Efficacy and Safety of Perindopril in Patients with Essential Hypertension.

INTRODUCTION: Perindopril is a tissue-specific ACE inhibitor with 24 hours long blood pressure-lowering effect, which protects blood vessels and decreases the variability of blood pressure. AIM: The aim of our study was to investigate the effectiveness and safety of perindopril in newly diagnosed or previously treated but uncontrolled adult hypertensive patients. METHODS: This prospective cohort study included primary care patients with essential hypertension. Primary study outcomes were decreasing arterial blood pressure to normal levels (<140/90 mmHg), reducing systolic arterial blood pressure for 10 mmHg or more and reducing diastolic arterial blood pressure for 5 mmHg or more. Safety was evaluated by type and frequency of adverse events. RESULTS: In the great majority of the study patients (more than 96%) perindopril was effective as monotherapy, achieving a significant reduction in both systolic and diastolic blood pressure, and in three-quarters of the study patients it normalized both systolic and diastolic blood pressure. The effectiveness of perindopril was shown in both patients with previously and newly diagnosed hypertension, adverse events were mild and rare, even hyperkalemia was encountered less often than before the onset of the therapy with perindopril. CONCLUSIONS: Our study confirmed excellent effectiveness of perindopril in the treatment of essential hypertension and its remarkable safety. When used as monotherapy of hypertension, perindopril's doses should be carefully titrated until the achievement of full effect, which in some patients should be awaited for at least 6 months from onset of the therapy.

Risk Factors in Patients with Non-ST Segment Elevation Myocardial Infarction.

INTRODUCTION: The most common cause of myocardial ischemia is atherosclerotic epicardial coronary artery disease, present in 90% of patients. Risk factors positively correlate with the onset, development and subsequent complications of atherosclerotic disease. AIM: Determine the percentage frequency of classic risk factors for coronary disease in patients with non-ST segment elevation myocardial infarction (NSTEMI), with regard to gender. METHODS: A retrospective study was conducted on 600 respondents, treated for NSTEMI at the Clinic for Internal Medicine of the University Clinical Center (UKC) Tuzla, in the period from June 2016 to December 2019. RESULTS: Overall, smoking was the leading risk factor (65%), followed by hypertension (58%), hyperlipoproteinemia (39%), overweight (33%), positive family burden (30%) and diabetes mellitus (19%). In male patients, the leading risk factor was smoking, rating at 74%, while in female patients - it was hypertension at 67%. In younger groups of patients leading risk factors were smoking and a positive family burden. CONCLUSION: With adequate prevention and treatment measures, a significant reduction in the prevalence of the cardiovascular disease can be achieved, since the risk factors for its development have long been known. Quitting smoking is one of the most effective secondary prevention measure since it reduces the reinfarction risk rate by 50%. Knowledge of coronary risks, as well as success in reducing them, can greatly contribute to patients' overall sense of contentment and significantly raise their self-confidence.

The Cumulative Incidence of Stroke, Myocardial infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation.

INTRODUCTION: Atrial fibrillation represents the most common cardiac arrhythmia in clinical practice. By year 2030, 14-17 million AF patients are anticipated in the European Union. Atrial fibrillation remains one of the major causes of stroke, heart failure, sudden death all over the world. RESEARCH OBJECTIVES: The objective of our study is to determine the cardiac and cerebrovascular events (myocardial infarction, heart failure, stroke, sudden cardiac death) and their cumulative incidence during 11 years follow up period. PATIENTS AND METHODS: This study includes 2352 ambulant and hospitalized patients with atrial fibrillation (AF) who were enrolled during the follow up period. All patients underwent clinical evaluation in order to determine cardiac and cerebrovascular events (myocardial infarction, heart failure, stroke, sudden cardiac death) and their cumulative incidence. RESULTS: The results of cumulative incidence for sudden cardiac death was 1.71%, for stroke 2.56%, for myocardial infarction 1.20% and for heart failure was 5.73%. In our study the age-adjusted incidence and prevalence of AF are slightly lower in women. The study shows that the risk of death is higher in females than in males with AF. CONCLUSION: Despite good progress in the management of patients with atrial fibrillation (AF), this arrhythmia remains one of the major causes of stroke, heart failure, sudden death. Effective treatment of patients with atrial fibrillation includes not only rate control, rhythm control, and prevention of stroke, but also management of cardiovascular risk factors and concomitant diseases.

The Impact of Risk Factors and Comorbidities on The Incidence of Atrial Fibrillation.

INTRODUCTION: Atrial fibrillation (AF) is the most common form of cardiac arrhythmia in clinical practice and its prevalence increases with age. Patients who develop AF also have cardiovascular risk factors, structural heart disease, and comorbidities, all of which can increase mortality. AF causes a significant economic burden with the increasing trend in AF prevalence and hospitalizations. RESEARCH OBJECTIVES: The objective of our study is to evaluate the impact of the most common known risk factors on the incidence of atrial fibrillation as an important precursor of cardiac and cerebrovascular morbidity and mortality among our patients in Bosnia and Herzegovina during median follow up period (September 2006 - September 2016). The other objective is to estimate the CHA2DS2-VASc score among our patients based on clinical parameters. PATIENTS AND METHODS: This study includes 2352 ambulant and hospitalized patients with atrial fibrillation. All patients underwent clinical evaluation which includes thorough assessment for potential risk factors and concomitant conditions in order to determine which of them represent the most common among examinees with atrial fibrillation. RESULTS: The results show that male gender has slightly more incidence of AF. Obesity and overweight with BMI ≥ 27, cigarettes smoking and sedentary life style are almost present in patients with AF. Arterial hypertension, coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal dysfunction, structural and valvular heart disease and peripheral vascular disease are the most common comorbidities among our patients. The mean CHA2DS2-VASc score was 3.2±1.4 and the mean HAS-BLED score was 2.1±1.2. CONCLUSION: Atrial fibrillation is the most common sustained cardiac rhythm disorder. The study shows that obesity, alcohol consumption, smoking cigarettes and dyslipidemia can be considered as triggers and predisposing factors for appearance of AF. Arterial hypertension, coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, Peripheral vascular disease and chronic kidney disease are playing important role in developing of AF.

The role of exercise test in stratifying the risk of asymptomatic patients with moderate/severe aortic stenosis.

OBJECTIVES: The role of exercise test in risk stratifying of asymptomatic patients with moderate and severe aortic stenosis (AS) in recent literature is still controversial. The aim of this study was to evaluate the role of exercise test in stratifying the risk of patients with moderate to severe aortic stenosis. METHODS: At the Internal Medicine Clinic, Department of Cardiology in Tuzla, in the period from January 2008 until January 2010 was followed 33 patients with clinical and echocardiographic parameters of moderate to severe asymptomatic aortic stenosis (mean effective orifice area EOA 0.9 +/- 0.34 cm2). In statistical analysis we used descriptive statistics, t-test, chi-square test and Kaplan-Meier life table for predictive values, sensitivity and specificity. A significance level of 0.05 was used. RESULTS: Two patients were excluded due to exclusion criteria, so 31 patient was followed up during 12 months period. Eighteen patients (58%) with EOA pounds sterling 0.8 cm2 had limiting symptoms during the test. During follow-up period, 11 patients developed serious spontaneous symptoms, and out of them 8 patients underwent surgical valve replacement, one patient died (sudden cardiac death), and 2 patients had serious complications (ischemic cerebral stroke). Twenty patients remained asymptomatic. The highest positive predictive accuracy had EOA pounds sterling 0.8 cm2 with limiting symptoms and it was 85%. The highest negative predictive accuracy had ST depression. CONCLUSION: only limiting symptoms along with EOA pounds sterling 0.8 cm2 had positive predictive accuracy.

Mortality at the Clinic of Internal Medicine of University Clinical Center in Tuzla during 2008.

INTRODUCTION: Accurate information about the cause of death is given by expert teams based on pathological or forensic expertise. Reliable information can be obtained from doctors from clinical-hospital institutions if the deceased person was treated in such an institution and with previously diagnosed disease (hospital mortality). Analysis of hospital mortality provides a lot of data that can be used in planning the hospital beds capacities, the amount of drug procurement, purchasing equipment, organization and creation of highly specialized medical teams (medical team for resuscitation), the number of reanimation techniques, the number of pathologists who are required for autopsy procedures, etc. GOAL was to determine the total number of deaths, the most common causes of death and the 10 leading diagnoses of deceased patients at the Clinic for Internal Medicine of Clinical Center in Tuzla during 2008. MATERIAL AND METHODS: We used the material from the archive (medical records and reports on deceased patients, delivered by physicians working at the Clinic for Internal Medicine of Clinical Center in Tuzla). RESULTS: During 2008 at the Clinic for Internal Medicine 368 patients died. According to the analyzed data leading cause of death and leading diagnosis as cause of death at the Clinic for Internal Medicine in 2008 were as follows: cardiogenic shock in 73 (19.84%), cerebrovascular stroke in 46 (12.50%), coma due to stroke in 32 (8.70%), coma not classified as cerebral in 25 (6.79%) (metabolic 13 (3.53%) and hepatic 12 (3.26%), cardiomyopathy in 22 (5.98%), malignant neoplasm of the abdomen in 17 (4.62%), respiratory insufficiency in 17 (4.62%), acute myocardial infarction and myocardial infarction with rupture in 17 (4.62%), pulmonary edema in 16 (4.35%), and cardiorespiratory arrest in 13 (3.53%) deaths. CONCLUSION: During 2008 at the Clinic for Internal Medicine of Clinical Center in Tuzla died a total of 368 patients. The most common cause of death of patients at the Clinic for Internal Medicine of Clinical Center in Tuzla are cardiovascular disease (n = 175; 47.55% of deaths), in second place was cerebrovascular disease (n = 76; 20.65% of deaths) for a total of 251 (68.20%) of deaths from cardiovascular and cerebrovascular disease.

Correlation between interleukin 6 and interleukin 10 in acute myocardial infarction.

The aim of this study was to analyze (i) ratios between pro-inflammatory cytokines interleukin 6 (IL-6), interleukin 1 (IL-1), tumour necrosis factor alpha (TNF-alpha) and anti-inflammatory cytokine interleukin 10 (IL-10) in patients with acute myocardial infarction (AMI) and stable angina pectoris (ii) as well as correlation between IL-6 and IL-10 in AMI and (iii) correlation between IL-6 and lipoproteins in AMI.The total of 71 patients were enrolled in this study, 41 of them with AMI (study group) and 30 with stable angina pectoris (control group). The concentrations of cytokines and lipoproteins were measured from blood samples. Pro-inflammatory to anti-inflammatory cytokine ratios were calculated by dividing concentrations of pro-inflammatory cytokines with IL-10. In statistical analyses we used descriptive statistics, normality tests and analysis of correlation.IL-6: IL-10 ratio is significantly higher in AMI than in stable angina (P < 0,001), TNF-alpha: IL-10 is also higher in study group but the difference is not significant. We found positive linear correlation between IL-6 and IL-10 (r =0,43; p = 0,015) and negative linear correlation between IL-6 and high density lipoprotein HDL (r = -0,47; p= 0,008) in AMI.IL-6: IL-10 ratio is higher in AMI than in stable angina. There is linear correlation between IL-6 and IL-10 and IL-6 and HDL in AMI.

Amino-terminal pro-brain natriuretic peptid in prediction of left ventricular ejection fraction.

We aimed to evaluate levels of amino-terminal pro-brain natriuretic peptid (NT-proBNP) in prediction of left ventricular ejection fraction (LVEF) in heart failure patients. Prospective study on 60 consecutive patients with symptoms and signs of heart failure was performed. Blood samples for NT-proBNP analysis was taken from all test subjects and echocardiography was also done in all of them. According to LVEF value, patients were divided into four groups; those with or=50%. NT-proBNP values correlated with LVEF value. Regression analysis was used to evaluate how well NT-proBNP values predict LVEF. We used Receiver Operating Characteristic Curve calculation to evaluate diagnostic performance of NT-proBNP in estimation of LVEF. Average value of NT-proBNP in test group was 3191.69+/-642.89 pg/ml (p<0.001). Average value of NT-proBNP decreased with higher LVEF categories with significant (p<0.001) and high negative correlation (r= -0,75). Stepwise multivariate linear regression analysis showed that logarithmic value of NT-proBNP was excellent predictor of LVEF value (p<0.05). Model equation based on regression analysis was LVEF=88.645-15.311 x log (NT-proBNP). Predictive model for LVEF yielded from regression analysis had sensitivities of 98% and 81%, specificities of 20% and 90%, positive predictive values of 86% and 78% and negative predictive values of 67% and 92% for predicting patients with LVEF<50% and LVEF<40%, respectively. There was negative linear correlation between NT-proBNP and LVEF. NT-proBNP was excellent predictor of LVEF value (p<0.05).

Left ventricular diastolic dysfunction in essential hypertension.

T Diastolic dysfunction is very frequent and is actually sign of manifest heart weakness. Over 40% of patients with heart weakness have isolated left ventricular diastolic dysfunction (LVDD). New diagnostics methods as Doppler Echocardiography with close monitoring enables precise and early LVDD diagnose. In all diastolic phases artery hypertension weakens relaxation and left ventricular hypertrophy (LVH) weakens compliance also. The purpose of this study is to demonstrate importance of all LVDD. Doppler echocardiography parameters usage and its important echocardiography characteristic in case of hypertensive patients. This study represents 64 patients with essential hypertension - random sample. Three patients had atrial fibrillation. Besides anamnestic data collection, echocardiography evaluation was undertaken on all patients. For LVDD diagnose following parameters were used: isovolumic relaxation time (IVRT), peak early filling velocity (E), peak atrial filling velocity (A), E/A ratio, DT (deceleration time), left ventricular (LV) mass. Left ventricular hypertrophy (LVH) was verified for 57 patients. Seven hypertensive patients didn't have verified LVH. Comparing patients with LVH with those without LVH differences were observed: patients with LVH had a longer IVRT, lower E/A ratio, A wave growth, IVRT directly correlates with LV mass increase and backward correlation LV mass with E/A was noticed. Among patients with LVH with E/A ratio =or> 1-1,5 and based on transmitral flow we used IVRT duration and pulse Doppler with volume sample over lateral mitral annulus measuring mitral annulus velocity. It appeared that it corresponds with IVRT duration in LVDD evaluation. Patients with atrial fibrillation had considerably extended IVRT that indicates LVDD existence. Patients with left ventricular hypertrophy were older and they have higher left ventricular mass comparing with patients without left ventricular hypertrophy. In case of patients with essential hypertension all above mentioned LVDD parameters have to be defined, specially IVRT duration for determination of LVDD existence in case of all patients with essential hypertension with and without LVH and in case of associated atrial fibrillation presence. It is necessary to tend to, as early as possible, detect LVDD and it's prevention with improved essential hypertension monitoring.

Effects of nebivolol on artery hypertension--multicentre study Bosnia and Herzegovina.

Hypertension is a major risk factor for cardiovascular diseases; drugs that reduce blood pressure and simultaneously improve or reverse endothelian dysfunction, as nebivolol, may be advantageous in terms of cardiovascular protection. The objective of this study is to show the anti-hypertensive efficacy and safety of nebivolol (5 mg once a day) given to patients with arterial hypertension for 3 months. It should also provide information about drug's influence on laboratory tests--fasting blood glucose and serum cholesterol, triglyceride and creatinine concentrations. Six centers--Tuzla, Sarajevo, Mostar, Bihac, Zenica and Banja Luka participated in this prospective study with follow-up period of 3 months that included 3 visits. The study group consisted of 328 hypertensic patients. Results showed a significant decrease in both systolic and diastolic blood pressure and heart rate at the end of the study. Fasting blood glucose level and serum cholesterol, triglyceride and creatinine changed significantly during the study, with lower levels of all the tests. Nebivolol seems to be free from some of the problems that generally accompany not only the classical beta- blockers but sometimes also newer classes of antihypertensive drugs. With its high anti-hypertensive efficiency and safety, and presence of statically significant difference in laboratory tests and beneficial effects, absence of adverse interaction with glucose and lipid metabolism, patients treated with Nebivolol may show an optimal adherence to therapy.

[Dysfunction of the left chamber after myocardial infarct]. / Disfunkcija lijeve komore poslije infarkta miokarda.

Dysfunction of the left chamber of the heart happens when the function is not sufficient to supply all organs with needed quantity of blood, oxygen and nourishing materials. Consequence is an exhaustion of the heart compensatory and peripheral mechanisms. The research is based on the results of the analysis of residual changes that remained since acute myocardium infarct got over (scar, contracture changes, conductivity) and analysis of the remained functional part of the left chamber myocardium. Electrocardiogram, echocardiography and exercise test were used. 60 patients were examined. 6 varieties of chronic myocardium infarcts were found: anteroseptal, inferior, anterolateral and anterior-broaden, high-lateral and posterior localisation. Wagner's method QRS-scoring system and scores for wall motion by the American of ehocardiography were found the damage size of the myocardium mass. Correlative coefficient is full (r = 1.0). In chi2-test there is no significant difference (Wagner, echocardiography) in dimensions of old infarct (p < 0.05). Dyastolic dysfunction was set by echocardiographic method for 75%, systolic 41.11% examinees, remodelling in 80%, extended isovolumetric relaxation time and time of deceleration in 100% cases, speed ratio E-wave and A-wave below 1.0 in 82.66% cases. Exercise test was made for 85% examinees. Dysfunction was registered in 84.37%, diastolic in 80.39%, systolic in 43.17% cases. On the base of coronarographie results (23.33% examinees) the sensitivity was set for: exercise test in systolic dysfunction is 42.86%, in dyastolic is 71.43% and echocardiography in systolic disfunction is 57.14%, in dyastolic 100%. According to echocardiographic analysis of parameters the greatest influence has reduction of ejection fraction with 36.67% in systolic and extension of the period of deceleration with 38.79% in diastolic dysfunction. There is a good complement of the tested methods (p < 0.05). There is possibility, with these methods to appraise dysfunction of the left chamber in old myocardium infarct with conclusion that echocardiography is more sensitive since gives more data and direct visualization of changes.

[Arrhythmia and left ventricle remodeling in acute myocardial infarct: recommendations for drug therapy]. / Aritmije i remodeliranje lijevog ventrikula u akutnom infarktu miokarda: preporuke za medikamentozni tretman.

Occurrences of arrhythmias during the acute myocardial infarction is explained with local ischaemia, but mechanism of later occurrences is unclear. Our study had for the aim to examine relationship between postinfarction left ventricle dilatation and appearance of arrhythhmias, and to show drug effects on remodelling. Patients who developed progressive left ventricle dilatation had higher mortality then patients without changes of left ventricle volume, and mortality is due of sudden cardiac death. Drugs who had preventive effects or reverse remodelling can help in prevention of malignant arrhythhmias and sudden cardiac death. It is showed that ACE inhibitors, beta-blockers and aldosterone antagonists had preventive effects on left ventricle remodelling. The combined therapy with ACE inhibitors, beta-blockers and aldosterone antagonists is showed as the most-effective in prevention of remodelling, appearaance of arrhythhmias and sudden cardiac death.

[Pericarditis and exudative pleuritis in patients with systemic lupus erythematosus before and after therapy]. / Perikarditis i eksudativni pleuritis u bolesnika sa sistemskim eritemskim lupusom prije i poslije terapije.

AIM OF THE STUDY: To establish the presence of pericarditis and exudative pleuritis in patients with systemic lupus erythematosus (SLE) prior to and after glicocorticoid and cytotoxic therapy. PATIENTS AND METHODS: In 43 patients, 39 women and 4 men, with SLE (disease was diagnosed according to revised American College of Rheumatology ACR criterias, 1997), aged between 20 and 61 and averaged disease duration of 5.54 +/- 5.74 years, heart/lung radiology and heart echosonography were performed in order to discover possible serositis (pericarditis and exudative pleuritis) prior to and after cytotoxic and glucocorticoid therapy. RESULTS: The presence of pericarditis and exudative pleuritis was established in 20 patients (47%) before the therapy. After the therapy pericarditis was present in 2 patients, average volume of 150 ml, and exudative pleuritis was also present in phrenicocostal sinus, but its volume was minimal. This table is showing the results of our study on patients with SLE and serositis. The results were compared with the results of European and Belgrade group in year 2000. [table: see text] CONCLUSION: Higher frequency of serositis (pericarditis and exudative pleuritis) in our study is probably a result of more active disease, and the effects of cytotoxic and glucocorticoid therapy were satisfing exept in two patients who were resistant on therapy. That is the reason why we had to consider plasmapheresis.

[The U-wave in ischemia and left ventricular dysfunction after myocardial infarct]. / U-val u ishemiji i disfukciji miokarda lijeve komore poslije infarkta miokarda.

INTRODUCTION: The occurrence of U-wave in electrocardiogram appears after T-wave. It is period of the greatest excitability of the myocardium in heart electrical activity usually of the some direction as its own T-wave. AIM OF THE WORK ANALYSE: U-wave with ischaemia and dysfunction of the myocardium in exercise test. MATERIAL AND METHODS: The prospective study has been done for 51 patients. Electrocardiogram, exercise test vas made for all patients and immediately after test, echocardiography with Doppler and colour-Doppler. In the analysis of dysfunction of the left chamber these important parameters were followed: METS; decrease of blood pressure, devaluation of ST-segment, U-wave, heart rate, dyspnea, sweating and paleness. RESULTS: Positive U-wave was noticed in 51%, negative in 24% examinees. Sensitivity of U-wave on the base of the breakdown of segmental vall motion in echocardiography (ischaemia) is 66.67% with false negative resists of 33.33%. Systolic dysfunction with influential parameters correlates in the best way with decrease of blood pressure and regressive coefficient is 66.93, but the weabest correlation is with U-wave (0.53). Correlative coefficient for U-wave in systolic function is 0.263. Regressive coefficient with influential parameters in diastolic dysfunction is 3.34, correlative coefficient is 0.108. CONCLUSIONS: U-wave in registered at rest after exercise test when heart rate is equal or below 95 in a minute. Registration of U-wave is an additional parameter in diagnostics of ischaemia and dysfunction of the myocardium of the left chamber (small influence).

[Statins in dyslipidemia associated with acute myocardial infarct]. / Statini kod dislipidemije u akutnom infarktu miokarda.

Long time ago lipids increased in blood have been known as risk factor for atherosclerosis that causes coronary heart disease among which myocardial infarction is the most complicated. Aim were to present the lipids status structure in patients with acute myocardial infarction and on the basis of that to suggest corresponding statin in treatment. Our research involved 202 patients with acute myocardial infarction, patients were both gender and from 37 to 89 year. Out of total number of patients, 100 of them were with anterior myocardial infarction (group I) and 102 with inferior myocardial infarction (group II). Whole cholesterol, low density lipoproteins, high density lipoproteins and triglycerides were followed. Hi square test and variance analysis were used to prove statistically significant difference. In the sample of group I increased LDL was found in 92 patients and increased TGL in 46 patients while decreased HDL was found in 61 patients. In the sample of group II increased LDL was found in 64 patients, increased TGL in 44 patients, while decreased HDL was found in 51 patients. We analysed the next combinations in both groups: LDL > with HDL <; LDL > with TGL >; HDL < with TGL >; LDL >, TGL > with HDL <. Combination decreased HDL with increased TGL was found in group I in 5 patients, and in group II in 12 patients. Other combinations in both groups were similarly values. On the basis of the obtained results we found statistically significant difference between the two groups of patients. Patients in group I have more frequently increased values of LDL in comparison to patients in group II (p < 0.00005). In patients in group II who had decreased HDL and increased TGL statistically significant difference was found in comparison to the patients in group I (p < 0.02). On the basis of the obtained results and up to now studies on statins effects we suggest Atorvastatin for treatment the patients with anterior myocardial infarction, increased LDL with normal values of HDL and Simvastatin for treatment the patients with inferior myocardial infarction, decreased HDL.

[Sensitivity, specificity and predictive value of the treadmill stress test in comparison with coronary angiography findings]. / Senzitivnost, specificnost i prediktivna vrijednost tredmil testa opterecenja srca u odnosu na koronarografski nalaz.

UNLABELLED: Precondition to prevention and control of morbidity and mortality of myocardial ischemia--coronary disease, is its good diagnostic. Goal of this study is to asses diagnostic significance of positive trademill stress test in diagnosis of coronary disease. MATERIAL AND METHODS: we analyzed 120 patients with markedly positive classic trademill stress test using Bruce protocol in the year 2003. In all cases, positive stress test was followed by selective angiography, using standard technique with multiple sections. Blood vessel narrowing of more than 50% was chosen as the criteria for positive angiographie finding. With the help of coronary angiography, it was found that 62 (51.7%) of patients has stenosis of less than 50% or normal angiographic finding. 58 (48.3%) of patients had stenosis of more than 50%. Of that number, 24 (41.4%) had one-vessel coronary disease, 12 (20.7%) two-vessel coronary disease, and 10 (34.5%) three-vessel coronary disease. 2 patients (3.4%) had stenosis of the trunk of left coronary artery. Results of this study show that the sensitivity of trademill stress-test is less than optimal, and should be supplemented by other non-invasive techniques (such as myocardial perfusion scintigraphy, radionuclide ventriculography and stress echocardiography) in diagnostics of coronary disease.