Aim. To identify markers of adverse outcomes in patients with a combination of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Materials and methods. 35 patients with COPD (without an anamnesis of coronary heart disease), 68 patients with COPD and CHF, 28 patients with CHF of ischemic genesis who were on treatment at the State Regional Clinical Hospital of Saratov were examined. The levels of the N-terminal fragment of the natriuretic peptide, galectin-3, the highly sensitive C-reactive protein, the proteins that bind fatty acids, the stiffness parameters of the arterial wall were determined; echocardiography was performed, calculated the index of comorbidity of Charlson. A year after entering the study, patients or their relatives were interviewed for their adverse outcomes. Results. The combination of COPD and CHF is accompanied by an increase in the likelihood of the development of heart failure decompensation compared with the isolated course of COPD. The main causes of death of patients with combined pathology were respiratory failure and cardiovascular complications. Decompensation of CHF was 3,6 times more likely in patients with COPD and CHF of ischemic origin than in patients without previous myocardial infarction. The risk group the development of acute decompensation of heart failure within the next year is composed of patients with COPD and CHF having 3-4 functional classes of CHF, signs of decompensation in the small circulation, angina pectoris, past myocardial infarction. The most significant prognostic echocardiographic parameters were marked dilatation of the left auricles, reduction of the left ventricular ejection fraction less than 45%. The development of cardiovascular complications in patients with COPD and CHF is interrelated with an increase in arterial rigidity. The increase in total mortality is associated with the severity of heart failure and increased 24-hour arterial rigidity. Conclusion. The obtained results will allow to form high-risk groups and optimize the treatment-diagnostic process.

Background. Stroke takes the second place among all causes for cardiovascular death and the first place in mortality and disability among other nervous system diseases. Atrial fibrillation (AF) is presently is a commonly recognized, independent risk factor for ischemic stroke, which fivefold increases the risk of an unfavorable outcome. Prevention of stroke is a complicated medical and social challenge. Aim. To study AF prevalence among patients with stroke/ transient ischemic attack (TIA) who had received an anticoagulant therapy before hospitalization. Materials and methods. A retrospective analysis of case reports was performed for patients diagnosed with acute cerebrovascular disease and TIA who had received a therapy from January, 2013 through December, 2015 (n=7921). From these case reports, 849 case reports of patients with concurrent AF were selected. Results. In patients with stroke/TIA, the AF incidence was 10.72%. Risk assessment using the CHA₂DS₂-VASc scale showed that the percentage of low-risk patients (score 0) was 0.8%, intermediate risk patients (score 1) - 5.3%, and high-risk patients (score ≥2) - 93.8%; 4.7% of patients with AF received preven tive therapy for thromboembolic complications. The death rate of patients with AF and stroke/TIA was 15.78% whereas in-hospital death rate of patients without AF was 7.01%. Therefore, AF is a statistically significant risk factor of in-hospital mortality for patients with stroke/TIA (OR=2.485, 95% CI: 2.023-3.053, p<0.001,). The following factors influenced the in-hospital mortality of patients with ischemic stroke and concurrent AF: severe CHF, type 2 diabetes mellitus, peripheral thrombosis, history of a transcutaneous coronary intervention, oncological disease, and impaired glomerular filtration rate. Conclusion. The study demonstrated an effect of AF on in-hospital mortality of patients with ischemic stroke and a low rate of preventive anticoagulant therapy in patients with AF.

Arterial hypertension (AH) is the most prevalent cardiac risk factor in old patients. Falls-related complications includes increased disability and mortality, decreased activity levels, quality of life, and overall health status. So falls are an important health problem. The aim of our study was to study falls in patients with AH 56+ years old finding fall risk factors in this population. Methods: We examined 146 patients. 50 patients with AH had a fall during last 6 month. 96 patients with AH had no falls during this period. Results: According to our study major risk factors for fall in population with AH are age, female sex, stratify sore value and blood pressure levels at admission. Patients who had experienced falls during last 6 month had significantly higher systolic, diastolic and pulsed blood pressure at admission without good blood pressure control. All differences in blood pressure were not reproduced in patients at discharge. So we suggest that ambulatory blood pressure control is important for fall prevention in people with AH 55+ years old.

Development and use of new anticancer drugs has resulted in the improving of 5-year survival rates in patients with cancer. However, many of the modern chemotherapies are associated with cardiovascular toxicities that increases cardiovascular risk in cancer patients, including hypertension, heart failure, thrombosis and thromboembolism, cardiomyopathy, and arrhythmias. These side effects limitation restrict treatment options and farther perspectives. With increasing use of modern chemotherapies and prolongation of the cancer patients survival, the incidence of cardiovascular disease in this patient population will continue to increase. Accordingly, careful assessment and management of cardiovascular risk factors in cancer patients by oncologists and cardiologists working together is essential for optimal care.

A growing body of data demonstrates that exercise capacity is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, obesity, high cholesterol, and type 2 diabetes mellitus. Individuals who maintain a regular program of PA that is longer in duration, of greater intensity, or both are likely to derive greater benefit than those who engage in lesser amounts. In this review, the authors have shown the possibility of assessing physical activity and the main provisions of the appointment of physical training to improve and preserve the cardiorespiratory fitness.

Thrombosis traditionally considered as a complication of cardiovascular disease, however, this problem until recently was rarely taken into account in the presence of cancer. Although the association between cancer and thrombosis has been known almost 150 years ago, awareness of the impact of thrombotic complications have increased only now. Cancer is an independent major risk factor for venous thromboembolism (VTE), which is the leading cause of death of cancer patient. The incidence ofVTE is steadily increasing in these patients. Thrombotic events have a significant impact on the quality of life of patients, and are associated with worsening of their short-term and long-term survival. The objective of this review is to summarize modern views on pathophysiology, as well as to outline new approaches to risk assessment, prevention and treatment of thrombosis in cancer patients.

The article presents an overview of data on polymorbidity. It is shown that polymorbidity is associated with higher mortality, disability, side effects of treatment, increased use of health system resources, and also with a lower quality of life. The issues of effective treatment of people with multiple chronic diseases are discussed. The necessity of clinical trials, including patients with multiple chronic diseases, and the development of new clinical recommendations, which could be based on practical doctors in the treatment of polymorbid patients, are substantiated.