the need for an out-patient follow-up system for patients undergoing CABG, including cardiac rehabilitation, therapy correction, and, if necessary, re-intervention.

Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data.Material and methods. The data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level.Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 [95% CI 2,08-4,57] comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.

In the frame of Multicenter observational study ECVD-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) by the unique protocol the investigation of representative selections of adult population at the age of 25-64 y.o. of 11 regions RF (n=18305, including males, n=6919 and females n=11386): Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Orenburg, Samara, Tomsk, Tyumen, Saint-Petersburg and Northern Osetia-Alania. The prevalence of the following risk factors (RF) of cardiovascular diseases is evaluated: high blood pressure — 33,8%, obesity — 29,7%, high total cholesterol — 57,6%, high glucose level or diabetes — 4,6%, smoking (tobacco consumption) — 25,7%, insufficient (low) level of physical activity — 38,8%, excessive salt consumption — 49,9% and insufficient vegetables and fruits consumption — 41,9%. Gender differences and an increase with the age of the parameters mentioned are described.The absence of a epidemiologic monitoring system at the Federal level leads to an impossibility of clear conclusions on the RF dynamics in Russian population. While comparing the ECVD-RF study with previous epidemiological studies we can just cautiously suppose the existence in 21st age of negative dynamics of one RF (obesity, dyslipidemia) and positive dynamics of the others (smoking).

Aim. To study VAI as diagnostic marker for MS and its usefulness for prognosis of cardiovascular complications development in MS comparing to other common antropometric parameters (WR, BMI, WR/HR, WR/height, TG/HDL). Material and methods. Totally 301 person included (148 men, 153 women). All participants undewent anthropometry, BP measurement, fasting glucose, lipid profile, adiponectine. At second stage (follow-up) the participants were divided into two groups depending on end-points: first group had cardiovascular complications (CHD, MI, cardiovascular disease), second group — DM 2 type. MS was assessed with IDF (2005).Results. MS was found in 108 respondents (35,9%). Significant positive correlations were found between VI and BP, fasting glucose, LDL; negative — with VAI and adiponectine. Significant predictors for MS dignosis were WR/height, TG/HDL and VAI (p<0,0001). By the results of multiple regression VAI, WR/height and adiponectine were independent factors of cardiovascular risk in MS; and risk factors for DM 2 type were VAI, TG/HDL, adiponectine.Conclusion. VAI proved its diagnostic reliability in MS diagnostics, as in cardiovascular risk prognosis of MS. Further studies required with longer follow-up period and various patient groups.

Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia.Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP <140/90 mmHg. Statistic data calculation was done with computer-based statistic software — SAS with standardising by age stratification of Europe.Results. Mean SBP and DBP were 130,7±0,1 mmHg and 81,6±0,1 mmHg respectively. Prevalence of AH — 44%, higher in men (p<0,001). Prevalence of AH was higher in rural area citizens in men — 51,8% vs 47,5% (р<0,02) and in women — 42,9% vs 40,2% (р<0,05). Awareness was 67,5% in men, 78,9% in women. Medications were taken by 60,9% of women and 39,5% of men. Effectively treated were 53,5% of women and 41,4% of men. With the age the part of effectively treated decreases (p<0,0005). BP is under control only in 1/3 of women and 14,4% of men.Conclusion. The role of AH as one of the main modifiable risk factors of cardiovascular diseases is proved, however it is depressing that the percent of controlled AH is low. BP control is the main task of outpatient surveillance at every local outpatient department, where now less than a half of those affected are being observed.

Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia. Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP <140/90 mmHg. Statistic data calculation was done with computer-based statistic software — SAS with standardising by age stratification of Europe. Results. Mean SBP and DBP were 130,7±0,1 mmHg and 81,6±0,1 mmHg respectively. Prevalence of AH — 44%, higher in men (p<0,001). Prevalence of AH was higher in rural area citizens in men — 51,8% vs 47,5% (р<0,02) and in women — 42,9% vs 40,2% (р<0,05). Awareness was 67,5% in men, 78,9% in women. Medications were taken by 60,9% of women and 39,5% of men. Effectively treated were 53,5% of women and 41,4% of men. With the age the part of effectively treated decreases (p<0,0005). BP is under control only in 1/3 of women and 14,4% of men. Conclusion. The role of AH as one of the main modifiable risk factors of cardiovascular diseases is proved, however it is depressing that the percent of controlled AH is low. BP control is the main task of outpatient surveillance at every local outpatient department, where now less than a half of those affected are being observed.

Aim. To study the prevalence of metabolic syndrome in an unorganized population of Orenburg city. Methods. The sample was formed by the method of random numbers. Examined were 301 people aged 25 to 75 years, of which 148 were males and 153 females. Studied were the socio-demographic characteristics and medical history (including filling out of a questionnaire), the clinical status of study participants (with the measurement of blood pressure, height, weight, waist and hip circumference, biochemical blood analysis to determine the concentration of glucose and lipid profile). In order to identify the metabolic syndrome the following diagnostic criteria were used: of the Work Group on the treatment of adults of the National Cholesterol Education Program of the U.S. (2001-2005), of the International Diabetes Federation (2005) and of the All-Russian Scientific Society of Cardiology (2009). Results. The prevalence of abdominal obesity was reduced by using less stringent thresholds for waist circumference. The most common variant of the metabolic syndrome was the combination of the following components: abdominal obesity, arterial hypertension and a low content of high-density lipoproteins. According to the criteria of the International Diabetes Federation such a combination occurred in 7.6%, while in accordance with the Criteria of the Work Group on for the treatment of adults of the National Cholesterol Education Program of the U.S. - it occurred in 4.3%. Conclusion. The frequency of registration of the metabolic syndrome depends on the criteria for its diagnosis.

Aim. Metabolic syndrome (MS) is a combination of the key cardiovascular risk factors, namely obesity, carbohydrate metabolism disturbances, arterial hypertension (AH), and dyslipidemia. MS prevalence varies, depending on the MS definition used. The aim of this study was to assess the prevalence of MS and its components in large Russian cities (St. Petersburg, Kursk, Orenburg, and Kaliningrad), using international MS criteria. Material and methods. In total, 1046 individuals were screened in 4 cities: 309 in St. Petersburg, 170 in Kursk, 279 in Orenburg, and 288 in Kaliningrad. All participants underwent a questionnaire survey on demographics, risk factors, lifestyle, family history, comorbidities and treatment. Blood pressure measurement (3 measurements on the right arm) and anthropometry were also performed. Lipid profile and fasting glucose levels were measured with the use of Hitachi-902 analyser (Roche Diagnostics). MS was diagnosed based on the criteria by ATP III (2001–2005), IDF (2005), and JIS (2009). Results. High prevalence of MS was observed regardless of the criteria used; the highest prevalence was registered for the JIS-2009 criteria. For all MS criteria, no significant difference in MS prevalence was registered across the cities, or between men and women in each city. The majority of the patients (over 80%, regardless of the criteria used) had at least one MS component, with the highest prevalence observed in Kursk (94% for IDF-2005 and JIS-2009 criteria). Conclusion. In each region, the prevalence of MS was high, which might be related to high levels of cardiovascular morbidity and mortality in Russia. The IDF-2005 criteria agreed with the JIS-2009 ones to a greater extent than with the ATP III definition. However, prospective studies are needed to establish the national normal values of waist circumference, for reliable diagnostics of abdominal obesity in the Russian population.

Aim. Metabolic syndrome (MS) is a combination of the key cardiovascular risk factors, namely obesity, carbohydrate metabolism disturbances, arterial hypertension (AN), and dyslipidemia. MS prevalence varies, depending on the MS definition used. The aim of this study was to assess the prevalence of MS and its components in large Russian cities (St. Petersburg, Kursk, Orenburg, and Kaliningrad), using international MS criteria.Material and methods. In total, 1046 individuals were screened in 4 cities: 309 in St. Petersburg, 170 in Kursk, 279 in Orenburg, and 288 in Kaliningrad. All participants underwent a questionnaire survey on demographics, risk factors, lifestyle, family history, comorbidities and treatment. Blood pressure measurement (3 measurements on the right arm) and anthropometry were also performed. Lipid profile and fasting glucose levels were measured with the use of Hitachi-902 analyser (Roche Diagnostics). MS was diagnosed based on the criteria by ATP III (2001-2005), IDF (2005), and JIS (2009).Results. High prevalence of MS was observed regardless of the criteria used; the highest prevalence was registered for the JIS-2009 criteria. For all MS criteria, no significant difference in MS prevalence was registered across the cities, or between men and women in each city. The majority of the patients (over 80%, regardless of the criteria used) had at least one MS component, with the highest prevalence observed in Kursk (94% for IDF-2005 and JIS-2009 criteria).Conclusion. In each region, the prevalence of MS was high, which might be related to high levels of cardiovascular morbidity and mortality in Russia. The IDF-2005 criteria agreed with the JIS-2009 ones to a greater extent than with the ATP III definition. However, prospective studies are needed to establish the national normal values of waist circumference, for reliable diagnostics of abdominal obesity in the Russian population. Russ J Cardiol 2012, 2(94): 55-62

In the frame of Multicenter observational study ECVD-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) by the unique protocol the investigation of representative selections of adult population at the age of 25-64 y.o. of 11 regions RF (n=18305, including males, n=6919 and females n=11386): Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Orenburg, Samara, Tomsk, Tyumen, Saint-Petersburg and Northern Osetia-Alania. The prevalence of the following risk factors (RF) of cardiovascular diseases is evaluated: high blood pressure — 33,8%, obesity — 29,7%, high total cholesterol — 57,6%, high glucose level or diabetes — 4,6%, smoking (tobacco consumption) — 25,7%, insufficient (low) level of physical activity — 38,8%, excessive salt consumption — 49,9% and insufficient vegetables and fruits consumption — 41,9%. Gender differences and an increase with the age of the parameters mentioned are described. The absence of a epidemiologic monitoring system at the Federal level leads to an impossibility of clear conclusions on the RF dynamics in Russian population. While comparing the ECVD-RF study with previous epidemiological studies we can just cautiously suppose the existence in 21st age of negative dynamics of one RF (obesity, dyslipidemia) and positive dynamics of the others (smoking).