Zaporožskij Medicinskij Žurnal最新文献

{"title":"The impact of overall obesity on serotonin level in the acute phase of coronavirus infection and post-coronavirus sequelae: aspects of neuropsychological and cognitive impairments","authors":"O. V. Zinych, N. M. Kushnarova, A. A. Shuprovych, O. M. Trofymenko","doi":"10.14739/2310-1210.2023.5.277230","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.277230","url":null,"abstract":"Aim: to study the relationship between neurotransmitter support and the degree of cognitive and psycho-emotional impairments in patients in the post-coronavirus period depending on the presence of overall obesity. Materials and methods. 44 patients aged 19 to 76 years (17 women and 27 men) with a history of moderate-to-severe COVID-19 were examined. 2 groups were allocated depending on body mass index (BMI): Group 1 – 20 non-obese patients (BMI <30 kg/m2; male / female 10/10); Group 2 – 24 obese people (BMI ≥30 kg/m2; male / female 17/7). The groups of subjects were comparable in age, length of hospital stay, severity of COVID-19, hematological and biochemical parameters, C-reactive protein, D-dimer. Parameters of quality of life (QL), psycho-emotional state, and cognitive function were studied by a questionnaire method 6 months after recovery. Results. It has been found that the serotonin level was significantly lower in the acute period of infection in the group of obese patients compared to that in the non-obese group. However, after treatment, serum serotonin returned to reference values. No significant differences were detected between the two groups of patients regarding the values of neurocognitive and social parameters in the post-COVID period. Correlation analysis has shown that QL scores in Group 1 were positively correlated with cognitive function (r from 0.54 to 0.73) and negatively – with anxiety and depression (r from -0.60 to -0.80). In Group 2, the serotonin level was positively correlated with self-assessments of the QL (r from 0.42 to 0.53) and negatively – with cognitive abilities and anxiety (r from -0.51 to -0.60). Conclusions. The presence of obesity (BMI ≥30 kg/m2) in patients with COVID-19 was accompanied by reduced serum serotonin levels during the acute phase of COVID-19. In the post-COVID period, the initial level of serotonin in obese patients was correlated with the deterioration of quality of life and worsening cognitive function assessments.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135469717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulties in diagnosing antibiotic-associated diarrhea using a clinical case example","authors":"V. I. Kryvenko, I. S. Kachan, O. P. Fedorova, A. V. Kechejieva, S. P. Pachomova","doi":"10.14739/2310-1210.2023.5.283350","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.283350","url":null,"abstract":"Aim. To identify challenges in the diagnosis and treatment of a patient with intestinal damage due to long-term use of antibiotics. Material and methods. The case of antibiotic-associated diarrhea in a 65-year-old patient is described and analyzed. Results. The patient with a combined pathology of the gastrointestinal tract and cancer of the sigmoid colon developed a complication after a splenectomy – antibiotic-associated diarrhea. The clinical picture of diarrhea was complicated by the development of pseudomembranous colitis, which was masked by a leukemoid reaction and a septic process. The patient with the relapsing disease course developed multiple organ failure that resulted in a lethal outcome. Conclusions. Diarrhea associated with Clostridia difficile caused the development of pseudomembranous colitis. At the same time, the clinical picture of the disease had a mask of a leukemoid reaction and a septic process.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and prognostic significance of C-reactive protein in the conditions of stable angina pectoris in combination with chronic obstructive pulmonary disease stage II–III","authors":"S. Ya. Dotsenko, О. О. Kraidashenko","doi":"10.14739/2310-1210.2023.5.283643","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.283643","url":null,"abstract":"The aim of the study: to evaluate the clinical and prognostic value of the altered C-reactive protein expression level in functional class II–III stable angina pectoris combined with chronic obstructive pulmonary disease (COPD) stage II–III. Materials and methods. In accordance with the goal of the study, 122 individuals were examined being assigned to 4 clinical groups: Group 1 – 30 patients with ischemic heart disease (IHD, functional class II–III stable angina pectoris, mean age 56.93 ± 1.25 years; male / female ratio 86.67 % / 13.33 %); Group 2 – 30 patients with COPD stage II–III (mean age 57.99 ± 1.12 years; male / female ratio 80.0 % / 20.0%); Group 3 – 40 patients with IHD + COPD (mean age 56.48 ± 1.16 years; male / female ratio 76.92 / 23.08 %) and Group 4 – 22 apparently healthy individuals (mean age 54.37 ± 1.84 years old, male / female ratio 77.50 % / 22.50 %). Results. Significant correlations have been found between the level of C-reactive protein (CRP) and troponin I (r = +0.71 and r = +0.82, p < 0.01 for both pairs) in IHD and IHD + COPD groups. When the level of CRP expression was elevated, a clear increase in the level of cardiospecific proteins (troponin I) was seen, which could indicate a damage to the myocardium. A positive association was found between the CRP level and the CAT scale score in COPD and IHD+COPD groups (r = +0.65 and r = +0.73, respectively, p < 0.05) indicating a significant association between the processes of systemic inflammation and the dynamics of a patient’s subjective condition, caused mainly by the severity of ventilatory and respiratory disorders and pulmonary obstruction. The relative risk for cardiorespiratory fitness impairment (according to 6MWD) in patients with a high level of CRP (>6 mg/L) was almost 13 times higher (EER 80.0 % CER 6.25 %, RR = 12.8 at 95 % CI, which was 1.87–87.56, р < 0.001), while the odds ratio was 60 (OR = 60.0 with CI 4.69–767.85, р < 0.001), compared to patients with a CRP level <6 mg/L, indicating systemic inflammatory process progression in the development of a negative prognosis of IHD combined with COPD. Conclusions. The study and examination of the CRP level is necessary as a prognostic predictor for assessing the risk for developing cardiovascular complications in ІHD combined with COPD.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to predicting life expectancy in elderly coronary artery disease patients with comorbid conditions","authors":"E. O. Asanov, G. P. Voinarovska, I. A. Dyba","doi":"10.14739/2310-1210.2023.5.280007","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.280007","url":null,"abstract":"The aim of the study was to develop a model for predicting the probability of survival up to 80 years of age for elderly and senile patients with coronary artery disease (CAD) and concomitant conditions. Materials and methods. A retrospective data analysis of elderly and senile CAD patients who were observed in the period 1997–2019 and died from a cardiovascular event. Results. Using binary logistic regression analysis, a model of the survival probability up to 80 years in CAD patients with comorbid conditions has been developed. The overall accuracy of the model was 83.12 % (χ2 = 6.70, p < 0.05), and the predictive accuracy of the model (AUC = 0.853, 95 % CI 0.802–0.896) was sufficiently high and adequate to use in clinical practice. Odds ratio has shown a greater contribution of arterial hypertension and diabetes mellitus to reduced probabilities of surviving to the age of 80, a less significant contribution – of chronic obstructive pulmonary disease and dyslipidemia. Conclusions. The developed model for predicting the survival probability up to 80 years for older age group patients with coronary artery disease and comorbid conditions can be used to evaluate the effectiveness and correct medical and preventive measures.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the diagnostic value of zonulin as a biomarker for intestinal permeability in patients with metabolic-associated fatty liver disease in combination with type 2 diabetes mellitus","authors":"O. K. Didyk, V. V. Cherniavskyi, V. P. Shypulin","doi":"10.14739/2310-1210.2023.5.280829","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.280829","url":null,"abstract":"The aim of the study was to assess the diagnostic value of serum zonulin concentrations in patients with metabolic-associated fatty liver disease (МAFLD) in combination with type 2 diabetes mellitus (T2DM). Materials and methods. The study involved 93 patients with MAFLD in combination with T2DM, who were examined and allocated to two groups. Group 1 consisted of 48 patients with non-alcoholic steatohepatitis (NASH) in combination with T2DM without small intestinal bacterial overgrowth (SIBO) syndrome. Group 2 comprised 45 patients with NASH in combination with T2DM and SIBO. The control group consisted of 25 apparently healthy persons. The ELISA method was used for quantitative determination of serum zonulin. Results. When comparing parameters of liver functional activity and ultrasonographic findings of liver steatosis and fibrosis, a significant increase in the activity of ALT and AST was revealed in Group 1 – 67.22 ± 2.25 U/l and 52.97 ± 1.04 U/l (p < 0.001) and in Group 2 – 69.20 ± 1.52 U/l and 54.82 ± 1.10 U/l (p < 0.001) compared to those in the control group – 18.00 ± 1.01 U/l and 18.96 ± 0.82 U/l (p < 0.001) respectively, as well as an increase in the ultrasound attenuation coefficient (UAC) in patients of Groups 1 and 2 amounting to 2.94 ± 0.03 dB/cm and 2.92 ± 0.04 dB/cm, respectively, and also the liver stiffness (LS) in Group 1 – 8.06 ± 0.07 kPa and in Group 2 – 8.00 ± 0.06 kPa compared to those in the control group (p < 0.001). When measuring the level of serum zonulin, a significant increase was revealed in patients of Group 1 – 61.69 ± 1.04 ng/ml and Group 2 – 89.39 ± 1.30 ng/ml compared to that in the control group – 16.76 ± 1.47 ng/ml (p < 0.001). Analyzing correlation coefficients in patients of Groups 1 and 2, a positive linear moderate association was found between the serum zonulin concentration and the activity of ALT, AST and UAC and LS. Conclusions. The study resultsobtained have demonstrated the great diagnostic value of serum zonulin as a biomarker of intestinal permeability in NASH patients in combination with T2DM, and with or without SIBO.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of hammertoe deformity (a literature review)","authors":"D. V. Prozorovskyi","doi":"10.14739/2310-1210.2023.5.275785","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.275785","url":null,"abstract":"Aim. To trace developmental origins of surgical treatment of hammertoe deformity and determine the most commonly used methods of its correction based on the published literature analysis. Material and methods. Publications from Google search, electronic databases PubMed, Google Scholar, archives of specialized journals and other relevant sources of scientific and medical information were analyzed. Results. The article covers the developmental origins of surgical treatment of hammertoe deformity both in the historical aspect and at the current level. Attention is paid to soft tissue procedures including tendons, metatarsophalangeal joint capsule, and plantar plate. An overview of operative interventions on the bone apparatus, phalanges and metatarsal bones and the combination of these surgeries is also presented in the article. The disadvantages of the existing surgical treatments, their advantages and the ways for forthcoming research concerning the improvement of surgical care in the treatment of hammertoe deformity are identified. Conclusions. The choice of a particular method of surgical correction between the phalangeal or metatarsal level, the feasibility of combining these interventions with restoring the integrity of the plantar plate and tendon reconstruction, remains debatable. Further study on these issues is a crucial task today for choosing the optimal method of hammertoe deformity correction.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135469718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum biochemical indicators in rats of different ages after replacing femoral metaphysis defects with allogeneic bone implants saturated with mesenchymal stem cells","authors":"P. M. Vorontsov, M. O. Korzh, F. S. Leontieva, V. O. Tuliakov","doi":"10.14739/2310-1210.2023.5.274774","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.274774","url":null,"abstract":"The aim of the study: to evaluate the course of metabolic processes after replacing femoral metaphysis defects with allogeneic bone implants saturated with allogeneic mesenchymal stem cells (MSCs) based on the analysis of serum biochemical indicators of connective tissue metabolism in laboratory rats. Material and methods. A critical-sized transcortical femoral defect model in the femur metaphysis of white rats was used. Blood serum concentrations of glycoproteins, total chondroitin sulfates, total protein and calcium, alkaline and acid phosphatase activity were measured. Results. On the 28th day, in 3-month-old animals with MSC, in comparison with the data of rats without MSC, clear signs of connective tissue formation and bone resorption activity were observed, as evidenced by an increase in serum chondroitin sulfates and acid phosphatase activity. On the 90th day, this group of rats under the influence of MSCs showed signs of decreased bone tissue formation with lower serum activity of alkaline phosphatase. In 3-month-old rats with MSC, signs of the inflammatory process chronization with higher serum concentrations of glycoproteins were detected on the 90th day of the experiment in comparison with data from animals without MSC. In 12-month-old rats with MSCs, signs of bone resorption were documented on the 14th day, which were manifested by a higher serum activity of acid phosphatase with less formation of connective tissue and lower concentrations of chondroitin sulfates. On the 28th day, the effect of MSCs in 12-month-old animals was manifested in the form of a slowdown in bone formation with a decrease in alkaline phosphatase activity. On the 90th day, the connective tissue formation was activated with higher concentrations of chondroitin sulfates in these animals. Conclusions. The studied biochemical indicators in 3-month-old animals showed greater lability. The regeneration phases were faster in 3-month-old animals as well as in animals with alloimplants without MSCs. Injections of allogeneic MSCs together with an allograft immediately after a bone damage, regardless of age, caused signs of bone formation slowing and excessive formation of connective tissue, therefore, the combination of allogeneic MSCs with an allogeneic bone implant is not advisable to use in fresh fractures.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial ischemia – reperfusion injury","authors":"S. V. Salo, V. O. Shumakov, S. S. Shpak, V. V. Tokhtarov","doi":"10.14739/2310-1210.2023.5.279461","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.279461","url":null,"abstract":"Aim. To summarize and broaden the idea about mechanisms of acute coronary insufficiency development and pathophysiological features of myocardial reperfusion injury. Today, in the event of acute coronary syndrome, according to the latest recommendations for myocardial revascularization, percutaneous coronary intervention should be performed to determine the anatomy of coronary artery lesions and further percutaneous therapy. But in some patients, after blood flow restoration, reperfusion injury occurs, which is primarily related to the duration of ischemia, infarct size, and the myocardial resistance to ischemia. Treatment of myocardial infarction, like any treatment method, has evolved. In the 60s of the previous century, it included morphine, oxygen, warfarin and bed rest for 4–6 weeks. Then, during the 70s, it consisted of morphine, oxygen, lidocaine, warfarin, bed rest for 2–3 weeks and possibly coronary angiography for the further bypass surgery. The late 1970s saw the rapid progress in thrombolysis, first intravenous and then intracoronary. And starting in the early 1980s, since G. Hartzler performed the first balloon angioplasty for acute coronary artery occlusion, the stage of mechanical myocardial reperfusion has come. At the same time, knowledge about the pathophysiology of acute coronary ischemia was deepened. The World Health Organization developed ECG criteria for acute myocardial infarction using population-based studies in the 1950s–1970s, and additional four normative European regulations since then were issued defining concepts, key points of diagnosis and possible complications of myocardial infarction. Conclusions. The development of myocardial ischemic-reperfusion injury is a staged process that has a complex pathogenesis, its own clinical manifestations, and an association with more negative long-term outcomes of myocardial infarction treatment. Its main components are myocardial swelling involving cardiomyocytes, endotheliocytes, and the interstitial space; downregulation of cytoskeleton and disruption of sarcolemma integrity; increased vascular wall permeability; spasm of arterioles; intravascular accumulation of platelets and leukocytes, and the resultant the most severe form of myocardial damage is intramyocardial hemorrhage. Clinically, this is manifested by the no-reflow phenomenon following percutaneous coronary intervention.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135469713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trigger survey approach to the evaluation of anxiety in patients with irritable bowel syndrome","authors":"V. V. Chuhunov, A. D. Horodokin, V. Ye. Kazakov, O. V. Havrish","doi":"10.14739/2310-1210.2023.5.279174","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.279174","url":null,"abstract":"Irritable bowel syndrome (IBS) is one of the most common psychosomatic conditions affecting near 10 % of general population. Despite its relevance for today, there is no a unified approach to understanding its pathogenesis, it could be recognized as a complex somatoform reaction (based on the argument of extremely high comorbidity with anxiety and depressive conditions) or as a functional disorder (based on stereotypical clinical manifestations). The understanding of IBS as a psychosomatic condition as one that has combined psychopathogenesis seems to have the greatest perspectives in a clinical way. The study on psychological and behavioral components of IBS presents a promising area to understand ways of providing high-quality medical care for IBS patients. Aim. To systematize and evaluate the triggers of anxiety in patients with mixed form of irritable bowel syndrome. Materials and methods. A prospective study was conducted over a period of 2022–2023 including 100 patients with the main diagnosis of IBS. A distribution of IBS forms was as follows: 67 individuals with IBS-D (ICD-10: K58.1), 12 individuals with IBS-C (ICD-10: K58.2), 21 individuals with IBS-M (ICD-10: K58.3). They all were enrolled in the study as voluntary participants in a closed-ended online survey for IBS community support group. A mean age of IBS group was 38.5 ± 6.1 years. The comparison group was presented by 100 healthy volunteers without diagnosed pathology of gastrointestinal (GI) tract (or any GI-associated complains). A mean age of healthy volunteers was 29.5 ± 4.2 years. The study relied on the following methods: anamnestic, psychodiagnostic and statistical. Results. To structurally evaluate triggers of anxiety in patients with IBS we managed to distribute 23 separate triggers in 3 categories (social activity violations, eating habits and diet restrictions, health concerns). Each category was associated with features of a specific mental disorder: social activity violations – social anxiety disorder; eating habits and diet restrictions – avoidant and restrictive food intake disorder; health concerns – hypochondriasis. Anxiety level rating was collected according to the Likert scale in 5 ranks: “0” no anxiety (calm state); “1” – mild anxiety (slightly nervous); “2” – moderate anxiety (nervous); “3” – severe but controlled anxiety (very nervous or experiencing fear); “4” – uncontrolled anxiety (panicking). A distribution of anxiety levels for each trigger was determined and compared between healthy and IBS individuals. Conclusions. The analysis of the trigger set for social activity violations has shown a dominance of the formal setting and complexity of social situations in increasing the level of anxiety. The analysis of the trigger set related to eating habits and diet restrictions has shown that the formal setting, complicated social activity, and diet violations also tended to induce more intensive anxiety. The analysis of the health concern trigger set has revea","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135469715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of coronary artery calcium estimation in the primary prevention strategy for cardiovascular diseases","authors":"M. Yu. Kolesnyk","doi":"10.14739/2310-1210.2023.5.285583","DOIUrl":"https://doi.org/10.14739/2310-1210.2023.5.285583","url":null,"abstract":"Calcification is one of the stages of complicated and uncomplicated atherosclerotic plaque development. Determination of calcium deposits in the composition of plaques by the method of multispiral computer tomography allows to assess the coronary atherosclerotic lesion severity. The advantages of the test include a relatively wide availability, low cost and dose of ionizing radiation, as well as no need to inject a contrast agent. Calculation of the coronary artery calcium (CAC) according to the Agatston method is the “gold standard” for quantitative assessment of the coronary atherosclerosis severity. The review highlights modern ideas about the role of the test in primary prevention in people without diagnosed cardiovascular disease. Methodological principles of determining coronary calcium are explained. The principles of test result interpretation and presentation based on the international СAC-RADS scale are described. Data from population studies on the prevalence of coronary calcification in people without cardiovascular disease in different age categories are provided. The results of the prognostic value of CAC based on the analysis of large population studies are presented. The prognostic value of a negative test (CAC = 0) for coronary calcium is discussed. Data are presented on the recommended frequency of repeated examinations in patients with CAC = 0 depending on an individual cardiovascular risk. The data of randomized clinical trials on the expediency of determining coronary calcium in certain age categories are given. The place of the test in international clinical recommendations for the primary prevention of cardiovascular diseases is analyzed. Research findings on a personalized approach to prescribing statins and aspirin based on coronary calcium test results are discussed. Data are provided on improved adherence in patients with coronary calcium screening compared with the standard approach. The limitations and shortcomings of the test are analyzed separately, among which the impossibility of controlling the effectiveness of hypolipidemic therapy with statins in dynamics can be identified. An integrated approach to the role of the coronary calcium test based on the analysis of current international clinical recommendations is provided.","PeriodicalId":23785,"journal":{"name":"Zaporožskij Medicinskij Žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}