ORAL ANTICOAGULANT MONOTHERAPY VS. ORAL ANTICOAGULATION WITH SINGLE ANTIPLATELET THERAPY IN PATIENTS WITH ATRIAL FIBRILLATION AND STABLE ISCHEMIC HEART DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

The objective is to investigate the influence of stress on the clinical and pathogenetic peculiarities of the course of stable coronary heart disease (SIHD) in conjunction with atrial fibrillation (AF). Materials and methods. The analysis of psychodiagnostic tests, labolatory and instrumental research methods in patients with and without AF has been performed. Patients were divided into three groups: group 1 – patients with stable ischemic heart disease (SIHD) with a constant form of AF (15 patients were examined), group 2 – patients with SIHD with paroxysmal form of AF (16 patients were examined), group 3 – patients with SIHD without AF (15 patients were examined). Results. According to the analysis of the data obtained, low level of stress was found in 6 (37.50%) patients with a permanent form of AF, whereas in patients without AF, it was observed in 1 (6.67%) person (p1<0.05) (p1 – the reliability of the differences in indicators relative to patients without AF). Moderate somatic disorder in women with paroxysmal AF was significantly higher than in the group of patients with a constant form of AF (p2<0.05) (p2 – the reliability of the differences in the indicators relative to patients with a constant form of AF). It is confirmed in patients with AF there are signs of the average stress level on the perceived stress level-10 (p2<0.05). Among the social factors that may have an impact on health are the influence of the media, the use of alcohol by relatives, the threat of unemployment for relatives and friends. These indicators were most often found in the group of patients with AF rather than without it (p2<0.05). Changes of ECG and echocardiographic parameters in all groups of patients were revealed. Conclusion. The association of stress with stable ischemic heart disease combined with atrial fibrillation has shown that stress disorders are associated with an increased risk of atrial fibrillation and may worsen their course and predict the risk of developing paroxysm. The dependence between the severity of clinical manifestations, psychodiagnostic tests, laboratory methods, ECG and echocardiographic parameters of the heart on the course of atrial fibrillation is proved.

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Mobile Phone Technologies in the Management of Ischemic Heart Disease, Heart Failure, and Hypertension: Systematic Review and Meta-Analysis

JMIR mhealth and uhealth ◽

10.2196/16695 ◽

2020 ◽

Vol 8 (7) ◽

pp. e16695 ◽

Cited By ~ 1

Author(s):

Praveen Indraratna ◽

Daniel Tardo ◽

Jennifer Yu ◽

Kim Delbaere ◽

Matthew Brodie ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Mobile Phone ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Ischemic Heart ◽

Valuable Adjunct

Background Cardiovascular disease (CVD) remains the leading cause of death worldwide. Mobile phones have become ubiquitous in most developed societies. Smartphone apps, telemonitoring, and clinician-driven SMS allow for novel opportunities and methods in managing chronic CVD, such as ischemic heart disease, heart failure, and hypertension, and in the conduct and support of cardiac rehabilitation. Objective A systematic review was conducted using seven electronic databases, identifying all relevant randomized control trials (RCTs) featuring a mobile phone intervention (MPI) used in the management of chronic CVD. Outcomes assessed included mortality, hospitalizations, blood pressure (BP), and BMI. Methods Electronic data searches were performed using seven databases from January 2000 to June 2019. Relevant articles were reviewed and analyzed. Meta-analysis was performed using standard techniques. The odds ratio (OR) was used as a summary statistic for dichotomous variables. A random effect model was used. Results A total of 26 RCTs including 6713 patients were identified and are described in this review, and 12 RCTs were included in the meta-analysis. In patients with heart failure, MPIs were associated with a significantly lower rate of hospitalizations (244/792, 30.8% vs 287/803, 35.7%; n=1595; OR 0.77, 95% CI 0.62 to 0.97; P=.03; I2=0%). In patients with hypertension, patients exposed to MPIs had a significantly lower systolic BP (mean difference 4.3 mm Hg; 95% CI −7.8 to −0.78 mm Hg; n=2023; P=.02). Conclusions The available data suggest that MPIs may have a role as a valuable adjunct in the management of chronic CVD.

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