[Dynamics of the mortality indicator of the population of the Irkutsk region from cerebrovascular diseases in age and gender aspect]. / Dinamika pokazatelya smertnosti naseleniya Irkutskoi oblasti ot tserebrovaskulyarnykh boleznei v vozrastno-polovom aspekte.

OBJECTIVE: To study and analyze the dynamics of the mortality rate of the population of the Irkutsk region from cerebrovascular diseases (CVD) in 2010 and 2020 in terms of age and gender. MATERIAL AND METHODS: The study included all registered deaths among the population of the Irkutsk region in 2010 and 2020 years in age and gender groups from CVD. The grouping of the material was carried out by distributing the deceased by sex and five-year age intervals (from 15 to 85+ years) with the subsequent calculation of mortality tables. The method of analysis of the time series was used with the calculation of indicators of absolute increase, rate of increase, growth rate, the content of 1% increase in the mortality rate in cases. RESULTS: A significant increase in the 1% increase in mortality among males both in 2010 and in 2020 years was observed starting with the age group 55-59 years. The 1% increase in mortality was 1.24 and 1.69 deaths, respectively. Among females, a significant increase in the 1% increase in mortality was recorded in the 60-64 age group in 2010 year and in the 65-69 age group (1.25 and 1.31 deaths, respectively). In 2020 year, compared to 2010 year, both among females and males in almost all age groups, there was a decrease in the intensity of the 1% increase in mortality cases, except for the 55-59 age group among males. gender and except for age groups 40-44 years old and 55-59 years old among females. CONCLUSION: In the Irkutsk region, among males, the decrease in the mortality rate from CVD compared with females from 2010 to 2020 years was less pronounced. During the study period of observation, the intensity of the ratio of the increase in the mortality rate from CVD in men to women increased. So, in 2010 year, the maximum ratio was 2.1:1, in 2020 year - 5.0:1. The exponent 1% increase in deaths in males was higher than in females.

[Indicators of stroke morbidity and mortality from stroke in the territories included in the Federal program of caring for patients with stroke]. / Pokazateli zabolevaemosti insul'tom i smertnosti ot nego na territoriyakh, voshedshikh v Federal'nuyu programmu reorganizatsii pomoshchi patsientam s insul'tomm.

OBJECTIVE: To study and analyze the dynamics of stroke morbidity and mortality rates among men and women in the territories included in the Federal program for the reorganization of care for stroke patients. MATERIAL AND METHODS: The study was based on data from the territorial-population register of strokes. The study included the following territories: Ivanovo region, Stavropol territory, the Republic of Bashkortostan, Sverdlovsk region, Irkutsk region, Sakhalin region, and the Republic of Tatarstan. Research period was from 2009 to 2016. A total of 29 779 stroke cases were analyzed. The age of the examined people was 25 years and older. RESULTS AND CONCLUSION: In the study areas, a 2.2 - fold decrease in stroke mortality among men and a 3-fold decrease among women was found. The values of morbidity and mortality from stroke over the entire study period were higher among men. It was also revealed that in 2015-2016, the mortality rate was in a narrow range of values, which demonstrates the impact of comprehensive measures to reduce stroke mortality in all the studied territories. The results of cluster analysis of stroke incidence rates obtained from seven territories over an 8-year period indicate similar measures for primary stroke prevention among men. Among women, there are also similarities in primary stroke prevention measures, with the exception of two regions - the Stavropol territory (4.8 cases per 1000 population) and the Republic of Tatarstan (4.5 cases per 1000 population), where the highest values of the stroke incidence rate were found. The results of cluster analysis of stroke mortality rates among men indicate a fairly large variation in the indicator values. The dominant value of the stroke mortality rate among men was found in the Sakhalin region (1.61 per 1000 population). The significance of stroke mortality rates among women in the regions was similar: six territories with similar levels of values were identified. The exception was the Stavropol territory (2.48 cases per 1000 population), where the highest death rate from stroke was revealed.

[An analysis of the long-term stroke morbidity and mortality in the regions of the Russian Federation included in the Federal patient assistance reorganization program]. / Analiz srednemnogoletnei zabolevaemosti i smertnosti ot insul'ta v regionakh Rossiiskoi Federatsii, voshedshikh v federal'nuyu programmu reorganizatsii pomoshchi patsientam s insul'tom.

OBJECTIVE: To analyze the average long-term incidence of stroke and mortality in the regions of Russia in the territories included in the Federal program for the reorganization of care for stroke patients from 2009 to 2016. MATERIAL AND METHODS: The study is based on data from the territorial population register for an eight-year period for seven territories in the regions of Russia included in the Federal program for the reorganization of care for stroke patients. The study included the following territories: Stavropol krai, the Republic of Bashkortostan, Sverdlovsk region, Irkutsk region, Sakhalin region, and the Republic of Tatarstan. The total number of stroke cases in the study areas was 29 779. RESULTS: The highest average incidence was shown in the Republic of Tatarstan, which had significant differences with all regions (p<0.001). The level of mean annual mortality was identified in Stavropol krai, which had significant differences with all regions (p=0.008-p<0.001). Significant differences in the average long-term stroke incidence were typical for nine pairs of territories out of 21 of the territories, and the average long-term stroke mortality was typical for six pairs of territories. CONCLUSION: The incidence of stroke does not depend on the geographical location of the region, its economic development and ethnic composition of the population. The quality and effectiveness of primary prevention of cardiovascular diseases comes to the fore. In regions where it is not carried out at the proper level, the incidence of stroke is the highest. Only high-quality implementation of appropriate preventive measures will significantly reduce these indicators. Stroke mortality rates depend primarily on the quality of diagnosis and specialized medical care provided to stroke patients. The decrease in the mortality rate of these patients is possible only with the mandatory implementation of the approved clinical guidelines and protocols for treatment.

[Epidemiology and prognosis of the level of morbidity and mortality from stroke in different age groups according to the territorial-population register]. / Épidemiologiia i prognoz urovnia zabolevaemosti i smertnosti ot insul'ta v raznykh vozrastnykh gruppakh po dannym territorial'no-populiatsionnogo registra.

AIM: To analyze epidemiological data and predict the morbidity and mortality of stroke for a 5-year period in different age groups. MATERIAL AND METHODS: The study of indicators of morbidity and mortality of stroke was conducted on the basis of data on the population aged 25 years and older from the territorial population register for 2009-2016 and covered 8 study areas. A total of 25.504 cases of primary stroke were analyzed in four age groups: young age, middle age, old age, oldest age. The prognosis of indicators of morbidity and mortality was made using the ARIMA (autoregressive integrated moving average) method. RESULTS AND CONCLUSION: The study revealed positive dynamics for 2009-2016 to reduce the incidence of stroke in middle age and old age. The morbidity in the group of young people in 2016 was lower than in 2009, though the difference was not significant. In the group of oldest age, there was a tendency to increase the incidence rate since 2012, the growth rate reached 10% per year. Prediction of stroke incidence for 5 years was impossible in all age groups due to the lack of significant autocorrelations. Positive dynamics of reduction of mortality of stroke was observed among middle, old and oldest age. The highest rate of decline in mortality was observed in middle aged and old people amounting to about 30% in 2012. Among the oldest age, the dynamics of the reduction of mortality rate was less pronounced. Among young people, the death rate has not changed since 2009 by 2016 and amounted to 0.05 per 1000 people. Prediction of the mortality rate for middle age assumes a decrease in mortality by 2019 inclusive with further stabilization of the indicator until 2021. The prognosis of mortality in old age suggests a gradual slight increase (about 1.5%) over the entire forecast horizon. Taking into account the progress in the 8-year decline by 81%, the projected growth does not change the burden of stroke in the old age.

[An analysis of the dynamics of the main types of stroke and pathogenetic variants of ischemic stroke]. / Analiz dinamiki osnovnykh tipov insul'ta i patogeneticheskikh variantov ishemicheskogo insul'ta.

To analyze the main changes in the prevalence of stroke types and pathogenetic variants of ischemic stroke based on the data obtained from seven regions of the Russian Federation among the population aged 25 years and older. MATERIAL AND METHODS: In total, 29 779 cases of stroke, of which 4167 cases were registered in 2009 and 3402 cases in 2016, were detected during the period from 2009 to 2016. RESULTS AND CONCLUSION: The comparative analysis showed that the proportion of unspecified stroke (unspecified as a hemorrhage and or heart attack) decreased by 11 times from 4.7% to 0.4% (p<0.001). A decrease in 28-day mortality in ischemic stroke, intracerebral and subarachnoid hemorrhage was registered. A change in the ratio of the prevalence of pathogenetic variants of ischemic stroke was revealed. Over the 8-year period, the prevalence of cardioembolic stroke decreased from 35% to 21% (p=0.037). The prevalence of other pathogenetic variants of ischemic stroke has undergone changes. The changes in the ratio of the types of stroke studied are primarily related to the improvement of the diagnosis of stroke types, due to an increase in the percentage of computer tomography/magnetic resonance imaging performed, as well as the introduction of high-tech methods of helping patients with stroke and its effective prevention.

[Dynamics of mortality rates in different types of stroke in the territories included in the Federal program of reorganization of care for stroke patients]. / Dinamika pokazatelei letal'nosti pri raznykh tipakh insul'ta na territoriiakh, voshedshikh v Federal'nuiu programmu reorganizatsii pomoshchi patsientam s insul'tom.

AIM: To study and analyze the dynamics of one-day, 7-day and 28-day mortality rates in different types of stroke. MATERIAL AND METHODS: The retrospective study was based on the data of the territorial population register for 2009-2016 from seven territories of the Russian Federation in which the Federal program of reorganization of care for stroke patients came into force in 2009. The study population included men and women, aged 25 years and older, registered in the study area. A total of 29.779 stroke cases were identified. The mortality rate was calculated as the ratio of the number of stroke cases that ended fatally to the number of stroke cases per year. The dynamics of the mortality rate of the following types of stroke was analyzed: subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH) and ischemic stroke (IS). RESULTS: Between 2009 and 2010, there was an increase in SAH one-day, 7-day and 28-day mortality rates and in ICH one-day, 7-day mortality rates. In the period from 2009 to 2010, the increased ICH 28-day mortality rates tended to increase, while the IS one-day, 7-day and 28-day mortality rates decreased. One-day, 7-day and 28-day mortality rates in SAH, ICH, IS had a declining trend from 2010 to 2016. A slight increase in SAH one-day mortality rate in 2014 and 2015 and SAH 7-day mortality rate in 2013 was observed. The same trend was noted for ICH mortality rates in 2013 and 2016 and in 2013, respectively. The IS one-day, 7-day and 28-day mortality rates slightly increased in 2014. CONCLUSION: According to the territorial-population register from 2009 to 2016, a significant decrease in one-day, 7-day and 28-day mortality rates in all types of stroke in the studied territories was registered. There is no doubt that this is due to the successful implementation of the Federal program of reorganization of care for stroke patients carried out in this period in the territories included in the study.

[Fractalkine level in chronic heart failure of varying severity].

Purpose of research. To examine the level changes of fractalkine in patients with chronic heart failure (CHF) depending on the ejection fraction of the left ventricle and the stage of the disease. MATERIALS AND METHODS: In total 340 people were examined. Of these, 280 patients with CHF divided into groups depending on the ejection fraction of the left ventricle (with a preserved and reduced ejection fraction) and the stage of the disease (stage I to III). Fractalkine level was determined by method of enzyme immunoassay in blood plasma. RESULTS: We revealed an increase in the level of fractalkine in patients with CHF with preserved and reduced ejection fraction compared with the control group. An increase in the level of fractalkine was more pronounced in patients with reduced ejection fraction. In the group of patients with preserved ejection fraction of stage IIB+III, a statistically significant decrease in the level of fractalkin was observed in comparison with patients with stage I to stage III. The method of correlation analysis established that there is a correlation between the level of fractalkine and clinical manifestations of CHF. CONCLUSION: It was revealed an increase in the level of fractalkine in blood plasma in patients with CHF with the control group, which was more pronounced in patients with reduced ejection fraction and the presence of correlation level fractalkine with indicators of clinical manifestations of CHF.

[Association of polymorphism 4a/4b and 4b/4b in endothelial nitric oxide synthase gene and markers of endothelial dysfunction in patients with chronic heart failure].

AIM: To examine the association of polymorphism 4a/4b and 4b/4b in endothelial nitric oxide synthase gene (eNOS) with levels of natriuretic peptide type-C, endothelin-1 and vasoregulative endothelial function in patients with chronic heart failure (CHF) depending on the ejection fraction of the left ventricle. MATERIALS AND METHODS: The study has included 280 patients with CHF of ischemic etiology and 60 somatically healthy individuals. A comprehensive assessment of the markers of the vascular endothelium function was carried out for all patients (endothelial function coefficient, natriuretic peptide type-C, endothelin-1) in association of polymorphism 4a/4b and 4b/4b gene of eNOS. RESULTS: Correlations between the ejection fraction of the left ventricle and the levels of the natriuretic peptide-type C and endothelin-1 have been established. Endothelial dysfunction was revealed in all patients with CHF, but patients with 4a/4b gene of eNOS had more pronounced disorders. The association between the levels of biochemical markers of the endothelial dysfunction with polymorphism 4a/4b gene eNOS was also rervealed. The levels of the natriuretic peptide type C and endothelin-1 were higher in subgroups with genotype 4a/4b of gene eNOS both in patients with CHF with a preserved and with a reduced ejection fraction of the left ventricle. CONCLUSION: In patients with CHF with preserved and reduced ejection fraction of the left ventricle the association of polymorphism 4a/4b gene eNOS with levels of biochemical markers of endothelial dysfunction and vasoregulative endothelial function was revealed.