Aim. To assess the secondary prevention in Russian patients with coronary artery disease in the long-term period after acute myocardial infarction, acute coronary syndrome (ACS), percutaneous ...coronary intervention and/or coronary artery bypass grafting, obtained in the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in comparison with the general population of the study.Material and methods. EUROASPIRE V is a cross-sectional study with 27 countries, including Russia, which involved patients with ACS or indications for myocardial revascularization. At participating centers, patients admitted to hospital due to ACS or for percutaneous coronary intervention or coronary artery bypass grafting were identified. After 6 months and <2 years after discharge, patients were examined.Results. In total, 699 patients were identified in Russia, 399 of which visit an interview (women, 27,1%; mean age, 62,8±8,7 years). In the general population of the study, 16,208 patients were identified, 8,261 of which were interviewed (women, 25,8%; mean age, 63,6±9.6 years). At the time of the interview, 18,5% of Russian patients continued to smoke (16,8% in the general study population), the prevalence of overweight or obesity – 85,4 and 81,7%, abdominal obesity – 60,4 and 58,5%, diabetes – 21,9 and 29,3% of patients, respectively. In 19,7 and 16,4% of patients, respectively, diabetes was first diagnosed with a glucose tolerance test in the study. The target glycated hemoglobin was achieved in 47,1 and 54,4%, blood pressure – in 64,0 and 53,7%, low-density lipoprotein cholesterol – in 27,6 and 29,0% of patients, respectively.Conclusion. There were significant differences between the Russian cohort and the general study population. Some key secondary prevention parameters were more favorable in the Russian cohort, and some parameters – in the general group. In both compared populations, significant reserves are retained for further optimization.
The picture of primary prevention obtained from real-life practice makes possible scheduling measures for prevention improvement.
To analyze features of drug and non-drug therapy aimed at decreasing ...cardiovascular risk in Russian patients with a high risk (HR) of CVD compared with the study general population.
14 European countries, including the Russian Federation, participated in this cross-sectional study. The study included patients aged 18-80 without clinical signs of atherosclerosis who have received antihypertensive and/or lipid-lowering therapy and/or therapy for diabetes mellitus (DM) within >6 to.
Aim. Analysis of psychosocial risk factors in coronary heart disease (CHD) patients among Russian centers of the EUROASPIRE IV study, comparing to overall study population.Material and methods. In ...the cross-sectional study, 24 European countries participated, including Russian Federation (3 centers). In the study, patients were included of the age 18-80 y.o., who, during the period ≥6 months to <3 years before the inclusion, had been hospitalized with myocardial infarction (MI) or other acute coronary syndromes (ACS) or for myocardial revascularization. To the study protocol, the analysis of medical charts was included, with following visit and structured interview. During the study, long-term results were evaluated, presence and level of the risk factors, including psychosocial, life quality parameters, adequacy of the acquired by patients recommendations and the grade of adherence. Prevalence of anxiety and depression symptoms was assessed with the Hospital Anxiety and Depression Scale (HADS).Results. Overall, in the Russian centers, 746 patients were included, of those to the interview visit 424 admitted (mean age 63,4±9,0 y.o., 25,2% females). Educational level of the Russian cohort was higher than of overall study population (higher education in 44,3% and 22,3%, respectively). Prevalence of the anxiety symptoms in Russian patients and in overall population almost matched: 8-10 points by HADS-A in Russia and overall had 15,7% and 15,0% of participants, respectively, the ≥11 points — 12,4% and 11,3%, respectively. Contrary, the prevalence of depression symptoms in Russia was slightly higher: 8-10 by HADS had 16,4% and 14,6%, and ≥11 — 10,9% and 7,8%, respectively. Both anxiety and depression symptoms were more common among women; depression symptoms were more common for post-MI/ ACS patients than in the re-vascularized.Conclusion. By the data from European monitoring center of EUROASPIRE IV, in Russian cohort of CHD post MI/ACS, and revascularized patients there are specific differences in comparison with overall study population in psychosocial risk factors. Prevalence of clinically significant anxiety and depression symptoms in Russian cohort of EUROASPIRE IV was significantly lower than in earlier trials, including EUROASPIRE III, and was just slightly higher than in overall study population.
Evaluation of the effectiveness of risk management in persons with high cardiovascular risk is an important element in reducing the death rate of the population from cardiovascular diseases (CVD).
...Analysis of the prevalence and level of risk factors control in patients with high CV risk CVD from the Russian centers of the primary care unit of the EUROASPIRE IV study in comparison with the general population of the study.
In this cross-sectional study, 14 European countries, including the Russian Federation, participated. Patients aged 18 to 79 years were included in the study, without clinical manifestations of atherosclerosis, who were prescribed antihypertensive therapy and/or lipid lowering therapy and/or treatment for diabetes between the ages of ≥6 months and.
Background
Genetic predisposition is one of the risk factors for the development of multiple primary cancers (MPCs), the frequency of which increases and ranges from 2 to 17%. This study describes a ...combination of rare mutations, rs746551843 in the
NOTCH2
gene and rs144933006 in the
SDK2
gene, in a woman with breast cancer and leiomyosarcoma without a clearly burdened family history.
Case presentation
A 55-year-old Caucasian woman received complex treatment on the basis of the National Medical Research Centre for Oncology for left breast cancer and leiomyosarcoma of soft tissues of the left thigh. The patient was referred for consultation with a geneticist. Among direct relatives, a maternal aunt with a history of kidney cancer was not a carrier of the studied single nucleotide polymorphisms (SNPs). The healthy son of the patient inherited both mutations.
Conclusion
Thus, perhaps in the described case, there is a synergistic effect of two alleles of moderate and low penetrance, which led to the phenotype of multiple primary cancers.
Aim To study associations between the risk of severe adverse cardiovascular outcomes (SACVO) and all-cause death with psychosocial risk factors (PS RFs), such as stress, anxiety and depressive ...symptoms, low level of education, low income, social isolation, and type D personality, in patients with arterial hypertension (AH) and ischemic heart disease (IHD) managed in primary health care institutions in a multi-year prospective study.Material and methods PS RFs were assessed in patients with AH or IHD, who participated in a multi-year prospective COMETA study, using the Hospital Anxiety and Depression Scale (HADS), DS-14 questionnaire, and a visual analogue scale (VAS) for assessment of stress level. Associations of PS FRs with SACVO and all-cause death after a 1.5-year follow-up were analyzed using multivariate Cox regression models.Results At 1.5 years after patients were included in the study, it was possible to obtain data for 2,538 patients (age at baseline, 66.6 ± 7.8 years, 28.1% men), 106 of whom died during that period. The incidence of SACVO was 40.0 per 1000 person-years. According to the results of multivariate regression analysis, a very high level of anxiety symptoms (HADS-A≥14) was significantly associated with SACVO (odds ratio (OR), 1.81; 95% confidence interval (CI), 1.04-3.15; p=0. 02). The composite endpoint that included all-cause death and/or SACVO was significantly associated with a high (VAS score ≥8) stress level (OR, 1.53; 95% CI, 1.00-2.33; p=0.04) and a very high (HADS-D≥14) level of depressive symptoms (OR, 2.11; 95% CI, 1.22-3.62; p=0.02). A low level of education adjusted for gender and age increased the likelihood of SACVO by 1.7 (95% CI, 1.19-2.43) times. No significant associations were found between the analyzed outcomes and type D personality or with social isolation.Conclusion In patients with AH or IHD, the presence of high-grade stress and severe depressive symptoms increased the likelihoods of all-cause death and SACVO while a low level of education and severe anxiety symptoms were associated with SACVO. The study results showed that PS RFs for cardiovascular diseases keep the PS RF prognostic significance in the conditions of modern treatment of AH and IHD. Due to the negative impact on the prognosis, PS RFs should be taken into account when taking measures for secondary prevention of AH and IHD.
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e22538
Background: The purpose of the study was to determine DNA content and distribution of cells in cell cycle phases by flow cytometry in patients with primary and recurrent soft ...tissue sarcomas. Methods: 60 patients with soft tissue sarcomas (STS) were recruited: 30 with primary tumors and 30 with recurrent ones. Mean age of patients with primary STS was 56±5.4 years, with recurrent STS – 55±6.7 years. DNA content was determined using the BD Facs Cantoo II flow cytometer with CycleTEST PLUS DNA Reagent Kit (Becton Dickinson). The data were processed using ModFit LT program. Results: Comparative analysis of the cell cycle kinetics showed an increase in the percentage of cells in G2+M phase by 2 times in diploid and by 2.1 times in aneuploid recurrent tumors in comparison with primary ones (1.8±0.5% vs. 0.9±0.1% for diploid tumors; 5.4±2.2% vs. 2.6±0.7% for aneuploid tumors). An increase in the percentage of aneuploid tumors was found in recurrent G2 and G3 tumors (from 50% in primary to 66.7% in recurrent G2 tumors and from 63.25% in primary to 85% in recurrent G3 tumors). Mean content of aneuploid cells in recurrent G2 tumors was 2.2 times higher (p≤0.05), while the differences in primary and recurrent G3 tumors were not significant. The percentage of aneuploid tumors depended on the disease stage and increased in stages IIb and III in recurrent tumors, compared to primary ones (from 37.5% to 71.4% in recurrent st. IIb; and from 65% in primary st. III to 72.7% in recurrences) (p≤0.05). Conclusions: DNA analysis by flow cytometry demonstrated a high biologic potential of both primary and recurrent tumors. Some values in the mitotic cycle in recurrent tumors were probably associated with adjuvant therapy, as well as influenced by the coefficient of two parameters – the percentage of cells in G2+M phase and the cell loss factor determining a high malignant potential of these tumors.
12076
Background: Numerous pharmacogenetic studies have identified genetic polymorphisms (SNPs) associated with an increased risk of anthracycline-mediated cardiotoxicity (AMC). The purpose was to ...search for SNP-SNP interactions associated with the risk of cardiotoxic manifestations caused by anthracycline therapy in breast cancer patients. Methods: The study included 256 Caucasian patients (median age - 55 years) with a diagnosis of breast cancer with normal cardiovascular system parameters at baseline, who were treated with anthracyclines in 2019-2020. For SNP genotyping of c.4544G > A rs8187710 (ABCC2), c.1744C > T rs11549465 ( HIF1A), g.22125504G > C rs1333049 ( CDKN2A/ B) and c.214T > C rs4673 ( CYBA). DNA was extracted from blood by using DNA-sorb-B (AmpliSens, Russia). HRM-PCR was performed on a CFX96 amplifier (Bio-Rad, USA). The presence of polymorphism was confirmed by the Sanger method on a Genetic Analyzer 3500 (ABI, USA). Results: During the follow-up period 21 (8.2%) patients developed signs of subacute (changes developed within several weeks after the last course of therapy) or early chronic anthracycline mediated cardiotoxicity (changes developed within a year after completion of anthracycline therapy). Using the multifactorial dimension reduction method. We obtained a 4-locus model of SNP-SNP interactions c.4544G > A rs8187710 ( ABCC2) x g.22125504G > C rs1333049 ( CDKN2A/B) x c.214T > C rs4673 ( CYBA) x g.23708527G > A rs28714259 which has high prognostic properties. The specificity of the test based on the 4-locus model was 68%, the sensitivity was 100%, and the overall accuracy was 71%. The results of the analysis of SNP-SNP interactions indicate the greatest contribution of rs4673 and rs28714259 to the predisposition to AMC. The first ones yet into antagonistic interactions with rs28714259, rs1333049 and rs11549465, the second with rs8187710, rs11549465 and rs4673. On the contrary rs11549465 and rs1333049 contribute to a synergistic effect. Conclusions: The 4-locus model discovered in this study can form the basis of prognostic tests that predict early the risks of developing AMC in cancer patients, which in the future allow to personalize and select the most optimal treatment regimen.
12077
Background: Anthracyclines are highly effective chemotherapeutic agents, used for a wide variety of malignancies. Despite their antitumor efficacy there is a risk of cardiotoxic manifestations ...that reduce the time and quality of life of patients. The purpose was to study the effectiveness of molecular genetic tests based on rs4673 CYBA genotyping (c.242C > T) and measurement of plasma paraoxonase 1 (PON1) level in patients with breast cancer (BC) for predicting and diagnosing anthracycline-mediated cardiotoxicity (AMC). Methods: The study included 256 Caucasian patients (median age - 55 years) with a diagnosis of breast cancer normal cardiovascular system parameters at baseline, who were treated with anthracyclines in 2019-2020. For rs4673 genotyping, DNA was extracted from the blood by using DNA-sorb-B (AmpliSens, Russia). HRM-PCR was performed on a CFX96 amplifier (Bio-Rad, USA). The presence of polymorphism was confirmed by the Sanger method on a Genetic Analyzer 3500 (ABI, USA). The concentration of PON1 in blood plasma was measured at baseline and after 4 course of chemotherapy with anthracyclines using ELISA kits (Cloud-Clone Corp., China/USA). Results: During the follow-up period 21 (8.2%) patients developed signs of subacute (changes developed within several weeks after the last course of therapy) or early chronic AMC (changes developed within a year after completion of anthracycline therapy). In the group of patients without AMC the frequency of the minor allele rs4673 (c.214C > T CYBA) was 0.38, the frequency of genotypes C/C was 0.4, C/T - 0.43, and T/T - 0.17. The risk of AMC increased by 6.49 times in the presence of the rs4673 polymorphic allele (p = 0.002). The area under the ROC curve of the test based on rs4673 genotyping was 71.9%. The concentration of PON1 after the 4 courses of chemotherapy increased by 19.57% in the group of patients without cardiotoxic manifestations (p = 0.018) and in the group of patients with AMC by 20.23% (p = 0.007) as compared to the initial level. Besides, after 4 courses of chemotherapy the PON1 level was higher in patients with AMC by 25.08% (p = 0.026) than in patients without cardiovascular complications. The sensitivity of the test based on the measurement of the PON1 level in the blood plasma after 4 courses of chemotherapy was 100%, the specificity was 70.8% with a cut-off value of 2.9 ng/ml. Conclusions: This study has showed that genotyping of patients for the rs4673 polymorphism allows pre-stratification of the risk group white determination of the PON1 level in blood plasma after 4 courses of chemotherapy gives the opportunity to identify patients with AMC and promptly correct the chosen treatment.
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