ST-Elevation Myocardial Infarction in Patients With Malignancies.

Acute myocardial infarction (MI), the most severe complication of coronary artery disease, develops in 2-4% of patients with various malignancies. PURPOSE: to explore the specific properties of ST-segment elevation myocardial infarction (STEMI) course in patients with cancer and its effect on short-term outcome. MATERIALS AND METHODS: We included in this study 45 patients with STEMI and history of cancer hospitalized in the period from 01.01.2015 to 01.01.2017 (group I; 58% men, mean age 69.07±11.60 years). In the comparison group (group II) we selected 90 age and gender matched persons (58% men, mean age 68.16±11.75 years) from patients with STEMI without oncological diseases. RESULTS: There were no differences between groups in main risk factors of cardiovascular diseases, except greater proportion of patients with damage of peripheral arteries in group 1 (22.2% compared with 5.6% in group 2, p=0.025). There were also no differences between groups in clinical characteristics at admission. However values of the following parameters were significantly lower in group I: concentration of hemoglobin (115.56±23.07 vs. 133.70±16.45 g/l in group 2, р<0.001), red blood cell count (3.95±0.66x1012/l vs. 5.57±0.72x1012/l in group 2, р<0.001), platelets (93±0.97x109/l vs 186±18.3x109/l in group 2, p<0.001), total cholesterol (4.12±2.17 vs. 6.24±2.56 mmol/L in group 2, р<0.001). There were differences in the frequency of use of antiplatelet drugs: at prehospital stage acetylsalicylic acid was given to 48.9% and 77.8% of patients in groups 1 and 2, respectively (p=0.044); clopidogrel and ticagrelor were also significantly more rarely used in group 1. There was no difference in use of thrombolysis and percutaneous coronary interventions (4.4 and 53.3% vs 5.6 and 56.6% in groups 1 and 2, respectively). In group 2 greater portion of patients was given statins (68.9 vs. 77.8%, p=0.021) and angiotensin-converting enzyme inhibitors (55.6 vs. 82.2%, p=0.008). Inhospital mortality was the same in both groups (4.4%). Occurrence of complications (bleeding, pulmonary edema, cardiogenic shock), and frequency of use of intra-aortic balloon counterpulsation, temporary cardiac pacing were similar. However in group 1 greater portion of patients had ventricular tachyarrhythmias (15.6 vs 2.2% in group 2, р=0.007); the presence of cancer was the only independent predictor of their emergence in multiple logistic regression (OR 8.11 [1.11-40.83], p=0.011). CONCLUSIONS: Rates of application of myocardial reperfusion in STEMI patients with and without history of cancer were the same. Despite similar hospital mortality revealed peculiarities of STEMI course could affect long-term outcomes. Confirmation of this hypothesis requires planned prospective studies.

[Modern technologies for extraction of balneological medicines from mineral waters].

A new technology for isolation of medicinal balneological preparations from mineral waters has been developed. It is based on the extraction of biologically active compounds (BAC) from mineral waters with ethanol following oxidative hydrolysis and water vapour distillation. This technology has no analogs both in this country and abroad. Unlike ordinary balneological medicines, those obtained by the new method do not contain inorganic matrix, show higher activity, and remain stable for a longer period. The primary composition of BACs isolated by the above technology was studied using solid-phase extraction and chromatomass-spectrometry. Analysis of Extramine, a medicinal preparation from Novonukutskaya hydrogen sulfide mineral water (Siberian Matsesta), allowed to identify active components responsible for its therapeutic effects and elucidate mechanisms of their action. The 15-year-long experience with practical application of BACs obtained with the help of the new technology has demonstrated that they possesses antiallergic, antiviral, and analeptic activities. These compounds increase general resistance of the organism to infection, promote removal of toxic substances, accelerate wound and injury healing, and prevent the development of herpes infection.

[Effect of Novonukutskaya mineral water extracts on the clinical course of wound disease and wound healing in experiment].

The objective of the present work was to study the wound-healing potential of the new preparation, Extramin (a 32% ethanol extract of organic substances from Novonukutskaya mineral water) in a series of experiments on a model of chemical burns in rabbits. The wound healing process was monitored based on biochemical, hematiological, and morphological indicators. Analysis of the results allows for the conclusion that Extramin is a powerful stimulator of the wound-healing processes and can be recommended for further clinical studies.