Principles of Diagnostic and Treatment of Coronary Artery Disease Combined with Chronic Obstructive Pulmonary Disease in Family Doctor Practice

2016 ◽  
pp. 98-101
Author(s):  
Yevheniia Zaremba ◽  
Mariana Fedechko ◽  
Oksana Makar ◽  
Lesia Kopchak ◽  
Nataliia Izhytska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Hypoxia ◽  
Family Doctor ◽  
Negative Influence ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Risk Factors ◽  
Artery Disease ◽  
Special Approach

Combined pathology is one of the most spread problems in a family doctor’s practice. One of the first places is taken by the combination of ischemic artery disease and chronic obstructive pulmonary disease. It is connected with both wide spread occurrence of these pathologies and common risk factors together with pathogenic development mechanisms. Such combination causes diagnostics problems since the symptoms of one disease may mask the signs of the other. Chronic hypoxia, system inflammation characteristic of chronic obstructive pulmonary disease may have negative influence on the dynamics of ischemic artery disease, as a result of which complications occur more often. Apart from this, treatment requires a special approach because of possible negative influence of pharmacological drugs on the dynamics of combined pathology.

scholarly journals Comorbidity of Chronic Obstructive Pulmonary Disease and Cardiovascular Diseases: Place of Therapy with Modern β-Adrenoblockers

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 48-55 ◽  
Author(s):  
Yu. N. Belenkov ◽  
O. A. Tsvetkova ◽  
E. V. Privalova ◽  
G. V. An ◽  
I. S. Ilgisonis ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular Diseases ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Common Risk Factors ◽  
Artery Disease ◽  
Morbidity Risk

Chronic obstructive pulmonary disease (COPD) is the fourth largest cause of worldwide mortality.  Presence of comorbidities is registered in 96% of COPD patients. The most important of these are cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure), which contribute to COPD patients’ mortality in every third case. COPD and cardiovascular diseases have common risk factors and pathogenesis mechanisms. Cardioselective beta-blockers reduce morbidity risk and frequency of COPD exacerbation, are effective and safe in treatment of COPD patients.

scholarly journals Biological effects of ticagrelor over clopidogrel in patients with stable coronary artery disease and chronic obstructive pulmonary disease

2017 ◽  
Vol 117 (06) ◽  
pp. 1208-1216 ◽  
Author(s):  
Gianluca Campo ◽  
Francesco Vieceli Dalla Sega ◽  
Rita Pavasini ◽  
Giorgio Aquila ◽  
Francesco Gallo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Pulmonary Disease ◽  
Primary Endpoint ◽  
Stable Coronary Artery Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease

SummaryPatients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery disease (SCAD) and concomitant chronic obstructive pulmonary disease (COPD). Forty-six patients with SCAD and COPD undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (n=23) or ticagrelor (n=23) on top of standard therapy with aspirin. The following parameters were assessed at baseline and after 1 month: i) rate of apoptosis and ii) nitric oxide (NO) levels in human umbilical vein endothelial cells (HUVECs), iii) levels of reactive oxygen species (ROS) in peripheral blood mononuclear cell, iv) 29 cytokines/chemokines, v) on-treatment PR. The primary endpoint of the study was the 1-month rate of HUVECs apoptosis. The rate of apoptosis after 1 month was significantly lower in patients treated with ticagrelor (7.4 ± 1.3% vs 9.3 ± 1.5%, p<0.001), satisfying the pre-specified primary endpoint. In the ticagrelor arm, levels of NO were higher (10.1 ± 2.2 AU vs 8.5 ± 2.6 AU, p=0.03) while those of ROS (4 ± 1.8 AU vs 5.7 ± 2.8 AU, p=0.02) and P2Y12 reactivity units (52 ± 70 PRU vs 155 ± 62 PRU, p<0.001) were lower. There were no differences in cytokines/chemokines levels and aspirin reactivity units between groups. In patients with SCAD and COPD undergoing PCI, ticagrelor, as compared to clopidogrel is superior in improving surrogate markers of endothelial function and on-treatment PR (ClinicalTrials.gov, NCT02519608).Supplementary Material to this article is available online at www.thrombosis-online.com.

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