Predictor significance of β2-microglobulinuria in determining the risk of cardiovascular complications in patients with chronic ischemic heart disease

2021 ◽  
Vol 25 (6) ◽  
pp. 49-55
Author(s):  
E. S. Levitskaya ◽  
M. M. Batiushin ◽  
A. V. Khripun
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Unstable Angina ◽  
Myocardial Revascularization ◽  
Cardiovascular Complications ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease

BACKGROUND. The relevance of identifying new biomarkers of the cardio-renal syndrome in patients with coronary heart disease is beyond doubt. It is promising to study the indicators of tubular dysfunctions as predictors of the risk of cardiovascular complications in patients without primary kidney pathology.THE AIM. Analysis of the effect of β2-microglobulinuria on the prognosis of cardiovascular complications in patients with chronic ischemic heart disease in the long-term period after myocardial revascularization.PATIENTS AND METHODS. The study included 90 patients with coronary artery disease and indications for myocardial revascularization. Coronary bypass surgery was performed in 64 people, coronary artery stenting - in 26. Clinical and anamnestic data were collected in all patients, standard laboratory and instrumental diagnostics were performed. In addition, the level of β2-microglobulin (β2-MG) in the first morning portion of urine was determined at different study dates. The endpoint was considered to be the presence of acute forms of coronary heart disease - myocardial infarction and unstable angina. Survival after 5.8 ±0.1 years after myocardial revascularization was 69 %.RESULTS. A positive linear relationship of weak strength was established between the level of diastolic blood pressure (DBP) and β2-MG of urine obtained before myocardial revascularization (r = 0.28, p = 0.03). Moreover, the Kaplan-Meyer survival analysis showed the effect of an increase in β2-MG of urine over 0.2 ng/ml on the risk of AMI in the long-term period after myocardial revascularization (p = 0.025). It was found that an increase in the concentration of β2-MG in urine determined before myocardial revascularization is a statistically significant risk factor for the development of unstable angina in the long-term period after RM (χ2-criterion = 7.17, p = 0.007).CONCLUSION. It has been shown that an increase in the concentration of β2-MG in urine, reflecting the presence of tubular dysfunctions, can be considered as a predictor of an unfavorable cardiovascular prognosis in patients in the long-term period after myocardial revascularization.

scholarly journals Modern strategies for the treatment of psychoemotional stress in patients with heart coronary disease after myocardial revascularization.

2019 ◽  
Vol 40 (1) ◽  
pp. 25-30
Author(s):  
B. M. Holdovskyy ◽  
I. V. Filimonova, ◽  
S. O. Potalov ◽  
K. V. Serikov ◽  
D. V. Lelyuk ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Depressive Disorders ◽  
Myocardial Revascularization ◽  
Ischemic Heart ◽  
Postinfarction Cardiosclerosis ◽  
Significant Difference ◽  
Before And After

Coronary heart disease in many countries of the world, including in Ukraine, causes high rates of morbidity, disability and mortality. The study of factors affecting the occurrence, course, prognosis and effectiveness of drug therapy for coronary artery disease is important and relevant. One of such factors is the psychological disorders of the anxiety-depressive spectrum, which often occur in patients with myocardial infarction and after coronary artery bypass grafting; therefore, such patients should be carefully examined for affective disorders and receive appropriate drug therapy.Purpose of the study. Improvement of diagnosis and optimization of patients treatment with ischemic heart disease with concomitant anxiety-depressive disorders after myocardial revascularization.Material and methods. The results of the study are based on survey data and dynamic observation of 95 patients with coronary heart disease, postinfarction cardiosclerosis after myocardial revascularization. The patients underwent examination during the initial examination and after 12 weeks.Results of the study and their discussion.In the study of the psychoemotional state in the patients examined after the treatment, a significant decrease in anxiety manifestations was revealed by 36,4% against the group without fluvoxamine, where there was no significant difference before and after treatment. The manifestations of depressive disorder in the fluvoxamine group significantly decreased after treatment by 45,8 (HADS) and by 47,0% (Beck), in contrast to the group without fluvoxamine, where there was no significant difference before and after treatment.Conclusions. Thus, it has been proved that with the addition of fluvoxamine to combined therapy for patients with ischemic heart disease, postinfarction cardiosclerosis after revascularization of the myocardium shows a more pronounced decrease in the manifestations of anxiety-depressive disorder. Keywords:anxiety-depressive disorders, ischemic heart disease, revascularization of myocardium, antidepressants.

Pathogenetic approaches to treatment of aspirin-induced gastroenteropathies in case of long-term intake of acetylsalicylic acid in patients with chronic ischemic heart disease

Therapy ◽  
2020 ◽  
Vol 3_2020 ◽  
pp. 56-62
Author(s):  
Borovkova N.Yu. Borovkova ◽  
Buyanova M.V. Buyanova ◽  
Bakka T.E. Bakka ◽  
Nistratova M.P. Nistratova ◽  
◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Acetylsalicylic Acid ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease

Myocardial Revascularization in Patients With Chronic Ischemic Heart Disease Combined With Chronic Obstructive Pulmonary Disease

Kardiologiia ◽  
2016 ◽  
Vol 1_2016 ◽  
pp. 51-55 ◽  
Author(s):  
V.K. Zafiraki Zafiraki ◽  
K.V. Skaletsky Skaletsky ◽  
E.D. Kosmacheva Kosmacheva ◽  
L.V. Shulzhenko Shulzhenko ◽  
J.M. Ramazanov Ramazanov ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Pulmonary Disease ◽  
Myocardial Revascularization ◽  
Ischemic Heart ◽  
Chronic Obstructive ◽  
Chronic Ischemic Heart Disease ◽  
Obstructive Pulmonary Disease

scholarly journals Comparative characteristics of coronary artery damage in different degree of ischemic mitral regurgitation

2019 ◽  
Vol 18 (4) ◽  
pp. 45-50
Author(s):  
V. V. Krylov
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Mitral Regurgitation ◽  
Ischemic Heart Disease ◽  
Myocardial Revascularization ◽  
Ischemic Mitral Regurgitation ◽  
Ischemic Heart ◽  
Military Hospital ◽  
Coronary Artery Lesions

Introduction. Despite an active study of the problem of ischemic mitral regurgitation, studies of its connections with the degree and localization of coronary artery lesions are contradictory.Objective. Study the features of coronary artery lesions according to coronary angiography in patients with ischemic heart disease and ischemic mitral regurgitation and the connections between the severity of coronary artery lesions and the degree of ischemic mitral regurgitation.Material and methods. A retrospective analysis of the results of the examination of 86 patients with various forms of ischemic heart disease in combination with ischemic mitral regurgitation, operated in the department of cardiovascular surgery of the P.V. Mandryka Central Military Hospital. Results. 89,5 % of patients showed multifocal atherosclerotic coronary artery lesions, requiring direct myocardial revascularization; the predominant type of coronary blood supply was right (82,6 %); the average number of affected main coronary arteries was 2,2±1,1, the average total degree of coronary artery lesion was 42,3±25,1 %.Conclusion. 1. The connections between the degree of ischemic mitral regurgitation and the severity and localization of coronary artery lesions was not revealed. 2. The degree of ischemic mitral regurgitation determined primarily by the progression of ischemic remodeling of the left ventricle. 3. Coronary angiography data cannot be a criterion for determining the degree of ischemic mitral regurgitation, however, they are necessary for determining the surgical tactics of direct myocardial revascularization.

Patterns of revascularization in stable ischemic heart disease in the pre-ISCHEMIA era

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Albuquerque ◽  
C Brizido ◽  
S Madeira ◽  
R Teles ◽  
L Raposo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Real World ◽  
Myocardial Revascularization ◽  
Ischemic Heart ◽  
World Population ◽  
Vessel Disease ◽  
Stable Ischemic Heart Disease

Abstract Introduction New evidence on the role of myocardial revascularization in stable ischemic heart disease (SIHD), recently presented, showed that revascularization guided by the presence of moderate-to severe ischemia relieves angina more effectively than optimal medical therapy (OMT), without a significant benefit in hard clinical endpoints. Aim To assess the representativeness of the ISCHEMIA trial in a real-world population and compare management strategies between patients who fulfill the eligibility criteria of the trial (Group 1, G1) and those who do not (Group 2, G2). Methods and population Single centre retrospective analysis including all consecutive patients referred to coronary angiography (CA) for SIHD from January 2018 to December 2019. Patients were stratified in two groups (G1 and G2) according to the ISCHEMIA trial inclusion and exclusion criteria. G1 was compared with G2 and with a subset of G2 with obstructive coronary artery disease (CAD), defined as ≥70% luminal stenosis in at least one coronary artery or >50% for the left main. Results A total of 1020 patients underwent CA, of whom only 124 (12.2%) would have been eligible for the ISCHEMIA trial (G1). Overall, there were no significant differences in baseline characteristics between the two groups. G1 patients had more extensive and severe disease, presenting more frequently with proximal left anterior descending (LAD) involvement (26.6% vs 10.4%; p<0.001), two vessel disease without proximal LAD stenosis (23.4% vs 10.3%; p<0.001) and three vessel disease (18.5% vs 5.9%; p<0.001). These patients had higher rates of revascularization, both CABG (25.8% vs 10.8%, p<0.001) and PCI (56.5% vs 39.5%, p<0.001). However, when comparing G1 with the subset of G2 patients with obstructive CAD, G1 patients had higher rates of CABG (26.8% vs 17.8%, p=0.034) but there were no differences on the rates of PCI (58.0% vs 56.9%, p=0.916). Conclusions Patients included in the ISCHEMIA trial are underrepresented in a real-world population of SIHD patients referred to coronary angiography. PCI rates were similar among patients with at least one significant coronary artery stenosis, regardless of previous evidence or severity of ischemia. Our findings underline the need for further refinement in criteria for revascularization in SIHD. Funding Acknowledgement Type of funding source: None

scholarly journals Prospects of rivaroxaban application in treatment of patients with chronic ischemic heart disease

2020 ◽  
pp. 44-50
Author(s):  
N. B. Perepech
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Antiplatelet Therapy ◽  
Low Dose ◽  
Cardiovascular Complications ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease ◽  
Artery Disease ◽  
Reduction Of Mortality ◽  
Positive Effect

The review is devoted to the analysis of the methods of hemostasis treatment in order to improve the prognosis of patients with chronic ischemic heart disease (IHD). The results of the most significant randomized clinical studies, which evaluated the effectiveness and safety of double antiplatelet therapy in the treatment of patients with chronic IHD, were discussed. The use of rivaroxaban in addition to ASA was justified in order to reduce the risk of cardiovascular events in patients with chronic IHD. The results of the COMPASS study, which confirmed the positive effect on the prognosis of patients with chronic IHD or peripheral artery disease of low-dose rivaroxaban and ASA combination therapy, were reviewed in detail. Safety aspects of this therapy were discussed. The results of double antiplatelet therapy and the combination of rivaroxaban and ASA in patients who had previously undergone myocardial infarction are compared. The position of rivaroxaban in the treatment of patients with chronic IHD and sinus rhythm was determined in accordance with the recommendations of the European Society of Cardiologists for the diagnosis and treatment of chronic IHD in 2019. The criteria of high ischemic and high hemorrhagic risks, which should be taken into account when deciding to add rivaroxaban to the ASA therapy, were presented. The expediency of wide application of the combination of rivaroxaban and ASA as a part of complex pharmacotherapy of patients with chronic IHD with high ischemic risk for prevention of cardiovascular complications and reduction of mortality is justified.

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