scholarly journals Antithrombotic therapy for chronic ischemic heart disease: how to balance risk and benefit in different categories of patients?

2020 ◽  
pp. 76-94
Author(s):  
N. B. Perepech
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Antithrombotic Therapy ◽  
Clinical Manifestations ◽  
Circulatory System ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease ◽  
Individual Values ◽  
Circulatory System Diseases

The review focuses on current guidelines for the use of medications that affect hemostasis in the treatment of patients with chronic ischemic heart disease (IHD). The review shows the important impact of negative outcomes of IHD on mortality from cardiovascular system diseases in the Russian Federation. The results of the most significant randomised clinical trials, which assessed the efficacy and safety of various antithrombotic therapy options in patients with various clinical manifestations of IHD, as well as methodological methods for individual assessment of ischemic and hemorrhagic risks, were discussed. Theoretically, the use of anticoagulants in combination with antithrombocytic drugs to reduce the risk of atherothrombotic complications in the phase of the stable course of the IHD is justified. The results of the COMPASS study, which proved the positive effect oflow-dose addition of rivaroxaban to acetylsalicylic acid on the risk of cardiovascular events, cardiovascular death and death from all causes in patients with chronic IHD with maintained sinus rhythm, are reviewed in detail. Discussions were held on how to determine the optimal duration of double antithrombocytic therapy in patients with IHD after percutaneous coronary intervention (PCI), taking into account individual values of ischemic and hemorrhagic risks. Long-term antithrombotic therapy schemes for patients with chronic IHD and atrial fibrillation (AF) that have not been exposed to PCI are presented, as well as current recommendations on how to choose the best antithrombotic therapy scheme for patients with IHD that have been exposed to PCI depending on the risk of stent thrombosis and the risk of bleeding. It has been substantiated that active differentiated antithrombotic therapy should be widely used in everyday practice, which, provided that ischemic and hemorrhagic risks are adequately assessed, creates a real prospect of reducing mortality from IHD and circulatory system diseases in general.

scholarly journals AGE/SEX-SPECIFIC MORTALITY RATES FROM CIRCULATORY SYSTEM DISEASES AMONG OUTPATIENTS OF A KRASNODAR POLYCLINIC

2019 ◽  
Vol 26 (3) ◽  
pp. 99-107
Author(s):  
Elena V. Bolotova ◽  
Anna V. Kontsevaya ◽  
Irina V. Kovrigina ◽  
Larisa P. Lyuberitskaya
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Circulatory System ◽  
Mortality Rates ◽  
Cerebrovascular Diseases ◽  
Ischemic Heart ◽  
Medical Documentation ◽  
Chronic Ischemic Heart Disease ◽  
Circulatory System Diseases ◽  
Specific Mortality

Aim.In this work, we undertook a study of age/sex-specific mortality rates from circulatory system diseases and certain nosological forms in 2015 and 2018 among outpatients of Research Institute — Ochapovsky Regional Clinical Hospital No. 1 delivering primary healthcare services.Materials and methods.We studied age/sex-specific mortality rates from circulatory system diseases among adult population using the data from the medical records of deceased outpatients (Form 025/u), extracts from autopsy reports, as well as medical certificates of death for 2015 and 2018. Non-standardised and standardised mortality rates were calculated.Results.In 2015, all-cause mortality rate by the medical organisation reached 6.2 per 1,000 population, with the total number of deaths from circulatory system diseases amounting to 49.6%. The non-standardised mortality rates from the circulatory system diseases totalled 307.81 per 100,000 population, including the non-standardised mortality rates from cerebrovascular diseases (44.68), ischemic heart disease (129.08) and myocardial infarction (4.96). Standardised mortality rates from circulatory system diseases amounted to 201.96 (men — 70.58, women — 131.38). In 2015, chronic ischemic heart disease (41.94%) ranked first as the cause of mortality among circulatory system diseases followed by diagnoses requiring additional interpretation and examination of primary medical documentation (35.48%), i.e. not clearly defined causes of death; and cerebrovascular diseases (14.52%). In 2018, chronic ischemic heart disease also ranked first (47.54%) followed by cerebrovascular (36.21%) and other diseases (16.39%) (ICD codes I26, I71.1, R00.8).Conclusion.It is shown that more attention from the cardiological and therapeutic services of primary health care is required in coding death-causing circulatory system diseases.

scholarly journals Antithrombotic Therapy in Atrial Fibrillation and Chronic Ischemic Heart Disease

Kardiologiia ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 80-86
Author(s):  
A. Yu. Rychkov ◽  
N. Yu. Khorkova
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Antithrombotic Therapy ◽  
Oral Anticoagulants ◽  
Coronary Intervention ◽  
Evidence Base ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease ◽  
Meta Analyses

The review is devoted to the use of antithrombotic therapy in patients with atrial fibrillation (AF) and chronic ischemic heart disease (IHD). We discuss data of international registries, meta-analyses assessing possibilities of the use of oral anticoagulants for secondary prevention of IHD. We present here results of randomized and observational clinical studies demonstrating advantages of prescription of monotherapy with oral anticoagulants (OAC) in combination of AF and chronic IHD. Modern evidence base of advantages of dual antithrombotic therapy with the use of direct OAC following percutaneous coronary intervention is also presented.  

Hypertonic disease and its involvement in the class of diseases of the circulatory system: epidemiological situation in Ukraine

2020 ◽  
Vol 26 (2-3) ◽  
pp. 68-74
Author(s):  
V.V. Ruden' ◽  
◽  
V.I. Diachyschyn ◽  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Negative Impact ◽  
Circulatory System ◽  
Well Being ◽  
The State ◽  
Ischemic Heart ◽  
Steady Increase ◽  
Circulatory System Diseases

Aim. A substantiation by the types of morbidity of biostatistic tendencies in the development of hypertonic disease and its involvement in the existing pathologies of the class of diseases of the circulatory system among the population of Ukraine. Material and Methods. An epidemiological, cross-sectional, continuous, prospective study was conducted with the use of statistical data of the Health Statistics Center of the Ministry of Health of Ukraine and the State Statistics Service of Ukraine (1993 and 2017), summarizing and processing them in spreadsheets of Microsoft Office Excel 2016 using retrospective, biostatistical and abstract research methods, as well as methods of copying, deductive awareness, structural-logical analysis and systematic principles. Results and Discussion. The results clearly indicated a steady increase in all forms of hypertonic disease among the population of Ukraine over the studied time period by Рincr=119.8%, when in 2017 this pathology affected ngen=10,388,376 persons, with the prevalence indicator Рgen= 29,844.1о/оооо, which testified that every fourth citizen had a case of hypertonic disease, whereas hypertonic disease accompanied ischemic heart disease in Рpr=40.4% of cases, - cerebrovascular disease in Рpr=23.1% of cases and - strokes in Рpr= 35.8% of cases. Conclusions. It is established that hypertonic disease is one of the most prevalent diseases of the cardiovascular system and has a direct negative impact on of socio-economic well-being and resource provision for society and, based on achievements in etiopathology, diagnostics and treatment, requires the highest governmental structures of the state to undertake prompt and adequate managerial preventive actions aimed at strengthening the health of patients with hypertonic disease and of changing the lifestyle of the population in consideration of established risk factors in the occurrence of this pathology. Keywords: circulatory system diseases, hypertonic disease, general and primary morbidity, tendencies, involvement, ischemic heart disease, cerebrovascular disease, stroke

scholarly journals Features of the Course and Treatment of Hypertension in Combination with Chronicis Chemic Heart Disease in Patients with Gastroesophagel Refluxdisease. Role of Proton Pump Inhibitors Test in the Diagnosis and Treatment of Different Forms of GERD

2016 ◽  
pp. 75-80
Author(s):  
Viktoriia Prikhodko ◽  
Diana Moreva
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Gastroesophageal Reflux ◽  
Ischemic Heart Disease ◽  
Blood Pressure Monitoring ◽  
Clinical Manifestations ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease ◽  
Chronic Coronary Artery Disease

The analysis of epidemiological data shows that the prevalence of GERD in Ukraine is 11.1. Prevalence of GERD increases with the age of respondents, which leads to changes in the structure of clinical disease and dominance of extraesophageal manifestations of disease. The objective: To study features of arterial hypertension (AH) combined with chronic coronary heart disease (CHD) in patients with GERD. Establish a connection presence of gastroesophageal reflux with possible clinical manifestations of coronary heart disease (arrhythmias, ischemic episodes according to the daily ECG monitoring, assessment of the severity of pain in the chest), and parameters of blood pressure and its lability. Patients and methods. As part of the fragment study examined 50 patients with hypertension I–II art. combined with chronic ischemic heart disease. Methods of examination: antopometric, biochemical blood tests, ambulatory blood pressure monitoring. Holter ECG, upper endoscopy, echocardiography, tests on a scale GerdQ. Results. Comorbidity of hypertension and chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and metabolic syndrome, which increases the level of cardiovascular risk in patients with GERD. The presence of gastroesophageal reflux disease in patients with hypertension with chronic coronary artery disease causes an increase in the frequency and severity of arrhythmias. Patients on the background of GERD is more common atrial fibrillation (AF). When concomitant GERD in patients with chronic ischemic heart disease was significantly greater frequency and duration of ischemic episodes. Comorbidity with GERD worsens hypertension and characterized by higher rates of SBP and DBP at night and high variability in SBP and DBP during the day. Conclusion. The presence of GERD in patients with hypertension and chronic ischemic heart disease is associated with more severe clinical manifestations of the underlying disease and can therefore be regarded as complicating CHD- and AH-factor.

scholarly journals Profoundly Reduced Neovascularization Capacity of Bone Marrow Mononuclear Cells Derived From Patients With Chronic Ischemic Heart Disease

Circulation ◽  
2004 ◽  
Vol 109 (13) ◽  
pp. 1615-1622 ◽  
Author(s):  
Christopher Heeschen ◽  
Ralf Lehmann ◽  
Jörg Honold ◽  
Birgit Assmus ◽  
Alexandra Aicher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Mononuclear Cells ◽  
Ischemic Heart ◽  
Bone Marrow Mononuclear Cells ◽  
Chronic Ischemic Heart Disease

scholarly journals Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh

2013 ◽  
Vol 3 (2) ◽  
pp. 50-56
Author(s):  
MBK Choudhury ◽  
MM Hossain ◽  
M Akhtaruzzaman ◽  
MM Jamal Uddin ◽  
MS Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Healthy Volunteers ◽  
Serum Magnesium ◽  
Ischemic Heart ◽  
Diagnostic Tools ◽  
Strong Positive Correlation ◽  
Chronic Ischemic Heart Disease

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13812 Bangladesh J Med Biochem 2010; 3(2): 50-56

scholarly journals EVALUATION OF THE INTERNAL PICTURE OF HEALTH IN PATIENTS WITH ACUTE CORONARY SYNDROME IN PRESENTING WITHOUT ST-SEGMENT AFTER PERCUTANEOUS CORONARY INTERVENTIONS AND IN THE PROCESS OF REHABILITATION

2019 ◽  
Vol 3 ◽  
pp. 9-17
Author(s):  
Roksolana Nesterak
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Conservative Treatment ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Life Questionnaire ◽  
Actual Problem ◽  
Coronary Syndrome ◽  
St Segment

Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine. One of the forms of ischemic heart disease (IHD) is an acute coronary syndrome (ACS) in patients presenting without persistent ST-segment, the treatment of which involves the use of conservative treatment and reperfusion techniques. An integral part of the management of patients after acute coronary syndrome is rehabilitation and restoration with the search for methods of changing the attitude of the patient to his health. To improve the rehabilitation of patients it is important to assess the internal picture of health with the formation of the correct attitude of the patient to his health. Aim. To study the peculiarities of the components of the internal picture of health in patients with acute coronary syndrome in patients presenting without persistent ST-segment in the process of treatment and rehabilitation. Materials and methods. There were examined 135 patients with ACS presenting without persistent ST-segment, who were divided into the groups depending on the treatment performed; 60 patients with conservative treatment tactics and 75 patients with the performed PCI. The analysis of the internal picture of health was carried out with the help of methods: hospital scale for the detection of anxiety and depression (HADS); patient health questionnaire (PHQ-9); scale for measuring the level of reactive (situational) and personality anxiety of Spielberg-Hanin; SF-36; indicators of the Seattle Quality of Life Questionnaire for Patients with Angine Pectoris (Seattle Angina Questionnaire - SAQ). Results. The study of the internal picture of health in patients with ACS presenting without persistent ST-segment showed low levels of emotional, sensory, cognitive, value-motivational, behavioral components on the appropriate scales, which also depend on the method of treatment used. The revealed peculiarities of patients with ACS presenting without persistent ST-segment need to increase the knowledge of the patient about the disease and the importance of rehabilitation measures. Conclusions. In assessment of the internal picture of health in patients with ACS presenting without persistent ST-segment after transcutaneous coronary intervention and in the process of rehabilitation, it has been determined that the course of ischemic heart disease in patients with ACS presenting without persistent ST-segment, both during conservative treatment and in the course of PCI at the stages of rehabilitation, is accompanied by significant changes of the internal picture of health (IPH); the most significant changes in patients with ACS presenting without persistent ST-segment is the value-motivational and behavioral components of the internal picture of health. In order to increase the effectiveness of rehabilitation after ACS, it is advisable to apply programs that will significantly affect the positive changes in the rehabilitation of patients with ACS.

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