The analyses of criteria of selection of projects for funding in FT P “Research and Development” was performed. The condition to increase the volume (up to 50 %) of co-financing of projects on the part of the industrial partner was noted as the main factor limiting the availability of FT P funds for research centers conducting biomedical researches. An extremely low interest on the part of Russian pharmaceutical industry enterprises in the usage of research results was shown.

Quality management system (QMS) is an effective instrument of medical care quality management. The article describes prerequisites and expectations of the system implementation in municipal budgetary health-care institution. The necessity of work under QMS is substantiated. The research goal is the analysis of prerequisites and expectations of quality management system introduction basing on international standards for controllability improvement of municipal health-care institution.

In a typical structure of cardiac hospital in accordance with the regulations do not provide for mandatory presence of an independent emergency department. Given the clinical features of acute coronary syndrome, increase the volume and character of Kemerovo Cardiology Clinic in 2007 organized an independent emergency department. Algorithms verify the diagnosis, screening patients with acute coronary syndrome groups early invasive and conservative treatment strategy, communication between emergency services and cardiology clinic.

In addition to traditional medical and demographic indicators of public health, such as mortality, morbidity, life expectancy, in some foreign countries DALY index is widely used. Unit of measurement of D ALY index shows losses of healthy life years due to illness, disability or untimely death. In Russia, in the first place, the necessity of comparative studies of health losses touches upon socially significant diseases which include a number of infectious diseases, cancer and cardiovascular diseases. The purpose of this study was to analyze the losses of life years from myocardial infarction (MI) using DALY index.

Standard method was used to calculate DALY index. Annual dynamics of changes of life years’ losses has a similar tendency with the same of mortality from myocardial infarction. Men have higher values of D ALY index compared to women. That fact is confirmed by the literature data. The study of health losses from MI depending on the population age distribution has shown a considerable contribution to the total values of D ALY index health losses at the age group of 60 and older The study showed a reduction in the health loses from MI in Kemerovo for the period of 2006–2012 which is caused by similar dynamics of the index in the senior age group. It should be noted that DALY index values in young population are characterized by absolute and relative growth. Health losses are predominantly connected with high mortality from MI among male population and senior age group in Kemerovo.

The main objectives of coronary artery bypass grafting (CABG) are restoration of patients’ normal functional status, improvement of life quality, as well as resumption of professional activity. A patient’s return to work is perceived as a marker of rehabilitation’s efficacy. However despite the improvement of clinical state of majority of operated patients, life quality and markers of labour ability in part of patients after CABG are not improved. The percentage of patients returning to work differs all over the world due to many factors – such as differences in patients’ insurance systems, labor market conditions, economic situation in a country. In Russia the marker of returning to work after CABG is extremely low, it has serious fluctuations in the different regions and is not determined by objective criteria. The provided data indicate that there are still no common approaches to the assessment of patients’ ability to return to work after CABG. In the present research we systemize the indications for performing medical and social assessment after CABG taking into account the regulatory framework.

Purpose. To evaluate the level of awareness of cardiologists and therapists of various medical institutions on major issues of anticoagulant therapy administration in patients with prosthetic heart valves.

Materials and methods. Analysis of awareness of cardiologists and therapists of various healthcare facilities of Kemerovo city and region was performed by random selection at 106 examinees by a specially developed questionnaire.

Results. High level of awareness (34 points) on major issues of warfarin administration after heart valve replacement was registered at cardiologists of specialized cardio surgical clinic. Cardiologists of Kemerovo city and region were characterized by an average level of knowledge (29–25 points). Therapists of Kemerovo city and region had a low level of awareness (18 points).

Conclusion. To increase the awareness of physicians it is needed to elaborate and implement a training program with an emphasis on correction of modifiable risk factors of anticoagulant therapy complications and application of pharmacogenetic approach in warfarin administration to patients after heart valve replacement.

Purpose. To study the effect of polyvascular disease (PolyVD) on quality of life (QoL) of coronary artery disease (CAD) patients.

Materials and methods. We examined 807 CAD patients (59,0 ± 8,0 years old; 648 men and 159 women), who were examined before planned coronary artery bypass surgery (CABG). The patients were additionally examined for subclinical stenosis of non-coronary arteries to identify the signs of PolyVD (artery stenosis 30% and more were included). The following groups were formed: PolyVD group (n = 336) and non-PolyVD group (n = 473). The groups were compared in terms of quality of life and depression. QoL was analyzed with the help of SF36 questionnaire, depression level – with the help of “Depression scale” questionnaire.

Results. In PolyVD group integral indicators of QoL were lower compared to non-PolyVD group both as for physical component (69 (51,5;72,3) and 71,3 (61,3;75,8) points; р = 0,004), and for psychological component (62.8 (48.5, 72.0) and 63.5 (57.0, 72.8) points, p = 0.045) of QoL. In multiple regression analysis the independent effect on physical component of QoL was provided by PolyVD (OR = 0,679; 95%CI 0,477–0,966; р = 0,031) and functional class of CHF (OR = 0,514; 95%CI 0,378–0,698; р < 0,001), on psychological component – functional class of CHF (OR = 0,577; 95%CI 0,425–0,784; р<0,001).

Conclusion. CAD patients with PolyVD as compared to patients with discrete lesion of coronary arteries have a higher level of depression and reduce of quality of life both as for certain scales of SF-36 questionnaire and integral indicators of physical and psychological components of QoL. In multivariate analysis the independent factors associated with a reduction in overall physical health were PolyVD presence and CHF severity, associated with a reduction in overall psychological health – only CHF severity.

The purpose. The purpose of our research was to study the role of diabetes mellitus in the inflammatory response of males and females with ST-elevation myocardial infarction (STEMI).

Materials and methods. The study enrolled 223 patients with STEMI – 167 (74,9 %) males and 56 (25,1 %) females. The mean male age was 57,1 (51; 62) years and the mean female age was 61,8 (57; 71) years (р = 0,00). The inflammatory marks were measured 10–14 days after STEMI (IL – 1α, 6, 8, 10, 12, CRP, TNFα, sCD40L, NT-proBNP, Neopterin).

Results. The research showed that diabetes mellitus is more often diagnosed in females than males. The females and males with diabetes mellitus had a similar levels of the inflammatory marks (IL – 1α, 6, 8, 10, 12, CRP, TNFα, sCD40L, NT-proBNP, Neopterin). However, females without diabetes mellitus had a higher level of IL-12 than males without diabetes mellitus (р = 0,00). The level of IL-1α in females with diabetes mellitus was higher than in females without diabetes mellitus (р = 0,04).

Conclusion. We assumed that diabetes mellitus in STEMI females was associated with a higher level of the inflammatory response than in females without diabetes mellitus. Diabetes mellitus eliminates gender differences in the inflammatory response.

Рurpose. The purpose of the study was to elicit the relationship between the left atrial load and its contractility.

Materials and methods. 33 patients, 56,9±6,7 y. o., were enrolled in the study. All of them underwent echocardiography due to different clinical indications. The Doppler spectrum of transmitral and pulmonary vein flow, left atrial dimensions and volumes were estimated.

Results. The relationship between the volume and pressure load, and contractility were established. This supports the hypothesis of the Frank-Starling law validity for the human left atrium in vivo.

Conclusion. In the human heart in vivo there is an inverse exponential relationship between the left atrial volume load and its contractility, as well as a positive linear relationship between the pressure load and contractility.

Purpose. To study the clinical efficiency and safety of application of drug-eluting and carbonic stents in patients with different forms of acute coronary syndrome in a long-term follow-up period.

Materials and methods. The study enrolled 600 patients with acute coronary syndrome (STEMI – 197 patients; nonSTEMI – 208 patients; unstable angina – 195 patients). Clinical outcomes of interventions in patients enrolled into the study were evaluated prospectively after 12 months.

Results. Intergroup analyses of long-term results of implantation of sirolimus-eluting stents, everolimus-eluting stents with stents with modified carbon surface showed a significant difference in the incidence of restenosis and repeat revascularization in favour of drug-eluting stents (р < 0,05 in all the groups by indicators of repeat revascularization and restenosis incidence for each drug). The fatality rate both from cardiac and other reasons didn’t differ among groups of patients. Intravascular ultrasound test demonstrated the advantage of sirolimuseluting stents over carbonic stents by the indicator of late lumen loss (STEMI – 0,20 mm vs. 0,65 mm; nonSTEMI – 0,22 mm vs. 0,67 mm; unstable angina – 0,20 mm vs. 0,65 mm, р < 0,05); and the advantage of everolimus-eluting stents by this indicator (STEMI – 0,16 mm vs. 0,65 mm, nonSTEMI – 0,16 mm vs. 0,67 mm, unstable angina – 0,18 mm vs. 0,65 mm, р < 0,05).

Conclusions. On the basis of the performed analyses the present study demonstrated a high clinical efficiency and safety of application of drug-eluting and carbonic stents in patients with different forms of acute coronary syndrome in a long-term follow-up period.

In the survey, the results of the largest comparative studies on the efficacy and safety of dabigatran and warfarin for the prevention of thromboembolic complications in patients underwent atrial fibrillation catheter ablation are discussed.

Natriuretic peptides (NUP) are important biomarkers in the diagnostics and determining of prognosis in patients with heart failure (HF). Evaluation of NUP (BNP, NT-proBNP) dynamics can be used as a success criterion of the ongoing therapy. Thus when reaching the target levels of NUP, a favourable disease outcome can be predicted. At the present time HF treatment with account of NUP levels is a part of HF treatment recommendations (class IIа) and improvement of its outcome (class IIb) in the USA; currently, this approach is not implemented in Russian hospitals.

Purpose. To present a modern understanding of the use of NUP levels in the assessment of therapy efficacy in patients with HF.

Abdominal catastrophe occurring after cardiac surgery with cardiopulmonary bypass, takes the leading place in the structure of possible complications. The authors present a review of the epidemiology, risk factors, and predictors of forecasting, principal directions of correction and prevention of such complications. It is noted that ultrasonic methods (contrast-enhanced ultrasound) and radiological (selective mesenteric angiography) diagnosis, modifications and variations of extracorporeal perfusion and pharmacological protection of the gastrointestinal tract may be optimal for such category of patients.