Expanding the possibilities of using sodium-glucose cotransporter 2 inhibitors in patients with heart failure.

OBJECTIVE: Aim: To study the potential mechanisms of the beneficial cardiovascular effects of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, the possibilities of improving the treatment and prognosis of patients with acute heart failure (HF) during their use. PATIENTS AND METHODS: Materials and Methods: The data analysis of literary sources has been conducted regarding the results of existing studies evaluating the clinical benefit and safety of SGLT-2 inhibitors in patients with acute heart failure. CONCLUSION: Conclusions: The peculiarities of the pharmacological action of SGLT-2 inhibitors and the obtained research results expand the possibilities of using this group of drugs, demonstrating encouraging prospects in improving the prognosis of patients hospitalized with acute heart failure.

IS FECAL CALPROTECTIN DETERMINATION USEFUL FOR PATIENTS WITH METABOLIC ASSOCIATED FATTY LIVER DISEASE?

OBJECTIVE: Aim: To investigate the possible relationship between fecal calprotectin (FC) level and ultrasound indicators of steatosis and fibrosis wich defined by attenuation coefficient (AC) and liver stiffness (LS) from two-dimensional (2D) shear-wave elastography (SWE) in patients with metabolically associated fatty liver disease (MAFLD). PATIENTS AND METHODS: Materials and Methods: The study included 110 persons with MAFLD; mean age 51.3±4.8 years, 65 (59.1%) men. There were used laboratory, sonography and statistical methods. RESULTS: Results: Stage S1 of steatosis was diagnosed in 42 (38.2%), S2 - in 56 (50.9%), S3 - only in 12 (10.9%) MAFLD patients. The carbohydrate metabolism disorders were found in 62 (56.4%); 38 (34.5%) patients among them suffered from type 2 diabetes. The lipid metabolism disorders were diagnosed in the vast majority of patients included in this study. The minimal excess of fecal calprotectin (FC) was detected in 72 MAFLD patients (65.5%), the moderate increase of FC was found in 12 persons, the FC more than 10-fold excess of the norm was observed in only 8 MAFLD patients. FC levels were significantly elevated in MAFLD patients with a S2-S3 compared to those with a S1 (75.8 [42.9-112.1] vs. 46.3 [28.2-65.4], p<0.01). CONCLUSION: Conclusions: Fecal calprotectin levels are significantly elevated in patients with MAFLD. Future studies are warranted to establish the definitive role and clinical utility of FC as a potential biomarker of probably liver steatosis as well as other diseases associated with methabolic syndrome and its complications.

CLINICAL EFFECTIVENESS OF EMPAGLIFLOZIN IN PATIENTS WITH HEART FAILURE.

OBJECTIVE: The aim: To study the possibilities of increasing the effectiveness of treatment and improving the prognosis of patients with various phenotypes of heart failure when using empagliflozin. PATIENTS AND METHODS: Materials and methods: The analysis of the data regarding the results of existing studies evaluating the clinical benefit and safety of empagliflozin in patients with various phenotypes of heart failure has been conducted. CONCLUSION: Conclusions: In the EMPA-REG OUTCOME study, empagliflozin has demonstrated the ability to improve cardiorenal outcomes and reduce the risk of hospitalization for heart failure in patients with diabetes. The results of the studies (EMPEROR-Preserved, EMPEROR-Reduced, EMPULSE) have shown the clinical advantages of empagliflozin over traditional heart failure therapy, manifested by a reduction in mortality and the number of hospitalizations for heart failure, as well as improvement in quality of life indicators. The clinical benefits of using empagliflozin were observed in patients with chronic heart failure with different left ventricular ejection fraction, as well as in patients with acute heart failure. Empagliflozin is a sodium-glucose co-transporter 2 inhibitor with a convincing evidence base for the treatment of all categories of patients with chronic heart failure, regardless of diabetes status. The results of the conducted studies indicate the unconditional benefit of early initiation of empagliflozin therapy in patients with both chronic and acute heart failure after the stabilization of their condition.

INFLUENCE OF COMPLEX TREATMENT ON BIOCHEMICAL BLOOD PARAMETERS OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND CONCOMITANT PRE-DIABETES.

OBJECTIVE: The aim: Of this research is to evaluate laboratory changes in the liver blood tests, carbohydrate and lipid metabolism in NAFLD patients with concomitant pre-diabetes, and to study the feasibility of their complex treatment with the inclusion of omega-3 polyunsaturated fatty acids and essential phospholipids. PATIENTS AND METHODS: Materials and methods: We have examined 55 patients with non-alcoholic fatty liver disease on the background of pre-diabetes aged 40 to 75 years. Modification of lifestyle was recommended to all patients as a basic treatment. In addition, the patients were prescribed essential phospholipids in 2 capsules 3 times a day and omega-3 polyunsaturated fatty acids 1000 mg per day for 28 patients (group 1) or rosuvastatin 10 mg per day for 27 persons (group 2). The effectiveness of the treatment was evaluated in 3 months, and the long-term outcomes were evaluated in 12 months. RESULTS: Results: Under the influence of the prescribed treatment, a hypolipidemic effect was observed in both groups, but a significant decline in the activity of alanine aminotransferase and aspartate aminotransferase occurred only under the influence of a combination of essential phospholipids and omega-3 polyunsaturated fatty acids. CONCLUSION: Conclusions: Thus, the described results allow to recommend this combination of medicines to patients with non-alcoholic fatty liver disease and concomitant pre-diabetes.