THE ROLE OF NT-PROBNP AND ST2 BIOMARKERS IN PATIENTS WITH ACUTE CORONARY SYNDROME.

OBJECTIVE: The aim: To determine the diagnostic value of serum levels of ST2 in patients with the acute coronary syndrome (ACS) and its correlation with NT-proBNP levels. PATIENTS AND METHODS: Materials and methods: NT-proBNP and ST2 concentration in serum of patients was measured on admission to the hospital and on the 10th day of the treatment using NT-proBNP ELISA (Biomedica, Slovakia) and Presage ST2 assay (Critical Diagnostics, USA), respectively. RESULTS: Results: Statistically significant direct correlations (p<0.05). The simultaneous increase of ST2 and NT-proBNP serum levels above their threshold in patients with ACSelST (sensitivity - 92.5 %, specificity - 74.2 %, AUC - 0.893, р<0.05) indicated a significant risk of cardiovascular (CV) complications of acute myocardial infarction (AMI) during the inpatient period, e.g. acute heart failure, acute LV aneurysm, recurrent AMI, as well as rhythm and conductivity disturbances. CONCLUSION: Conclusions: The data suggest that both ST2 and NT-proBNP may prove useful in predicting unfavorable prognosis during the inpatient care of AMI, as the simultaneous increase of these biomarkers above their threshold values indicates a significant risk of CV complications.

Impact of risk factors of ischemic heart disease on the development of acute coronary syndrome, platelet ultrastructure, and aspirin resistance.

OBJECTIVE: Introduction: Risk factors of ischemic heart disease have an impact on blood cell apoptosis, platelets in particular, and their calcification. 5-40% of patients with high cardiovascular risk have anti-platelet drug resistance. The study of the morphofunctional status of platelets in patients with acute coronary syndrome is relevant and requires further research. The aim: to find out the impact of various risk factors for coronary heart disease on ultrastructural changes in platelets and the causes of their resistance to antiplatelet drugs. PATIENTS AND METHODS: Materials and methods: 36 patients with acute coronary syndrome and risk factors such as arterial hypertension, dyslipidemia, type 2 diabetes mellitus, smoking, alcohol abuse, and occupational hazards were examined. The mean age of patients was 56±5.6 years. The control group consisted of 10 apparently healthy people. Functional state and ultrastructure of platelets were studied using electron microscopy. RESULTS: Results: Most platelets of patients in the control group were discoid without pseudopods with evenly distributed platelet and dense granules. Platelets of patients with acute coronary syndrome were mostly activated, as evidenced by the presence of pseudopods, as well as moderate concentrations of platelet granules in their central region. In the study group of patients, part of platelets was aggregated, osmiophilic, and vacuolated with signs of microclasmatosis of the pseudopods. Particular attention should be paid to platelets with signs of calcification, as evidenced by their excessive osmiophilic property and manifestations of apoptosis. CONCLUSION: Conclusions: The presence of ischemic heart disease risk factors in acute coronary syndrome patients leads to platelet calcification and activation of blood cell apoptosis. With the use of electron microscopy, we detected degenerative changes of platelets and their calcification, which in the future may lead to the development of resistance to aspirin and require new oral coagulants.

[Cardiorehabilitation of hypertonic disease].

OBJECTIVE: Introduction: Considering the great medical, social and economic significance of the problem of treatment of hypertension, cardiological rehabilitation is of great importance in restorative treatment of patients. The aim: To analyze the scientific literature on the necessity of different methods of cardiorehabilitation, which proved their effectiveness and shown for use in the complex regenerative treatment of patients with hypertonic disease. PATIENTS AND METHODS: Materials and methods: Analysis and generalization of scientific and methodical literature on modern directions and methods of cardiorehabilitation at hypertonic disease. CONCLUSION: Conclusions: The effectiveness of hypertonic disease treatment depends on the complex combination of a wide range of rehabilitation products, such as medical therapy, physical exercises, physiotherapy, ergotherapy, psychological correction; application of them depending on the current tasks of a certain restorative stage of treatment, which allows to achieve optimal physical rehabilitation.