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2012 year, number 1

1.
Atherogenic lipid disorders in adolescence: long-term population study in Novosibirsk (1989-2009)

D.V. Denisova, L.G. Zavyalova, M.V. Ivanova
Keywords: blood lipid profile, dislipidemias, trends, adolescents, population
Pages: 5-13

Abstract >>
Objective of the study was to examine 20-year trend in the prevalence of atherogenic lipid disorders in adolescents 14-17 years - residents of a large Russian industrial city (Novosibirsk). Methods. Five cross-sectional population surveys of representative samples of schoolchildren aged 14-17 of both sexes were conducted during the period from 1989 to 2009. The study sample included 3311 adolescents (43 % boys) with the response rate 88-93 %. Blood total cholesterol, high-density lipoprotein cholesterol, triglycerides, were measured by enzymatic methods. Low-density lipoprotein cholesterol was calculated with Friedwald's formula. Prevalence of dyslipidemia was evaluated with NCEP-peds criteria. Results. During the period from 1989 to 2009 blood lipid profile in adolescents 14-17 years has changed significantly. Mean levels of total cholesterol and low-density lipoprotein cholesterol decreased significantly in both gender groups. Mean values of high-density lipoprotein cholesterol for the 20-year period did not changed. Frequency of hypercholesterolemia for twenty years has fallen by more than 5 times. Significant regression coefficients for total cholesterol controlled by age, sex and year of study were revealed with body mass index, diastolic blood pressure and triceps skinfolds. Conclusion. During the period from 1989 to 2009 the prevalence of atherogenic dislipidemias among adolescents of Novosibirsk significantly changed.



2.
The Prognostic Value of Peripheral Arteries Diseases in Patients with ST-Segment Elevation Myocardial Infarction

M.V. Zykov, D.S. Zykova, V.V. Kashtalap, T.B. Pecherina, O.L. Barbarash
Keywords: acute coronary syndrome, polyvascular diseases, GRACE score model
Pages: 14-21

Abstract >>
Aims. To evaluate the clinical and prognostic role of hemodynamically insignificant stenosis of the extracranial arteries and lower extremity arteries in patients after myocardial infarction with ST - Segment elevation. Methods and results. The study sample consisted of 423 consecutively admitted patients in Kemerovo Cardiological Clinic with ST-Segment elevation myocardial infarction (STEMI). The disease outcome was defined in 397 patients (95.4 % of the initially discharged patients) a year later. 39 fatal outcomes were registered. The incidence of polyvascular diseases (PVD), defined by the intima-media thickness of the common carotid artery or presenting stenosis of any severity of the extracranial arteries (ECA) or lower extremity arteries (LEA) was substantially high - 95 %. The increasing severity degree of peripheral arteries stenosis was noted to raise significantly the cardiovascular risk factors incidence. In patients without PVD (n = 18) no fatal outcomes were registered, in patients with the ECA or LEA stenosis - >30 % (n = 193), the mortality rate was 5.7 %, and with stenosis < 30 % (n = 186) - 15,1 % (χ2 = 11,4, p = 0.003). Using the GRACE score model together with the additional factors determination (presenting congestive heart failure, PVD, prior stroke, smoking) enables to create a scheme (KemScore) of death risk stratification for 12-month period, with the value of the area under the ROC-curve 0.83 (0.76, 0.90), that is significantly higher than the initial GRACE score - 0.71 (0.63, 0.79). Conclusion. Additional risk factors determination, including peripheral arterial stenosis of 30 % and more, enables to optimize the predictive GRACE score model value.



3.
TRENDS IN PREVALENCE OF DYSLIPIDEMIA AMONG WORKERS OF THE WEST-YAKUT INDUSTRIAL REGION

YU.A. Nikolaev, V.G. Selyatitskaya, I.M. Mitrofanov, V.YA. Polyakov, YU.V. Lutov
Keywords: the North, dyslipidemia, prevalence, structure, men, women
Pages: 21-26

Abstract >>
The results were received from the screening surveys of workers of the industrial enterprises of Myrnyi town among non native nationalities according to the report of the program of European regional Bureau WHO/CINDI. The purpose was to reveal risk factors of development of chronic noncommunicable diseases in 1991, 2000 and 2007 and for the characteristics of trends in prevalence of lipid disorders in a population. Among men during the period from 1991 to 2007 the concentration of blood total cholesterol, cholesterol of low density and high density lipoproteins (LDL-C and HDL-C) have decreased, the concentration of triglycerides increased and the index of atherogenesis increased too. Among women similar changes were found. Prevalence of lipid disorders among men and women were more than 70 %. During the specified years (1991-2007) the prevalence of hypertriglyceridemia and hyper-HDL-C increased. The greatest increasing of the parameters has been marked during the period from 1991 to 2000.



4.
A possible role of influenza virus in atherosclerosis-associated diseases: is prevention effective?

O.V. Reshetnikov, S.А. Kurilovich, YU.P. Nikitin
Keywords: influenza virus, cardiovascular disease, myocardial infarction, prevention
Pages: 27-35

Abstract >>
The paper presents the literature data, as well as the results of our research on some aspects of the relationship between influenza infection and cardiovascular diseases. Influenza virus-induced endothelial dysfunction, modification of lipoprotein metabolism, atherosclerotic plaque outgrowth, and inflammation additionally support the opinion concerning the role of influenza infection as a strong cardiovascular risk factor. The feasibility of vaccination against these viruses is discussed because this might serve as an important tool for short- and long-term prevention of infection-associated cardiovascular disease.



5.
MELATONIN, SERUM LIPIDS, AND ATHEROSCLEROSIS: A REVIEW OF CLINICAL STUDIES

K.V. Danilenko
Keywords: melatonin, serum lipids, atherosclerosis, clinical trial, review
Pages: 36-43

Abstract >>
The article includes a general information on melatonin - its content in the human body, regulation of secretion, clinical effects. Taking into account the antioxidant and antiinflammatory properties of melatonin, clinical studies of the influence of melatonin on serum lipid profile and atherosclerosis in humans have been reviewed. The results of the clinical studies, particularly of placebo-controlled ones (N=4), appeared to be inconclusive towards the efficacy of melatonin for the lowering of cholesterol levels and normalization of the blood lipid profile.



6.
Apoprotein(a) isoforms: a link with quantitative levels of lipoprotein(a), aspects of multi-stage atherogenicity and other apo(a) correlations

A.V. Tikhonov, A.V. Shabalin, YU.I. Ragino, YU.P. Nikitin
Keywords: atherosclerosis, genetics, lipid metabolism, lipoprotein(a), apo(a) isoforms, structure
Pages: 43-54

Abstract >>
Most of the recent studies demonstrate that the quantitative level of Lp(a) and especially its low-molecular apo(a) phenotypes are independent risk factors of coronary atherosclerosis and correlate directly with the appearance, progress, and severity of manifestation of ischemic heart disease (IHD).
Several studies investigated the quantitative levels of Lp(a) and low-molecular apo(a) phenotypes in patients with stroke or transient ischemic attacks taking into account the presence and severity of atherosclerosis of the main arteries of the head with high risk of stroke and cerebrovascular complications of atherosclerosis. These indices appeared to be less informative for diagnostics, prognosis, and the severity of clinical course of these disorders than for the coronary atherosclerosis and IHD. On the other hand, in the retrospective studies of patients with stroke, quantitative Lp(a) levels and its low-molecular apo(a) isoforms were significantly higher than in the control group of healthy individuals (standardized odds ratio was 1.37 and 1.74, respectively). The contradiction between the results obtained in the mentioned studies and the Physicians Health Study about the risk of the development of ischemic and other types of stroke may be explained by post-stroke augmentation of Lp(a) level and by the different significance of Lp(a) level and apo(a) phenotypes in different populations.
There is no common opinion about necessity to correct high levels of Lp(a). But in case of augmented Lp(a) level, one of the actual strategy to influence the established risk factors of IHD is aggressive decreasing the concentration of cholesterol of low-density lipoproteins first of all that seems to be useful and reasonable in IHD patients. There are no highly effective methods of diet and/or drug management to correct the levels of Lp(a) and/or low-molecular phenotypes of apo(a), except for using high doses of nicotine acid, neomycin and estrogen-containing drugs. However, recommended doses of these drugs are associated with a lot of side effects. All these arguments evidence the necessity for determining the apo(a) phenotype/genotype and Lp(a) concentration levels.



7.
PREVENTION AND TREATMENT OF THE COGNITIVE DISORDERS OF LATE AGE BY USE OF THE POLYUNSATURATED FATTY ACIDS: CURRENT STATE AND PERSPECTIVES

A.V. Sukhanov
Keywords: cognitive disorders of the old age, Alzheimer's disease, omega-3 unsaturated fatty acids, docosahexaenoic acid, eicosapentaenoic acid, preventive measures, treatment
Pages: 54-61

Abstract >>
The article discusses the possibility of using of polyunsaturated fatty acids for prevention and treatment of cognitive disorders in old age. Current state and prospects of using of the eicosapentaenoic acid and the docosahexaenoic acid for this purpose are analyzed. Considering a demographic trends in developed countries in recent decades, the growing proportion of the elderly and the accompanying increase of frequency of the neurodegenerative diseases, it seems appropriate the prophylactic administration of a polyunsaturated fatty acids. It is clear that the prevalence of atherosclerosis-related disease (coronary heart disease, myocardial infarction) and its risk factors (arterial hypertension, obesity, diabetes mellitus, hyperhomocysteinemia) vary in different populations and lower in Mediterranean regions due to nutrition peculiarities such as consumption of polyunsaturated fatty acids. In addition, it is shown that the risk factors for Alzheimer's disease and atherosclerosis-related diseases are similar.