scholarly journals Clinical efficiency of restorative treatment after percutaneous coronary intervention in patients with coronary artery disease

2021 ◽  
Vol 17 (1) ◽  
pp. 133-137
Author(s):  
Nodir Kayumov Ulug’bekovich ◽  
Djamshid Payziev Djuravaevich ◽  
Orziev Daler Zavkiddinovich
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Lipid Metabolism ◽  
Coronary Artery ◽  
Platelet Aggregation ◽  
Coronary Intervention ◽  
Restorative Treatment ◽  
Percutaneous Coronary ◽  
Artery Disease

The article discusses topical issues of treatment and rehabilitation strategies in patients with ischemic heart disease (IHD). The results of our own research on assessing the effectiveness of complex rehabilitation of patients with myocardial changes with the study of indicators of lipid metabolism, platelet aggregation, functional state of patients with coronary artery disease, after stenting of the coronary arteries have been stated in the article.

Chronic Stable Angina

2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

Chronic Stable Angina

2015 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 12 tables, and 109 references.

Chronic Stable Angina

2018 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

scholarly journals Resistência plaquetária ao clopidrogel em pacientes diabéticos submetidos à intervenção coronariana percutânea: revisão da literatura

2019 ◽  
Vol 9 (27) ◽  
pp. 73
Author(s):  
Marco Antônio Gomes da Silva
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Platelet Aggregation ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Platelet Aggregation Inhibitor ◽  
Percutaneous Coronary ◽  
Aggregation Inhibitor ◽  
Artery Disease

A antiagregação plaquetária é peça chave no tratamento dos pacientes submetidos a intervenção coronaria percutânea com implante de stent coronariano. Entretanto, uma parcela destes pacientes não se encontram devidamente antiagregados. O objetivo foi identificar mediante a revisão de literatura, artigos que mostram os mecanismo de resistência plaquetária ao clopidrogel em pacientes diabéticos submetidos à intervenção coronariana. Trata-se de uma pesquisa de revisão de literatura no qual os artigos estavam disponíveis nas bases de dados SCIELO, LILACS e PubMed, publicados entre os anos de 2006 a 2015 com os seguintes descritores: inibidores da agregação plaquetária, intervenção coronária percutânea e doença da artéria coronária. Foram encontradas seis publicações cientificas entre os anos de 2006 a 2015 abordando o tema da pesquisa. Foi possível observar nas publicações um alto índice de resistência plaquetária ao clopidrogel nos pacientes diabéticos em relação com os pacientes não diabéticos.Descritores: Inibidores da Agregação Plaquetária, Intervenção Coronária Percutânea, Doença da Artéria Coronária. Platelet Resistance to Clopidogel in Diabetic Patients Undergoing Percutaneous Coronary Intervention: literature reviewAbstract: Platelet antiaggregation is a key element in the treatment of patients undergoing percutaneous coronary intervention with coronary stent implantation. However, a portion of these patients are not adequately antiaggregated. The objective was to identify through the literature review, articles that show the mechanisms of platelet resistance to clopidrogel in diabetic patients submitted to coronary intervention. This is a review of the literature in which the articles were available in the SCIELO, LILACS and PubMed databases, published between the years 2006 and 2015, with the following descriptors: platelet aggregation inhibitors, coronary intervention percutaneous coronary artery disease. Six scientific publications were found between the years 2006 and 2015, addressing the research theme. It was possible to observe a high index of platelet resistance to clopidrogel in diabetic patients in relation to non-diabetic patients.Descriptors: Platelet Aggregation Inhibitor, Percutaneous Coronary Intervention, Coronary Artery Disease. Resistencia plaquetaria con clopidogrel en pacientes diabéticos sometidos a intervención coronaria percutánea: revisión de la literaturaResumen: Platelet antiagregación es un elemento clave en el tratamiento de los pacientes en curso percutáneo coronario con una coronaria stent implantación. Sin embargo, la parte de estos pacientes no está adecuadamente antiagregada. El objetivo era identificar a través de la revisión, los artículos que muestran los ajustes de la resistencia al azar en el clopidrogel en los pacientes diabéticos sometidos a una intervención coronaria. Esta es una revisión de los casos en los que se incluyeron los artículos en el SCIELO, LILACS y PubMed de las bases de datos, publicados entre los años 2006 y 2015, con los siguientes descriptores: los inhibidores de la intervención de la insulina, la interrupción de la intervención de los pacientes. Se han encontrado seis estadísticas científicas entre los años 2006 y 2015, el tema de la investigación. Es posible observar un alto índice de la resistencia al azar en los pacientes con diabetes en pacientes con diabetes.Descriptores: Platelet Aggregation Inhibitor, Corrección de la Coronaria de Coronaria Arterial, Enfermedad de la Arteria Coronaria.

Stable Ischemic Heart Disease: Medical Therapy With or Without Revascularization

2019 ◽  
Author(s):  
Ashish Sarraju ◽  
David J Maron
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Medical Therapy ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Percutaneous Coronary ◽  
Artery Disease

Coronary artery disease (CAD) poses a significant global public health burden. Patients with CAD who do not present with acute coronary syndromes are considered to have stable ischemic heart disease (SIHD). Options for the management of SIHD are medical therapy including pharmacologic therapy and lifestyle modification and revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Guideline-directed medical therapy is recommended for all patients with SIHD. Aside from severe stenosis in an unprotected left main coronary artery, the role of routine revascularization in the management of SIHD is unclear. Early CABG trials from the 1970s and 1980s demonstrated prognostic benefit with CABG versus medical therapy, but these results have limited applicability in the setting of modern medical therapy, including the widespread use of statins and aspirin and intensive lifestyle interventions. Contemporary strategy trials examining PCI plus medical therapy versus medical therapy alone have not demonstrated prognostic benefit with the addition of PCI. The addition of revascularization offers consistent symptom and quality-of-life benefit compared with medical therapy alone based on trial data, though this benefit may be time limited with PCI. Thus, there is a state of equipoise regarding the addition of revascularization to guideline-directed medical therapy in the management of SIHD. Therefore, shared decision-making is key when determining the best management strategy for a patient with SIHD and should include discussion of expected risks and benefits based on high-quality evidence, costs, and patient preferences. This review contains 6 figures, 8 tables, and 55 references.  Key Words: angina, antianginal therapy, coronary artery disease, coronary artery bypass grafting, guideline-directed medical therapy, ischemia, optimal medical therapy, percutaneous coronary intervention, revascularization

scholarly journals ADMINISTRATION OF LOADING DOSES OF STATINS FOR PREVENTION OF CONTRAST-INDUCED KIDNEY INJURY DURING ENDOVASCULAR INTERVENTIONS IN PATIENTS WITH ISCHEMIC HEART DISEASE

2019 ◽  
Vol 33 (4) ◽  
pp. 111-118 ◽  
Author(s):  
O. E. Shalaeva ◽  
E. O. Vershinina ◽  
A. N. Repin
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Myocardial Revascularization ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Loading Dose ◽  
Percutaneous Coronary ◽  
Artery Disease

Percutaneous coronary interventions have become a key method of revascularization in patients with coronary artery disease. Contrast-induced nephropathy is one of the main complications in patients who undergo coronary angiography and percutaneous coronary intervention. Loading doses of statins are often used for the purpose of nephroprotection. However, a clear available algorithm for prescribing statins for the prevention of acute contrast-induced kidney injury has not been identified. The purpose: to evaluate the effectiveness of high loading doses of statins (atorvastatin and rosuvastatin) to prevent acute contrast-induced kidney injury in patients with chronic ischemic heart disease during planned endovascular treatment.Material and Methods. Patients with clinical manifestations of FC II and III angina pectoris and hemodynamically significant stenoses of the coronary arteries were referred for a planned endovascular myocardial revascularization. Two groups of patients were assigned based on the intake of synthetic statins: atorvastatin and rosuvastatin. Before the endovascular intervention, patients were administered with high loading doses of statins. All patients underwent general clinical examination, routine assessment of creatinine levels, other blood tests, assessment of glomerular filtration rate, and control of lipid profile of blood.Conclusion. The incidence rate of contrast-induced kidney injury in patients with coronary artery disease, administered with loading doses of rosuvastatin, in the course of planned percutaneous coronary intervention was lower compared with the loading therapy of atorvastatin: 3.33 and 12.12%, respectively. On average, an increase in creatinine concentration to the maximum level occurred more often in the group of patients administered with a loading dose of atorvastatin than in the other group administered with a loading dose of rosuvastatin (14.3 versus 8.1%, p=0.024). A decrease in renal function in terms of GFR of less than 60 mL/min/1.73 m2 on day 5 was observed in 12 patients (34.3%) in the first group versus 9 patients (27.3%) in the second group. Therapy with loading doses of rosuvastatin before endovascular myocardial revascularization was more effective than treatment of patients with atorvastatin. 

Chronic Stable Angina

2018 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

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