Aim. To evaluate diagnostic properties of qualitative tests for cardiac fraction of the fatty acid binding protein (cFABP) in patients hospitalized with suspected acute coronary syndrome (ACS), depending on glomerular filtration rate (GFR) level.Material and methods. Totally, 465 patients included, admitted with ACS within 24 hours from onset. All patients underwent cFABP test with immune chromatographic express tests “CardioFABP” (Novosibirsk, Russia) and/or “CARD-INFO” (Obninsk, Russia), as the levels of serum creatinine with further GFR calculation. Assessment of diagnostic characteristics was done by the values of specificity, sensitivity, and diagnostic correctness, as well as overall positive and negative test results according to GFR.Results. The analysis did not reveal significant difference in the number of positive and negative results of cFABP with the “CARD-INFO” (χ2=6,822, р=0,146), “CardioFABP” 10 ng/mL (χ2=4,968, р=0,291) and “CardioFABP” 15 ng/mL (χ2=8,673, р=0,07) in comparison by GFR. With coupled comparison, in the groups of patients by GFR there were differences in specificity for “CARD-INFO” (Fischer criteria =0,017, р˂0,05) and precision for “CardioFABP” (10 ng/mL) (χ2=5,793, р=0,017) in patients by GFR levels 60-90 and 30-59 mL/min/1,73 m2. For the other parameters of diagnostical efficacy there were no differences by GFR. In severe renal dysfunction (GFR ˂15 mL/min/1,73 m2) results of qualitative cFABP were false positive in 10 cases among 11 (90,9%).Conclusion. In patients hospitalized for suspected ACS, the results and diagnostic characteristics of the express-tests for cFABP “CARD-INFO” and “CardioFABP” depended mildly on GFR level with its values ≥15 mL/min/1,73 m2. Low number of patients with GFR ˂15 mL/min/1,73 m2 made not possible to acquire significant data on cFABP in this category of patients, however the data available make it not to apply the test in this category of patients.

Aim. To investigate on the clinical, anamnestic and laboratory-instrumental predictors of short term outcomes development in pulmonary thromboembolism (PTE).Material and methods. To the study, 136 patients included with the high and intermediate risk PTE confirmed by multispiral computed tomography. The endpoints were obstructive shock, fatal relapse, fatal outcome, necessity of resuscitation, urgent thrombolysis and hemodynamic support. Follow-up lasted for 30 days. Patients were selected to groups of complicated (n=44) and noncomplicated (n=92) course.Results. The predictors of adverse course of PTE were chronic heart failure of II stage (p=0,02), diabetes type 2 (p=000001), atrial fibrillation (p=0,001), permanent risk factor for PTE (p=0,002), syncope (p=0,02), positive test for the fatty acid binding cardiac protein (cFABP) (p=0,00001), troponin I positive test (p=0,02), heart rate ≥110 bpm (p=0,002), systolic BP ≤100 mmHg (p=0,00001), creatinine clearance ≤70 mL/min (p=0,0008). By the method of logistic regression a combination selected showing most predictive power, that includes heart rate ≥110 bpm, BP ≤100 mmHg, positive cFABP and diabetes. Upon the logistic regression coefficients the prediction score was formulated, named ROCky (Risk of Complications) that includes heart rate ≥110 bpm (1,5 points), BP ≤100 mmHg (2,5 pts), positive cFABP test (2 pts), diabetes type 2 (2,5 pts). The threshold estimated for prediction of combination endpoint ≥2,5 (Se 84%, Sp 75%), obstructive shock ≥3,5 (Se 83%, Sp 83%) and fatal outcome within 30 days ≥4,5 (Se 79%, Sp 82%). Combination of ≥2,5 points by ROCky and presence of echocardiographical signs of the right ventricle dysfunction showed more efficacy than the algorithm of European Society of Cardiology (2014) in the studied population of hemodynamically stable patients, for the obstructive shock, fatal relapse of PTE, fatal outcome and combination endpoint.Conclusion. The ROCky scale has demonstrated high efficacy in prediction of complications among hemodynamically stable patients and can be recommended for further investigation and implementation into clinical practice.

Recently, researchers have been increasingly interested in the association between the incidence of cardiovascular events (such as myocardial infarction, MI) and leptin – an adipocyte-produced hormone, which normally is involved in the body mass regulation. Aim. To assess the role of leptin in the clinical course of acute myocardial infarction with ST segment elevation (STEMI) on ECG. Material and methods. The study included 89 men aged 23–77 years. All patients underwent coronary angiography (CAG) in the first 12 hours of STEMI. Based on the CAG findings, 80 patients underwent percutaneous coronary interventions (PCI). All participants were divided into two groups, based on the plasma levels of leptin. Group 1 (n=42) had elevated leptin levels (>5,63 ng/ml), while Group 2 (n=47) had normal leptin levels (<5,63 ng/ml). Results. In MI patients, leptin concentration was a predictor of the in-hospital diagnosis of Type 2 diabetes mellitus (DM-2). The plasma leptin concentration in the first 24 hours of MI was associated with the levels of interleukin-1-beta, potassium, creatinine, triglycerides, haemoglobin, body mass index, and left ventricular enddiastolic dimension. Conclusion. Leptin levels in the acute phase of STEMI could be used for the prediction of MI complications and DM-2.

Recently, researchers have been increasingly interested in the association between the incidence of cardiovascular events (such as myocardial infarction, MI) and leptin – an adipocyte-produced hormone, which normally is involved in the body mass regulation. Aim. To assess the role of leptin in the clinical course of acute myocardial infarction with ST segment elevation (STEMI) on ECG. Material and methods. The study included 89 men aged 23–77 years. All patients underwent coronary angiography (CAG) in the first 12 hours of STEMI. Based on the CAG findings, 80 patients underwent percutaneous coronary interventions (PCI). All participants were divided into two groups, based on the plasma levels of leptin. Group 1 (n=42) had elevated leptin levels (>5,63 ng/ml), while Group 2 (n=47) had normal leptin levels (<5,63 ng/ml). Results. In MI patients, leptin concentration was a predictor of the in-hospital diagnosis of Type 2 diabetes mellitus (DM-2). The plasma leptin concentration in the first 24 hours of MI was associated with the levels of interleukin-1-beta, potassium, creatinine, triglycerides, haemoglobin, body mass index, and left ventricular enddiastolic dimension. Conclusion. Leptin levels in the acute phase of STEMI could be used for the prediction of MI complications and DM-2.