Kardiologiya
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Randomized Controlled Trial
[Efficiency of meldonium in the complex therapy of acute coronary syndrome].
We examined 140 patients (mean age 54.8±3.1 years) with ST elevation acute coronary syndrome resulting in Q-wave myocardial infarction of the left ventricle. From the first hours complex therapy of these patients comprised meldonium (1 g/day intravenously for 2 weeks then orally until 1.5 months). ⋯ It was established that administration of meldonium led to reduction of number of high grade ventricular extrasystoles during first 6 hours after thrombolysis, to lowering of blood concentration of lipoperoxide degradation products. Early use of meldonium decreases probability of emergence of fatal arrhythmias and improves prognosis of hospital stage of rehabilitation of patients with acute coronary syndrome resulting in Q-wave myocardial infarction.
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The article deals with renal dysfunction, methods of assessment and monitoring in patients receiving anticoagulant therapy. Due to the negative impact of renal impairment on the incidence of thromboembolic and hemorrhagic complications in patients with atrial fibrillation problem identifying renal failure and its degree is an actual problem. Set forth in Article current recommendations and practical aspects of the evaluation of renal function and selecting dosing regimen can improve the safety of anticoagulants therapy.
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The ATLANTIC trial compared effects of initiation of ticagrelor at the prehospital (ambulance) or hospital (in the catheterization laboratory) stage of treatment of patients with ST-segment elevation myocardial infarction. Initiation of therapy with ticagrelor at prehospital stage short before percutaneous coronary intervention was safe, but did not improve coronary reperfusion before this procedure. However, earlier administration of ticagrelor significantly reduced the risk of stent thrombosis after percutaneous coronary intervention.