Drug Therapy and Adherence in Patients With Coronary Heart Disease: Results of the Russian Part of the EUROASPIRE V International Multicenter Study

Kardiologiia ◽  
2021 ◽  
Vol 61 (8) ◽  
pp. 4-13
Author(s):  
N. V. Pogosova ◽  
S. A. Boytsov ◽  
A. K. Ausheva ◽  
O. Y. Sokolova ◽  
A. A. Arutyunov ◽  
...  
Keyword(s):  
Heart Disease ◽  
Drug Therapy ◽  
Ace Inhibitors ◽  
Beta Blockers ◽  
Entire Study ◽  
Russian Part ◽  
Long Term Treatment ◽  
Hospital Patients ◽  
Study Population

Aim      To study the practice of drug treatment of ischemic heart disease (IHD) and the consistency of this practice with the established guidelines.Material and methods  Results of the Russian part of the EUROASPIRE V study were compared with the general European population of the study. At ≥6 mos. and <2 years after the discharge from the hospital, patients were invited to visit the site for an interview. The drug therapy recommended upon discharge and taken by patients in the long-term as well as the patients’ compliance with the treatment were analyzed. In Russian centers, 699 patients were registered, and 399 of them visited the centers for the interview.Results             Upon discharge from the hospital, patients of the Russian cohort and of the entire study population were prescribed acetylsalicylic acid or other antiplatelet drugs (99.2% and 94.1%, respectively); beta-blockers (87.2 and 81.6%, respectively); angiotensin-converting enzyme (ACE) inhibitors (69.9% and 61.1%, respectively); sartans (16.5% and 14.2 %, respectively); calcium channel blockers (19.3 and 19.4 %, respectively); nitrates (8.0% and 22.5 %, respectively); diuretics (31.1 and 32.5 %, respectively); statins (98.0% and 85.0 %, respectively); and anticoagulants (6.6 and 8.3 %, respectively). For the long-term treatment, patients of the Russian cohort and of the entire study population took antiplatelets (94.7 % and 92.5 %, respectively); beta-blockers (83.2% and 81.0 %, respectively); ACE inhibitors (60.2% and 57.3 %, respectively); sartans (19.3% and 18.4 %, respectively); calcium antagonists (21.1% and 23.0 %, respectively); nitrates (9.0% and 18.2 %, respectively); diuretics (31.8% and 33.3 %, respectively); statins (88.2% and 80.8 %, respectively); and anticoagulants (8.8% and 8.2 %, respectively). High intensity hypolipidemic therapy was prescribed to 54.0 % of patients in Russian centers and 60.3 % of patients in the entire study. Both Russian and international patients evaluated their compliance with the prescribed medication as high.Conclusion      According to results of the EUROASPIRE V study as compared to earlier studies, the practice of drug therapy in Russian patients with IHD has significantly approached European indexes. Further optimization is possible by a more extensive use of high intense hypolipidemic treatment and antidiabetic drugs with a documented positive effect on prognosis of cardiovascular diseases.

Abstract P118: Use of Statins and Antihypertensive Medications in Relation to Recurrence of Atrial Fibrillation and Progression to Permanent Atrial Fibrillation

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Evan L Thacker ◽  
Paul N Jensen ◽  
Bruce M Psaty ◽  
Barbara McKnight ◽  
W. T Longstreth ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ace Inhibitors ◽  
Beta Blockers ◽  
Medication Use ◽  
Hazard Ratios ◽  
One Year ◽  
Healthy User Bias ◽  
Statin Use

Objective. We sought to determine among people whose initial atrial fibrillation (AF) terminated whether use of statins, beta-blockers, and ACE inhibitors or ARBs was associated with lower risk of recurrent AF or progression to permanent AF. Methods. In Group Health, an integrated health care system, we identified an inception cohort of people aged 30-84 with newly diagnosed AF in 2001-2004 whose initial AF terminated within six months. Follow-up was through 2009. Medication use throughout follow-up was determined from the pharmacy database. Recurrent AF and permanent AF were determined from medical records and ECG and procedure code databases. Permanent AF was defined as AF present on two dates at least six months apart with no evidence of sinus rhythm in between. Cox proportional hazards models were used to estimate hazard ratios. We compared current statin use with nonuse. To reduce healthy user bias, we compared statin use one year prior with nonuse one year prior. To reduce confounding by indication, we compared beta-blocker use with nondihydropyridine calcium channel blocker use. We compared current ACE inhibitor or ARB use with nonuse. Results. Analyses included 1,511 people. Mean age was 70 years and 51% were men. Statins were used for 36% of person-time, beta-blockers for 48%, and ACE inhibitors or ARBs for 42%. Five-year cumulative incidence of recurrent AF was 74% and of permanent AF was 24%. Current statin use vs. nonuse was associated with lower permanent AF risk. However, statin use vs. nonuse one year prior was not associated with permanent AF ( Table ). Use of beta-blockers and ACE inhibitors or ARBs was not associated with recurrent AF or permanent AF. Adjusted hazard ratios of recurrent AF and permanent AF according to medication use. Medication use Recurrent AF Adjusted HR * (95% CI) Permanent AF Adjusted HR * (95% CI) Statins -- current use analysis Nonuse 1.00 (reference) 1.00 (reference) Current use 0.96 (0.82, 1.12) 0.76 (0.58, 0.99) Statins -- lagged analysis Nonuse one year prior 1.00 (reference) 1.00 (reference) Use one year prior 0.94 (0.79, 1.13) 0.98 (0.74, 1.30) Beta-blockers Current nondihydropyridine CCB use 1.00 (reference) 1.00 (reference) Current beta-blocker use 0.91 (0.74, 1.12) 1.04 (0.69, 1.56) ACE inhibitors or ARBs Nonuse 1.00 (reference) 1.00 (reference) Current use 0.99 (0.86, 1.14) 0.98 (0.77, 1.25) * Adjusted for age, sex, BMI, diabetes, hypertension, coronary heart disease, valvular heart disease, heart failure, prior stroke, and chronic kidney disease. Conclusion. The lagged statin analysis suggests that the association of current statin use with lower permanent AF risk may have been due to an acute effect of statins that did not persist after discontinuation of use, or to a healthy user bias. We found little evidence that use of statins, beta-blockers, or ACE inhibitors or ARBs reduces risk of recurrent AF or permanent AF.

Community prevalence, mechanisms and outcome of mitral or tricuspid regurgitation

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318482
Author(s):  
Thomas J Cahill ◽  
Anthony Prothero ◽  
Jo Wilson ◽  
Andrew Kennedy ◽  
Jacob Brubert ◽  
...  
Keyword(s):  
Heart Disease ◽  
Tricuspid Regurgitation ◽  
Valvular Heart Disease ◽  
Surgical Intervention ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Age Dependent ◽  
Study Population

ObjectiveThe study aims were (1) to identify the community prevalence of moderate or greater mitral or tricuspid regurgitation (MR/TR), (2) to compare subjects identified by population screening with those with known valvular heart disease (VHD), (3) to understand the mechanisms of MR/TR and (4) to assess the rate of valve intervention and long-term outcome.MethodsAdults aged ≥65 years registered at seven family medicine practices in Oxfordshire, UK were screened for inclusion (n=9504). Subjects with known VHD were identified from hospital records and those without VHD invited to undergo transthoracic echocardiography (TTE) within the Oxford Valvular Heart Disease Population Study (OxVALVE). The study population ultimately comprised 4755 subjects. The severity and aetiology of MR and TR were assessed by integrated comprehensive TTE assessment.ResultsThe prevalence of moderate or greater MR and TR was 3.5% (95% CI 3.1 to 3.8) and 2.6% (95% CI 2.3 to 2.9), respectively. Primary MR was the most common aetiology (124/203, 61.1%). Almost half of cases were newly diagnosed by screening: MR 98/203 (48.3%), TR 69/155 (44.5%). Subjects diagnosed by screening were less symptomatic, more likely to have primary MR and had a lower incidence of aortic valve disease. Surgical intervention was undertaken in six subjects (2.4%) over a median follow-up of 64 months. Five-year survival was 79.8% in subjects with isolated MR, 84.8% in those with isolated TR, and 59.4% in those with combined MR and TR (p=0.0005).ConclusionsModerate or greater MR/TR is common, age-dependent and is underdiagnosed. Current rates of valve intervention are extremely low.

Sustained and non-sustained ventricular tachycardia and no associated heart disease (idiopathic ventricular tachycardia)

ESC CardioMed ◽  
2018 ◽  
pp. 2288-2293
Author(s):  
Victor Bazan ◽  
Enrique Rodriguez-Font ◽  
Francis E. Marchlinski
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Drug Therapy ◽  
Catheter Ablation ◽  
Beta Blockers ◽  
Young Patients ◽  
Structural Heart Disease ◽  
Holter Monitoring ◽  
Severe Arrhythmia ◽  
The Right

Around 10% of ventricular arrhythmias (VA) occur in the absence of underlying structural heart disease. These so-called ‘idiopathic’ VAs usually have a benign clinical course. Only rarely do these “benign” arrhythmias trigger polymorphic ventricular tachycardia (PVT) and idiopathic ventricular fibrillation (VF). Due to their focal origin and to the absence of underlying myocardial scar, the 12-lead ECG very precisely establishes the right (RV) or left (LV) ventricular site of origin of the arrhythmia and can help regionalizing the origin of VT for ablation. A 12-lead ECG obtained during the baseline rhythm and 24-hour ECG Holter monitoring are indicated in order to identify structural or electrical disorders leading to PVT/VF and to determine the VA burden. The most frequent origin of idiopathic VAs is the RV outflow tract (OT). Other origins include the LVOT, the LV fascicles (fascicular VTs), the LV and RV papillary muscles, the crux cordis, the mitral and tricuspid annuli and the RV moderator band. Recognizing the typical anatomic sites of origin combined with a 12 lead ECG assessment facilitates localization.  Antiarrhythmic drug therapy (including use of beta-blockers) or catheter ablation may be indicated to suppress or eliminate idiopathic VAs, particularly upon severe arrhythmia-related symptoms or if the arrhythmia burden is high and ‘tachycardia’-induced cardiomyopathy is suspected. Catheter ablation is frequently preferred to prevent lifelong drug therapy in young patients.

The Frequency of Coronary Heart Disease and Myocardial Infarction in Patients with Rheumatoid Arthritis

1975 ◽  
Author(s):  
S. Czaplicki ◽  
J. Gietka ◽  
K. Sulek
Keyword(s):  
Rheumatoid Arthritis ◽  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Normal Population ◽  
Term Treatment ◽  
Coronary Risk Factors ◽  
Long Term Treatment ◽  
Adhesion Of Platelets

The frequency of coronary heart disease and myocardial infarction in 500 persons with rheumatoidearthritis (116 men and 384 women) receiving salicylates during long period time were examined. Coronary heart disease in 2 cases (1 man and 1 woman) and myocardial infarction in 1 man were found.On the basis of the age and duration observations the authors discovered that the coefficient morbidity was statistically significant lower than in the same population but without rheumatoid arthritis. The coronary risk factors as hypertenia arterialis, hyper-cholestrolemia and diabetes was less frequent than in normal population too. The cigarettes smoking and obesity were found equally frequent.The authors suggested that long term treatment with acetylsalicylic acid effects inhibition adhesion of platelets and in this way protects before arterial thrombosis and may be artherosclerosis.

scholarly journals Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET

2005 ◽  
Vol 26 (13) ◽  
pp. 1303-1308 ◽  
Author(s):  
Karl Swedberg ◽  
Lars G. Olsson ◽  
Andrew Charlesworth ◽  
John Cleland ◽  
Peter Hanrath ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Heart Failure ◽  
Beta Blockers ◽  
Term Treatment ◽  
Prognostic Relevance ◽  
Long Term Treatment

scholarly journals Review on Coexistence of Hypertension with Diabetes Mellitus

2021 ◽  
pp. 220-223
Author(s):  
Nargis Saharan
Keyword(s):  
Diabetes Mellitus ◽  
Drug Therapy ◽  
Ace Inhibitors ◽  
Beta Blockers ◽  
Diabetic Patients ◽  
Beneficial Effects ◽  
Low Sodium ◽  
Target Organs ◽  
Effective Role ◽  
Common Target

The coexistence of both diabetes mellitus and hypertension affect the some major target organs. Their common target organ is heart and kidney. The primary goal in the management of the hypertensive diabetic patients is lowering blood pressure to less than 130/80mm Hg Beta- blockers have been reported to adversely affect the overall risk factor profile in the diabetic patient. Initially ACE inhibitors and ARB are initially can be given to diabetic hypertensive. Beta blockers also show great effects in preventing further cardiovascular diseases in diabetic hypertensive. Although combined drug therapy is usually required to achieve goal but in addition to drug therapy some other precautions should also plays effective role like exercise، low sodium chloride intake, lower lipids in diet, maintaining glucose level, stress less patients environment. Calcium channels blockers and diuretics in combination with ACE inhibitors and antidiabetic drugs will also exerts beneficial effects.

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