This article examines the efficacy and safety of statins. It examines the main reasons for failure to achieve target lipid levels. The causes of adverse reactions to these medications, their incidence, and possible mechanisms for the development of statin-associated muscle symptoms are analyzed. The article discusses drug interactions between statins and other medications, particularly the coadministration of statins and P2Y12 platelet receptor inhibitors, primarily ticagrelor.

Microvascular angina is a form of ischemic heart disease in which myocardial ischemia is not associated with significant stenosis of the epicardial coronary arteries and is caused by dysfunction of the coronary microcirculatory bed. The disease is characterized by a complex pathogenesis, including endothelial dysfunction, inflammation, vascular remodeling, and metabolic disturbances. This clinical lecture presents the pathogenesis associated with morphological and functional changes in the microvessels and myocardium, clinical manifestations, modern approaches to diagnosis and treatment, and principles of clinical diagnosis.

Introduction. Pharmacological or electrical cardioversion is recommended for the elective restoration of sinus rhythm in patients with persistent atrial fibrillation (AF). However, predictors of long-term sinus rhythm maintenance following cardioversion are insufficiently studied.
Objective. To determine the impact of clinical and echocardiographic parameters on the risk of AF recurrence after cardioversion.
Materials and methods. The study included 105 patients with persistent and long-standing persistent AF who underwent successful cardioversion. Prospective follow-up was conducted for 12 months post-cardioversion to identify arrhythmia recurrence.
Results. AF recurrence within 12 months after elective cardioversion was observed in 57/105 (54.3%) patients. According to multivariate regression analysis with stepwise exclusion of less significant predictors, achieving target blood pressure levels (beta -1.088, OR 0.153, 95% CI 0.048-0.490, p = 0.002) and target lipid profile parameters (beta -1.250, OR 0.286, 95% CI 0.089-0.920, p = 0.036) reduced the likelihood of AF recurrence, while an increase in left atrial volume index (beta 0.079, OR 1.082, 95% CI 1.032-1.133, p = 0.001) increased the risk of arrhythmia recurrence. The use of sodium-glucose cotransporter 2 inhibitors in patients with congestive heart failure contributed to the maintenance of sinus rhythm for 12 months after cardioversion.
Conclusion. Achieving target blood pressure and lipid profile parameters before cardioversion reduces the risk of AF recurrence, whereas a significant increase in left atrial volume index promotes arrhythmia recurrence within 12 months after successful cardioversion.

The article describes a clinical case of Fabry’s disease – orphan hereditary X-linked disease, characterized by the accumulation of sphingolipids in various organs and the development of their dysfunction. This disease can occur in the practice of doctors of various specialties, and the patient's prognosis depends on early diagnosis and enzyme replacement therapy. 
The purpose of the article is to describe a clinical case of cardiological manifestation of Fabry's disease in a woman. The article discusses the pathogenesis of Fabry's disease, the symptoms of the disease, the management and criteria for treatment effectiveness.

We present a clinical case of exudative pericarditis associated with generalized cytomegalovirus infection in a patient with seropositive rheumatoid arthritis receiving long-term immunosuppressive therapy. At the onset of the disease, polyserositis (pericarditis and pleuritis) was regarded as a systemic manifestation of rheumatoid arthritis, which was supported by a favorable response to methotrexate and glucocorticoid therapy. More than one year later, during ongoing immunosuppression, the patient developed severe recurrent serosal involvement with massive exudative pericarditis and pleuritis associated with cytomegalovirus infection. The clinical course was further complicated by infective endocarditis accompanied by Staphylococcus aureus bacteremia. This clinical case demonstrates the challenges of differential diagnosis between autoimmune and infectious pericardial involvement in patients with rheumatoid arthritis and highlights the importance of excluding opportunistic infections in patients receiving long-term immunosuppressive therapy.

Connective tissue dysplasia (CTD) is manifested by almost all body systems. In the gastrointestinal tract (GIT) with CTD, abnormalities in the structure of the digestive system are mainly detected. Features of the structure and function of enterocytes are rarely described. A clinical case of a 13-year-old adolescent with gluten intolerance suspected of being associated with impaired structure and function of CTDrelated enterocytes is presented. A hypothesis on the possible cause of gluten intolerance due to excessive zonulin formation is proposed, requiring further research.

This year marks the 85th anniversary of the Siege of Leningrad. Due to martial law in 1941, conscripts were mobilized, and in June, more than 30 staff members of the 1st Leningrad Medical Institute's Faculty Therapy Clinic, headed by G.F. Lang, went to the front. They served as military doctors, chief physicians at hospitals and at the front, and were awarded orders and medals. Some staff remained in the besieged city, and in addition to their clinical work, they continued their research, collecting and publishing unique data on malignant hypertension caused by the siege.