[Glomerular filtration rate in centenarians with coronary artery disease.]

The study objective was to compare the CKD-EPI, MDRD, BIS1, and Cockroft-Gault equations for calculating GFR, and analyze the various relationships between the glomerular filtration rate and clinical and laboratory parameters in long-living patients with coronary artery disease (CAD). A cross-sectional study of 270 patients from 90 to 106 years old, hospitalized with CAD diagnosis, was performed. The mean estimated GFR according to CKD-EPI was 51,4±14,2 ml/min, MDRD - 50,9±13,4, BIS1 - 38,4±7,7, Cockroft-Gault - 40,6±12,6 ml/min. Only 75 patients (27.8%) had CKD-EPI eGFR greater than or equal to 60 ml/min. The most common stage of chronic kidney disease was stage 3A, while stage CKD 5 did not occur at all. CKD staging results calculated using the MDRD and CKD-EPI equations were similar. However, when using the BIS1 equation, eGFR of more than 60 ml/min was not observed in any patient, and the vast majority of patients (64,1%) had stage 3B CKD. At high creatinine levels, there were no considerable differences between eGFR according to different equations, while at low and medium creatinine values, there were significant differences in eGFR, assessed using the CKD-EPI and MDRD equations on the one hand and BIS1 and Cockroft-Gault on the other. The maximum differences reached 21 ml/min.

[Relationships between body composition and hematological parameters in long-living patients with coronary artery disease.]

The study objective to investigate hematological parameters and determine the relationships between these indicators and body composition in centenarians with coronary artery disease. This work is a cross-sectional study, which enrolled 239 patients over 90 years old hospitalized with a diagnosis of coronary artery disease; most of them (67,8%) were women. The age of the patients ranged from 90 to 106 years, averaging 92,8 (±2,5) years. Body composition was analyzed by dual energy X-ray absorptiometry. Anemia was detected in 108 (45,2%) patients, while a significant direct correlation was found between the hemoglobin level and all indicators of bone mineral density (p=0,004-0,00002). Patients with osteoporosis had lower levels of hemoglobin (p=0,002) and blood iron (p=0,02). Direct correlations were established between the hemoglobin level and lean tissue mass (p=0,06-0,003). Patients with obesity had higher levels of hemoglobin (p=0,007), erythrocytes (p=0,03), leukocytes (p=0,04), lymphocytes (p=0,01) and monocytes (p=0,05). A direct correlation was registered between the platelets count and fat tissue mass (p=0,04-0,00006) along with an inverse correlation between platelets and lean tissue (p=0,001-0,0004). The study results indicate significant relationships between the parameters of body composition and hematological indicators.

[Tumor necrosis factor alfa in very elderly patients with coronary artery disease.]

The results of a study of the concentration of TNF-α as well as the relationship of this cytokine with a number of pathological conditions in very elderly patients with coronary artery disease compared with the control group of patients without CAD are presented in the article. The average group concentration of TNF-α reached 9,2+4,7 pg/ml (from 3,9 to 31,9 pg/ml) with normal TNF-α values of less than 8,1 pg/ml. An increase in the level of TNF-α was detected in 54,6% of patients. In patients with coronary artery disease the average concentration of TNF-α reached 10+4,9 pg/ml, while in the group of patients without CAD - 6,1+1,8 pg/ml (р=0,000001). TNF-α content was higher in patients with chronic heart failure (р=0,002) and with hyperuricemia (р=0,000006). The correlation analysis revealed a significant positive correlation between the level of TNF-α and uric acid (р<0,000001), between the concentration of TNF-α and the content of ß-Cross Laps (degradation products of type I collagen) (р=0,0001), as well as serum creatinine (р=0,002) and urea (p=0,00004) levels. In addition, a negative correlation was found between the values of TNF-α and high-density lipoprotein cholesterol concentration (р=0,00005), as well as leptin level (h=0,01). A decrease in the concentration of TNF-а was observed with increasing age of the patients (р=0,006).

[Bone mineral density in long-living patients with coronary artery disease.]

The results of cross-sectional study aimed to investigate bone mineral density (BMD) in 202 patients over 90 years old with coronary artery disease are presented in this atricle. Normal BMD indices in the lumbar spine were observed in 40,9%, osteoporosis - in 26,9%, osteopenia - in 32,2% of patients. Normal BMD indices in the proximal femur were observed in 21,3%, osteoporosis - in 39,9%, and osteopenia - in 38,8% of patients. A negative correlation between the severity of frailty, assessed using the questionnaire «Age is not a hindrance¼, and indicators of BMD (r=0,26; р=0,01) was found. A positive correlation was found between BMD indices and functional abilities of patients assessed using the Barthel index (r=0,44; p=0,000002) and the IADL scale (r=0,36; p=0,00008). Fractures in history were observed in 27,6% of patients.

[Lipid Blood Profile in Old Patients With Ischemic Heart Disease].

PURPOSE: to assess prevalence of dyslipidemia in patients with ischemic heart disease (IHD) older than 75 years as well as to evaluate possible associations between serum lipids and various cardiovascular and other diseases in these patients. METHODS: We enrolled in this cross sectional study 555 hospitalized IHD patients aged 75-98 years (mean age 86.8 years, 74.5 % women). Levels of lipids (total cholesterol [TC], triglycerides [TG], low and high-density lipoprotein cholesterol [LDLC, HDLC]) were measured by enzyme method on the biochemistry analyzer Konelab 60i. RESULTS: Elevated TC; hypertriglyceridemia and elevated LDLC were observed in 13.3, 10.4 and 26.3 % of patients, respectively. In the majority of patients severity of dyslipidemia was mild. With increasing age serum levels of TC and LDLC decreased. Negative correlation between TC level and patient's age was significant (r= -0.13; p=0.001). Mean TC level was 5.43, 5.0 and 4.7 mmol / l in patients aged.

[Vascular mechanisms of disorders of rheological properties of the blood in patients with myocardial infarction]. / Sosudistye mekhanizmy narusheniia reologicheskikh svoistv krovi u bo'lnykh infarktom miokarda.

The contribution made by vascular factors to impairment of blood rheological properties was demonstrated on the basis of examination of 65 apparently healthy persons by using a vascular occlusion test. The vascular endothelium showed a decrease in fibrinolytic, anticoagulant, antiaggregatory activities. The new term "hemorheological tolerance to vascular occlusion" was proposed to use. A number of quantitative and qualitative indices for normal hemorheological tolerance were identified. The paper provides data on the frequency of particular mechanisms responsible for its decrease. It also emphasizes that the knowledge of the mechanisms of vascular impairments makes it possible to choose a combined drug therapy for myocardial infarction in a differential fashion.