scholarly journals Choosing an antianginal therapy strategy in patients with stable coronary artery disease in real clinical practice: the advantages of trimetazidine

2021 ◽  
pp. 25-32
Author(s):  
E. V. Borisova ◽  
O. D. Ostroumova ◽  
A. P. Pereverzev ◽  
E. E. Pavleeva
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Russian Federation ◽  
Stable Coronary Artery Disease ◽  
Cardiovascular Complications ◽  
Ministry Of Health ◽  
Conduction Disorders ◽  
Therapy Strategy ◽  
Stable Coronary Heart Disease ◽  
The Russian Federation

Cardiovascular diseases (CVD) are the leading cause of death among adults worldwide, including in the Russian Federation. At the same time, the leading position in the structure of causes of death from CVD is occupied by coronary heart disease (CHD) (16% of the total number of deaths in the world per year). The new clinical guidelines of the Ministry of Health of the Russian Federation for the management of patients with stable coronary heart disease in 2020 identify two main goals of conservative therapy – the elimination of symptoms of the disease and the prevention of cardiovascular complications (CVD). In this connection, when choosing antianginal therapy in patients with stable angina, it is necessary to consider the possibility of using combinations of both first-line and second-line drugs in order to really improve the effectiveness of treatment and achieve the goals set. It is advisable and justified to use more widely 2-line drugs, in particular trimetazidine, at any stage of therapy to enhance the antianginal effectiveness of b-blockers, calcium antagonists and prolonged-acting nitrates, especially in patients with hemodynamic features (arterial hypotension, rhythm and conduction disorders), which is demonstrated in the given clinical example. The effective addition of tremetazidine to the arsenal of traditional antianginal drugs is legislated in practice and is reflected in the new clinical recommendations of the Ministry of Health of the Russian Federation in 2020. The accumulated experience of using trimetazidine allows a pathogenetically sound approach to the treatment of stable CHD, restoring the balance between the need and delivery of oxygen to the heart muscle, and the safety profile expands the possibilities of use in patients with comorbid pathology. 

scholarly journals The Impact of the Introduction of Clinical Recommendations on Cardiology in the USA and Russia Federetionon Mortality from Ischemic Heart Diseas

2018 ◽  
Vol 17 (4) ◽  
pp. 30-37
Author(s):  
A. A. Gerasimov
Keyword(s):  
United States ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
The United States ◽  
Ischemic Heart ◽  
The Russian Federation ◽  
The Impact

1 million 824 thousand people died in the Russian Federation in 2017, including 457 thousand from ischemic heart disease (IHD). IHD caused more than a quarter of deaths in Russia. Goal. The article analyzes the impact of implementation of clinical guidelines in cardiology in medical practice in the United States and the Russian Federation on the dynamics of mortality from ischemic heart disease and its outcomes in different age groups. Results. The results showed that the implementation of clinical guidelines (CG) increased the rate of mortality reduction from coronary heart diseases in Russia and the United States, which may indicate a positive impact CG on the quality of medical care. Conclusions. A higher level of mortality from coronary heart disease in Russia compared to the United States may be due to less commitment of doctors to the principles of therapy and diagnosis of various forms of coronary heart disease, set out in clinical guidelines.

scholarly journals LIFE QUALITY ASSESSMENT OF PATIENTS WITH STABLE CORONARY ARTERY DISEASE AFTER MYOCARDIAL REVASCULARIZATION

2021 ◽  
Vol 8 (6) ◽  
pp. 465-475
Author(s):  
I. A. Narkevich ◽  
O. D. Nemyatykh ◽  
K. A. Kovaleva ◽  
L. G. Ratova ◽  
I. O. Trushnikova ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Stable Coronary Artery Disease ◽  
Life Quality ◽  
Stable Coronary Heart Disease ◽  
Artery Disease ◽  
Angioplasty And Stenting

The aim of this study is to assess the life quality of patients with stable coronary artery disease after angioplasty and stenting of coronary arteries at the post-hospital stage.Materials and methods. Methods of the sociological analysis (questionnaire surveys) and methods of mathematical statistics (descriptive statistics, time series method, factor and variance analyses) were used at different stages of the prospective observational study. The research materials were as follows:1458 electronic patient records with a stable coronary heart disease (SCHD) after angioplasty and stenting of coronary arteries (ASCA); 620 questionnaires filled in by patients before the surgery, 1, 6, 12 months after discharge. The statistical analysis was performed using the IBM SPSS Statistics software.Results. The results of a comprehensive survey make it possible for us to assert that during the studied period, stable good healths of cardiac surgery patients with ASCA were maintained. Within the framework of the EQ-5D-5L questionnaire, it was revealed that more than 50% of patients have no physiological problems. The results of the SAQ analysis demonstrate that 58% of the patients feel better, and more than 34% of the patients do not have shortness of breath 1 year after the surgery. A statistically significant improvement in their healths was established according to a visual analogue scale relatively to the annual observation mark (62.82 ± 20.95), which corresponds to the high results assessment of the medical technology use. At the same time, 53% of the patients notify that the treatment results meet their own expectations.Conclusion. The proposed calculation of the integrated index of patients’ treatment efficiency demonstrated by the patients with stable coronary heart disease after angioplasty and stenting of the coronary arteries is based on the results of the factor analysis. This calculation can be used to assess the efficiency of pharmacotherapy in the framework of a value-oriented approach to the treatment of a number of other pathologies.

scholarly journals The polymorphism of IL18RAP and IL18R1 genes associated with risks of the development of myocardial infarction in patients with stable coronary artery disease

2018 ◽  
Vol 5 (4) ◽  
pp. 12-22
Author(s):  
A. V. Ponasenko ◽  
A. V. Tsepokina ◽  
M. V. Khutornaya ◽  
V. A. Dolgikh ◽  
I. Yu. Malshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Stable Coronary Artery Disease ◽  
Molecular Genetic ◽  
Clinical Signs ◽  
Stable Coronary Heart Disease ◽  
Artery Disease ◽  
Prospective Monitoring

Objective:to assess the probability of pathogenic effects OF Il-18 (IL18, IL18R1 and IL18RAP) gene polymorphism on the risk of myocardial infarction in patients with stable coronary heart disease.Materials and methods: the present study was performed with the inclusion of 260 patients with stable coronary heart disease (CHD), residents of the industrial region of Western Siberia. Molecular genetic testing was performed on nine polymorphic sites of il18, IL18R1, IL18RAP genes.Results:associations of polymorphic sites rs13015714 IL18R1 and rs917997 IL18RAP with risks of myocardial infarction were Determined (OR =1.95 (95% CI =1.06-3.58), p =0.029 and OR =2.01 (95% CI =1.11-3.64), p=0.018).Conclusion:to confirm the role of polymorphism IL18, IL18R1, IL18RAP in the pathogenesis of atherosclerosis, prospective monitoring of this group of patients is necessary to identify cases of manifestation of clinical signs in persons with adverse prognosis.

scholarly journals WHY CARDIOVASCULAR MORTALITY IN MOSCOW IS LOWER THAN IN OTHER REGIONS OF THE RUSSIAN FEDERATION?

2015 ◽  
Vol 14 (2) ◽  
pp. 4-12
Author(s):  
N. V. Pogosova ◽  
R. G. Oganov ◽  
S. V. Suvorov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Care ◽  
Russian Federation ◽  
Cardiovascular Mortality ◽  
High Technology ◽  
Economic Level ◽  
The Russian Federation ◽  
In The Beginning ◽  
Cvd Mortality

Since 2003 there is a decline of cardiovascular (CVD) mortality of the RF, that established in 2006 in women and in men. From 2003 to 2013 y. total coefficient of cardiovascular mortality (number of died per 100 thousand of population) decreased by 25% (698,1 vs. 927,5), although still it is higher than in the beginning of the nineties (621,0 per 100 thous. of population in 1991 y.). The significant differences in RG regions are noted by the values of morbidity and mortality from CVD. For the period 2006-2013 y. the standardized value of mortality from coronary heart disease (CHD) in Moscow decreased by 35,7% that is 1,5 more than in RF and 1,3 more higher than in St-Petersburg, and 2,6 times more than in Moscow region. In 2012 the value of the suspected life duration (SLD) of Moscow citizens was 76,0 y. (mean in Russia — 70,0 y), and just 4 years is the gap between then and EU citizens. In 2013 SLD in Moscow reached 72,3 y. Significantly lower values of mortality from CVD and higher values of SLD can be explained by higher socio-economic level, higher psychological endurance and better availability of psychological (psychotherapeutic) help, higher level of fish, fruits and berries consumption, better availability of outpatient and high technology medical care for Moscow citizens. 

scholarly journals 2020 Clinical practice guidelines for Stable coronary artery disease

2020 ◽  
Vol 25 (11) ◽  
pp. 4076
Author(s):  
. Russian Society of Cardiology (RSC)
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Practice ◽  
Coronary Artery ◽  
Russian Federation ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Stable Coronary Artery Disease ◽  
Ministry Of Health ◽  
The Russian Federation ◽  
Artery Disease

Approved by the Research and Practical Council of the Ministry of Health of the Russian Federation.

Features of treatment and rehabilitation of patients suffering from stable coronary heart disease with comorbid background at the outpatient stage

2021 ◽  
Vol 3 ◽  
Author(s):  
D.Yu. Gamayunov ◽  
◽  
V.A. Khaptanova ◽  
A.N. Kalyagin ◽  
N.M. Balabina ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Oral Cavity ◽  
Inflammatory Diseases ◽  
Beta Blockers ◽  
Cardiovascular Complications ◽  
Angle Closure ◽  
Deficiency Anemia ◽  
Stable Coronary Heart Disease ◽  
Coronavirus Infection

This literature review highlights the relevance of both cardiovascular diseases in general and coronary heart disease in particular. The features of the therapy of coronary heart disease and some comorbid conditions are considered: atrial fibrillation, arterial hypertension, diabetes mellitus, chronic kidney disease, gastrointestinal tract diseases, bronchial patency disorders, iron deficiency anemia, inflammatory diseases of the oral cavity, angle-closure glaucoma, new coronavirus infection COVID-19. Attention is drawn to the paradoxical relationship between cholesterol levels and the risk of cardiovascular complications and death in patients with end – stage CKD. The effect of omeprazole on reflux-induced myocardial ischemia is described. The possibility of using cardioselective beta -blockers in patients with COPD is emphasized. The choice of the form of nitrate release in inflammatory diseases of the oral cavity requires special attention. An urgent problem is the interaction of antiviral drugs and drugs of basic therapy of coronary heart disease in patients with a new coronavirus infection COVID – 19. Thus, patients taking CYP3A4 inhibitors are recommended to use prasugrel. The article examines the effect of comorbidity on the severity of persistent loss of body functions. Attention is drawn to the existing problems of rehabilitation of patients with coronary heart disease at the outpatient stage: patients ignoring non – drug rehabilitation methods, insufficiently attentive attitude to the issue of full – fledged secondary prevention. It is necessary to further improve the algorithms for the tactics of management of comorbid patients with coronary heart disease at the outpatient stage and a more detailed solution to the issue of medical and labor expertise and rehabilitation of this category of patients.

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