Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2940
T. H. Hoang, V. Maiskov, I. Merai, A. F. Safarova, Z. Kobalava
Aim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161 MI patients who underwent coronary angiography within 24 hours of admission. Type 2 MI (T2MI) diagnosis aligned with the Fourth Universal Definition. Echocardiography and speckle-tracking echocardiography were performed within 72 hours of hospitalization. MACEs encompassed cardiovascular death, non-fatal MI, non-fatal stroke, and HF-related readmissions. Logistic regression analysis was conducted to evaluate their associations with the outcomes.Results. T2MI were diagnosed in 74 patients (median age, 65 years; males, 55,4%). During follow up, 18 patients for each MI type experienced at least one MACE event. Left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) was observed in 41 (55.4%) T2MI patients, compared with 66 (75.9%) T1MI patients (p=0.014). Median LVEF and global longitudinal strain [GLS] were 47.5% and 13.4%, respectively, for T2MI, compared to 45% and 13.9%, respectively, for T1MI (p=0.032 and p=0.332, respectively). LV diastolic dysfunction [DD] was observed in 56 (75.7%) T2MI and 77 (88.5%) T1MI patients. Grade III was more frequent in T2MI in comparison with T1MI (14.9% vs 1.1%, p=0.001, respectively), whereas grade I was more common in T1MI patients (75.9% vs 43.2%, p=0.004, respectively). Right ventricular (RV) dysfunction was observed more frequent in T2MI patients, compared to those with T2MI (52.7% vs. 35.6%, p=0.025, respectively). In univariate analysis, grade III DD was significantly associated with MACEs in T2MI (odds ratio [OR] 5.1, 95% confidence interval [CI], 1.3–18.5, p=0.017). In multivariate analysis, GLS ≤ 9.6% (OR = 17.3, 95% CI 3.0-99.5, p=0.001), and prior MI (OR = 16.6, 95% CI 1.7–157.6, p=0.015) were significantly associated with a heightened risk of MACEs in T2MI patients.Conclusion. Patients with T2MI had high prevalence of LV and RV dysfunction. Echocardiographic assessments, particularly speckle-tracking echocardiography, hold promise in predicting adverse outcomes for these individuals.
{"title":"Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction","authors":"T. H. Hoang, V. Maiskov, I. Merai, A. F. Safarova, Z. Kobalava","doi":"10.20996/1819-6446-2023-2940","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2940","url":null,"abstract":"Aim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161 MI patients who underwent coronary angiography within 24 hours of admission. Type 2 MI (T2MI) diagnosis aligned with the Fourth Universal Definition. Echocardiography and speckle-tracking echocardiography were performed within 72 hours of hospitalization. MACEs encompassed cardiovascular death, non-fatal MI, non-fatal stroke, and HF-related readmissions. Logistic regression analysis was conducted to evaluate their associations with the outcomes.Results. T2MI were diagnosed in 74 patients (median age, 65 years; males, 55,4%). During follow up, 18 patients for each MI type experienced at least one MACE event. Left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) was observed in 41 (55.4%) T2MI patients, compared with 66 (75.9%) T1MI patients (p=0.014). Median LVEF and global longitudinal strain [GLS] were 47.5% and 13.4%, respectively, for T2MI, compared to 45% and 13.9%, respectively, for T1MI (p=0.032 and p=0.332, respectively). LV diastolic dysfunction [DD] was observed in 56 (75.7%) T2MI and 77 (88.5%) T1MI patients. Grade III was more frequent in T2MI in comparison with T1MI (14.9% vs 1.1%, p=0.001, respectively), whereas grade I was more common in T1MI patients (75.9% vs 43.2%, p=0.004, respectively). Right ventricular (RV) dysfunction was observed more frequent in T2MI patients, compared to those with T2MI (52.7% vs. 35.6%, p=0.025, respectively). In univariate analysis, grade III DD was significantly associated with MACEs in T2MI (odds ratio [OR] 5.1, 95% confidence interval [CI], 1.3–18.5, p=0.017). In multivariate analysis, GLS ≤ 9.6% (OR = 17.3, 95% CI 3.0-99.5, p=0.001), and prior MI (OR = 16.6, 95% CI 1.7–157.6, p=0.015) were significantly associated with a heightened risk of MACEs in T2MI patients.Conclusion. Patients with T2MI had high prevalence of LV and RV dysfunction. Echocardiographic assessments, particularly speckle-tracking echocardiography, hold promise in predicting adverse outcomes for these individuals.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"19 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139283703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2970
N. A. Shatalova, D. Sychev, K. Mirzaev, A. I. Kochetkov, E. Y. Ebzeeva, V. B. Dashabylova, P. Bochkov, S. N. Tuchkova, S. V. Glagolev
Aim. To study the possible relationship between polymorphic variants of ABCB1 (rs2032582, rs1045642, rs1128503), CYP3A5 (rs776746), CYP3A4 (rs35599367) and CYP2J2 (rs890293) genes with residual equilibrium concentrations (Cmin,ss) of rivaroxaban in patients with non-valvular atrial fibrillation (AF) and stage 3 and 4 chronic kidney disease (CKD).Material and methods. A total of 123 patients 52 to 97 years old (median age, 82 years) with AF in combination with stage 3 and 4 CKD were included in the study. Each patient underwent a pharmacogenetic and pharmacokinetic study.Results. Cmin,ss and dose-adjusted concentration (Cmin,ss/D) of rivaroxaban were significantly higher in patients with the TT genotype than with the CT genotype of the polymorphic variant rs1045642 of the ABCB1 gene (Сmin,ss 60,5 [36,7;173] ng/ml and 54,8 [23,1;97,3] ng/ml, respectively, р=0,016; Сmin,ss/D 4,06[2,3;8,1] ng/ml/mg and 2,2 [1,1;4,9] ng/ml/mg, р=0,006). In patients with the T allele (CT and TT genotypes), compared with CC genotype carriers, Cmin,ss and Cmin,ss/D were significantly higher (Cmin,ss 60,5 [36,7;173] ng/ml and 45,8 [20,9;82,3] ng/ml, respectively, p=0,029; Cmin,ss/D 4,06 [2,3;8,1] ng/ml/ mg and 2,6 [1,2;4,8] ng/ml/mg, respectively, p=0,014). Also, Cmin,ss and Cmin,ss/D was significantly higher in patients with the TT genotype according to the polymorphic variant rs2032582 of the ABCB1 gene than in patients with the GG genotype (p=0,02 and р=0,016 respectively). Cmin,ss and Cmin,ss/D in T allele (GT and TT genotypes) carriers were significantly higher than in T allele homozygotes (Cmin,ss 57,1 [27,7;106,0] ng/ml versus 37,6 [18,6;61,7] ng/ml respectively, p=0,024; Cmin,ss/D 3,6 [1,7;7,4] ng/ml/mg versus 2,3 [1,1;4,09] ng/ml/mg respectively, p=0,032). Differences in Сmin,ss and Сmin,ss/D of rivaroxaban were detected when comparing TC, CC and TT genotypes of polymorphism rs1128503 of the ABCB1 gene. When comparing Сmin,ss and Сmin,ss/D of rivaroxaban among carriers of AG and GG genotypes of the rs776746 polymorphism of the CYP3A56986A>G gene, no significance was detected (p>0,05). Also, no difference in Cmin,ss and Cmin,ss/D was found when comparing carriers of the CC and CT genotypes of the rs35599367 polymorphism of the CYP3A4 gene, and carriers of the CC and AC genotypes of the rs890293 polymorphism of the CYP2J2 gene (p>0,05).Conclusion. The carriage of T allele by polymorphic variants rs1045642 and rs2032582 of the ABCB1 gene affects Cmin,ss and Cmin,ss/D of rivaroxaban.
{"title":"Pharmacogenetics and pharmacokinetics of rivaroxaban in patients with atrial fibrillation and chronic kidney disease","authors":"N. A. Shatalova, D. Sychev, K. Mirzaev, A. I. Kochetkov, E. Y. Ebzeeva, V. B. Dashabylova, P. Bochkov, S. N. Tuchkova, S. V. Glagolev","doi":"10.20996/1819-6446-2023-2970","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2970","url":null,"abstract":"Aim. To study the possible relationship between polymorphic variants of ABCB1 (rs2032582, rs1045642, rs1128503), CYP3A5 (rs776746), CYP3A4 (rs35599367) and CYP2J2 (rs890293) genes with residual equilibrium concentrations (Cmin,ss) of rivaroxaban in patients with non-valvular atrial fibrillation (AF) and stage 3 and 4 chronic kidney disease (CKD).Material and methods. A total of 123 patients 52 to 97 years old (median age, 82 years) with AF in combination with stage 3 and 4 CKD were included in the study. Each patient underwent a pharmacogenetic and pharmacokinetic study.Results. Cmin,ss and dose-adjusted concentration (Cmin,ss/D) of rivaroxaban were significantly higher in patients with the TT genotype than with the CT genotype of the polymorphic variant rs1045642 of the ABCB1 gene (Сmin,ss 60,5 [36,7;173] ng/ml and 54,8 [23,1;97,3] ng/ml, respectively, р=0,016; Сmin,ss/D 4,06[2,3;8,1] ng/ml/mg and 2,2 [1,1;4,9] ng/ml/mg, р=0,006). In patients with the T allele (CT and TT genotypes), compared with CC genotype carriers, Cmin,ss and Cmin,ss/D were significantly higher (Cmin,ss 60,5 [36,7;173] ng/ml and 45,8 [20,9;82,3] ng/ml, respectively, p=0,029; Cmin,ss/D 4,06 [2,3;8,1] ng/ml/ mg and 2,6 [1,2;4,8] ng/ml/mg, respectively, p=0,014). Also, Cmin,ss and Cmin,ss/D was significantly higher in patients with the TT genotype according to the polymorphic variant rs2032582 of the ABCB1 gene than in patients with the GG genotype (p=0,02 and р=0,016 respectively). Cmin,ss and Cmin,ss/D in T allele (GT and TT genotypes) carriers were significantly higher than in T allele homozygotes (Cmin,ss 57,1 [27,7;106,0] ng/ml versus 37,6 [18,6;61,7] ng/ml respectively, p=0,024; Cmin,ss/D 3,6 [1,7;7,4] ng/ml/mg versus 2,3 [1,1;4,09] ng/ml/mg respectively, p=0,032). Differences in Сmin,ss and Сmin,ss/D of rivaroxaban were detected when comparing TC, CC and TT genotypes of polymorphism rs1128503 of the ABCB1 gene. When comparing Сmin,ss and Сmin,ss/D of rivaroxaban among carriers of AG and GG genotypes of the rs776746 polymorphism of the CYP3A56986A>G gene, no significance was detected (p>0,05). Also, no difference in Cmin,ss and Cmin,ss/D was found when comparing carriers of the CC and CT genotypes of the rs35599367 polymorphism of the CYP3A4 gene, and carriers of the CC and AC genotypes of the rs890293 polymorphism of the CYP2J2 gene (p>0,05).Conclusion. The carriage of T allele by polymorphic variants rs1045642 and rs2032582 of the ABCB1 gene affects Cmin,ss and Cmin,ss/D of rivaroxaban.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"6 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139285859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2955
E. V. Fomina, S. A. Kardovskaya, D. A. Budanova, P. Markin, S. Appolonova, A. S. Lishuta, Y. Belenkov, I. Ilgisonis
Aim. To study the changes of the levels of cardiac biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (hsTnI)) in patients with newly diagnosed multiple myeloma (MM) during programmatic treatment with bortezomib (VCd regimen).Material and methods. This prospective pilot study included patients with a newly diagnosed MM (n=30), who were scheduled for a cycle of chemotherapy including a proteasome inhibitor (bortezomib). All patients underwent standard laboratory (complete blood count, biochemical tests, serum protein electrophoresis), electrocardiography, echocardiography, as well as the level of specific laboratory markers of myocardial dysfunction (NT-proBNP) and injury (hsTnI) was determined immediately before treatment, after 3 and 6 cycles of chemotherapy.Results. The mean age was 63,8±10 years with a slight predominance of men (56,7%, n=17). The patients initially had an increased level of NT-proBNP (316 [75,9; 602,6] pg/mL) with its decrease to 144,0 [102,3; 294,0] pg/ml after 3 cycles and to 109,2 [59,9; 344,5] pg/ml after 6 cycles of chemotherapy. At the MM onset, the mean hsTnI values were 0,06 [0,03; 0,49] ng/mL, whereas after 3 and 6 chemotherapy cycles it accounted for 0,02 [0,01-0,68] and 0,65 [0,02; 1,51] ng/ml, respectively, with the normal range of less than 0,1 ng/ml. Despite this, no statistical significance has been obtained. There were no clinical and/or laboratory signs of heart failure, ischemia, or other non-cardiac causes of elevated NT-proBNP levels in this cohort. Multivariate regression analysis revealed the following significant factors influencing the initial hsTnI level: paraprotein, hemoglobin and erythrocyte sedimentation rate (ESR). The resulting regression model was characterized by a strong correlation (r=0,702, p<0,001).Conclusion. MM and its pathogenetic features such as paraproteinemia may be challenging for NT-proBNP and hsTnI levels assessment in group of interest before treatment. An unreliable assessment of these markers before chemotherapy may lead to incorrect baseline cardiovascular risk stratification and make it difficult for a cardiologist/cardio-oncologist to choose proper management strategy.
{"title":"Changes of myocardial dysfunction and injury biomarkers over chemotherapy for multiple myeloma: difficulties in laboratory data interpretation","authors":"E. V. Fomina, S. A. Kardovskaya, D. A. Budanova, P. Markin, S. Appolonova, A. S. Lishuta, Y. Belenkov, I. Ilgisonis","doi":"10.20996/1819-6446-2023-2955","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2955","url":null,"abstract":"Aim. To study the changes of the levels of cardiac biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (hsTnI)) in patients with newly diagnosed multiple myeloma (MM) during programmatic treatment with bortezomib (VCd regimen).Material and methods. This prospective pilot study included patients with a newly diagnosed MM (n=30), who were scheduled for a cycle of chemotherapy including a proteasome inhibitor (bortezomib). All patients underwent standard laboratory (complete blood count, biochemical tests, serum protein electrophoresis), electrocardiography, echocardiography, as well as the level of specific laboratory markers of myocardial dysfunction (NT-proBNP) and injury (hsTnI) was determined immediately before treatment, after 3 and 6 cycles of chemotherapy.Results. The mean age was 63,8±10 years with a slight predominance of men (56,7%, n=17). The patients initially had an increased level of NT-proBNP (316 [75,9; 602,6] pg/mL) with its decrease to 144,0 [102,3; 294,0] pg/ml after 3 cycles and to 109,2 [59,9; 344,5] pg/ml after 6 cycles of chemotherapy. At the MM onset, the mean hsTnI values were 0,06 [0,03; 0,49] ng/mL, whereas after 3 and 6 chemotherapy cycles it accounted for 0,02 [0,01-0,68] and 0,65 [0,02; 1,51] ng/ml, respectively, with the normal range of less than 0,1 ng/ml. Despite this, no statistical significance has been obtained. There were no clinical and/or laboratory signs of heart failure, ischemia, or other non-cardiac causes of elevated NT-proBNP levels in this cohort. Multivariate regression analysis revealed the following significant factors influencing the initial hsTnI level: paraprotein, hemoglobin and erythrocyte sedimentation rate (ESR). The resulting regression model was characterized by a strong correlation (r=0,702, p<0,001).Conclusion. MM and its pathogenetic features such as paraproteinemia may be challenging for NT-proBNP and hsTnI levels assessment in group of interest before treatment. An unreliable assessment of these markers before chemotherapy may lead to incorrect baseline cardiovascular risk stratification and make it difficult for a cardiologist/cardio-oncologist to choose proper management strategy.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"12 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139285876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2948
A. Kochergina, O. Barbarash
Aim. To study the effect of azilsartan medoxomil (AZL-M) on the 24-hour blood pressure (BP) profile in patients with hypertension (HTN), type 2 diabetes (T2D) and stable coronary artery disease (CAD).Material and methods. A total of 183 patients with CAD in combination with HTN and T2D took part in the study (100 men (54,64%), 83 women (45,36%)). All patients were previously prescribed a statin, antiplatelet therapy, a beta-blocker, and an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB). At baseline, the proportion of people taking ARBs and ACEIs was 30% and 70%, respectively. All study participants were discontinued from a previously prescribed ARBs or ACE inhibitors and were prescribed 6-month AZL-M (Edarbi®) therapy. During this period, according to the study plan, patients visited the medical center to assess the effectiveness and safety of therapy and blood pressure changes.Results. The mean age of the patients was 65,0 years (60-69 years), while the mean body mass index (BMI) — 31,24 kg/m2. The mean age of female participants was higher than the mean age of males: 66,35±6,59 vs 62,72±8,82 years (p=0,002). The mean BMI in women was higher and was 33.08 kg/m2, while in men it was 30,74 kg/m2 (p=0,001). Six-month AZL-M therapy decreased 24-hour BP values. Thus, the time index of systolic blood pressure (SBP) hypertension in the daytime decreased from 63% to 12%, while at night from 70% to 10%, and the time index of diastolic blood pressure (DBP) hypertension in the daytime from 18% to 10%, and at night from 44% to 8%. The main result is confirmation of AZL-M effectiveness in relation to BP control, as well as good drug tolerability. At the visit after 1-month AZL-M therapy, target BP values were recorded in 45,4% of participants, and after six months — the proportion of people with normal 24-hour BP values was 69,9%.Conclusion. Edarbi® therapy in patients with HTN in combination with T2D and stable CAD leads to 24-hour BP normalization. At the same time, the drug has a good safety profile, since the reported adverse events were not related to the drug.
{"title":"Efficacy of azilsartan medoxomil in patients with hypertension and stable coronary artery disease in combination with type 2 diabetes","authors":"A. Kochergina, O. Barbarash","doi":"10.20996/1819-6446-2023-2948","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2948","url":null,"abstract":"Aim. To study the effect of azilsartan medoxomil (AZL-M) on the 24-hour blood pressure (BP) profile in patients with hypertension (HTN), type 2 diabetes (T2D) and stable coronary artery disease (CAD).Material and methods. A total of 183 patients with CAD in combination with HTN and T2D took part in the study (100 men (54,64%), 83 women (45,36%)). All patients were previously prescribed a statin, antiplatelet therapy, a beta-blocker, and an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB). At baseline, the proportion of people taking ARBs and ACEIs was 30% and 70%, respectively. All study participants were discontinued from a previously prescribed ARBs or ACE inhibitors and were prescribed 6-month AZL-M (Edarbi®) therapy. During this period, according to the study plan, patients visited the medical center to assess the effectiveness and safety of therapy and blood pressure changes.Results. The mean age of the patients was 65,0 years (60-69 years), while the mean body mass index (BMI) — 31,24 kg/m2. The mean age of female participants was higher than the mean age of males: 66,35±6,59 vs 62,72±8,82 years (p=0,002). The mean BMI in women was higher and was 33.08 kg/m2, while in men it was 30,74 kg/m2 (p=0,001). Six-month AZL-M therapy decreased 24-hour BP values. Thus, the time index of systolic blood pressure (SBP) hypertension in the daytime decreased from 63% to 12%, while at night from 70% to 10%, and the time index of diastolic blood pressure (DBP) hypertension in the daytime from 18% to 10%, and at night from 44% to 8%. The main result is confirmation of AZL-M effectiveness in relation to BP control, as well as good drug tolerability. At the visit after 1-month AZL-M therapy, target BP values were recorded in 45,4% of participants, and after six months — the proportion of people with normal 24-hour BP values was 69,9%.Conclusion. Edarbi® therapy in patients with HTN in combination with T2D and stable CAD leads to 24-hour BP normalization. At the same time, the drug has a good safety profile, since the reported adverse events were not related to the drug.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"126 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139285439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2957
S. Konstantinov, G. I. Stryabkova, A. Basarab, V. Kravchuk, I. V. Kаzhanov, S. V. Ivanov, Z. Chefranova, S. S. Markin
A case report of double thrombolytic therapy with non-immunogenic staphylokinase at a dose of 15 mg bolus over 15 s in a patient with a high-risk massive pulmonary embolism (PE) in the early postoperative period due to femoral wound is described. After the second thrombolysis, a decrease in the pulmonary arteries thrombotic lesions according to multislice computed tomography data, restoration of right ventricular function, and a decrease in pulmonary hypertension were observed. Reuse of the non-immunogenic staphylokinase did not lead to the major bleeding and hemorrhagic stroke, did not provoke a drop in hemoglobin and did not require blood transfusion. Upon discharge of the patient, normalization of the general blood test parameters was noted: the level of hemoglobin increased from 86 to 112 g/l, erythrocytes — from 2.8 to 3.5x1012/l, hematocrit — from 26 to 32%. Thus, non-immunogenic staphylokinase has demonstrated high efficacy and safety in the treatment of patient with a high-risk massive PE in the early postoperative period.
{"title":"Non-immunogenic staphylokinase in the treatment of high-risk massive pulmonary embolism in the early postoperative period due to femoral fragment wound","authors":"S. Konstantinov, G. I. Stryabkova, A. Basarab, V. Kravchuk, I. V. Kаzhanov, S. V. Ivanov, Z. Chefranova, S. S. Markin","doi":"10.20996/1819-6446-2023-2957","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2957","url":null,"abstract":"A case report of double thrombolytic therapy with non-immunogenic staphylokinase at a dose of 15 mg bolus over 15 s in a patient with a high-risk massive pulmonary embolism (PE) in the early postoperative period due to femoral wound is described. After the second thrombolysis, a decrease in the pulmonary arteries thrombotic lesions according to multislice computed tomography data, restoration of right ventricular function, and a decrease in pulmonary hypertension were observed. Reuse of the non-immunogenic staphylokinase did not lead to the major bleeding and hemorrhagic stroke, did not provoke a drop in hemoglobin and did not require blood transfusion. Upon discharge of the patient, normalization of the general blood test parameters was noted: the level of hemoglobin increased from 86 to 112 g/l, erythrocytes — from 2.8 to 3.5x1012/l, hematocrit — from 26 to 32%. Thus, non-immunogenic staphylokinase has demonstrated high efficacy and safety in the treatment of patient with a high-risk massive PE in the early postoperative period.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"24 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139286538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2953
A. D. Gavrilko, E. Mezhonov, S. Shalaev, D. V. Krasheninin
Aim. To study the effectiveness of atorvastatin 80 mg, prescribed immediately prior emergency endovascular intervention, in reducing the incidence of acute kidney injury (AKI) defined by сontrast-induced nephropathy (CIN) and by Kidney Disease: Improving Global Outcomes (KDIGO) criteria in patients with ST-segment elevation myocardial infarction (STEMI).Material and methods. The study included 386 patients with STEMI. Main group patients immediately prior to sheath insertion took atorvastatin at a high dose (80 mg). The control group was not prescribed statins before the intervention. In both groups, further statin therapy in the postoperative period was not regulated by the study protocol and was prescribed taking into account current guidelines. In order to equalize the groups according to the main clinical indicators, propensity score matching was carried out, as a result of which new comparison groups of 86 patients each were formed. In order to assess the nephroprotective properties, the following end points were selected: the incidence of AKI according to the CIN and KDIGO criteria, the frequency of serum creatinine level recovery to initial values on the 7th day.Results. In the study sample, the median glomerular filtration rate (GFR) on admission was 86,5 [70,0-97,0] ml/min/1,73 m2. There were 22 (12,7%) and 15 (8,7%) patients with GFR<60 ml/1,73 m2 at admission and kidney pathology, respectively. The median volume of contrast injected during coronary angiography (CAG) and percutaneous coronary intervention (PCI) was 100 [90-200] ml, while there were 8 (4,7%) patients in whom the volume of contrast injected exceeded 3,7xGFR. In the group of patients receiving atorvastatin before the intervention, the incidence of AKI was significantly lower according to CIN criteria as follows: 9 (10,5%) vs 21 (24,4%) (p=0,016, odds ratio (OR) (95% confidence interval (CI) — 0,36 (0,16-0,85)), while in case of diagnosis according to KDIGO criteria there was no significant difference: 6 (7,0%) vs 13 (15,1%) (p=0,143, OR (95% CI) — 0,42 (0,15-1,17)).The frequency of serum creatinine level recovery to initial values on the 7th day was higher in the main group: 57 (66,3%) vs 43 (50,6%) (p=0,037, OR (95% CI) — 1,92 (1,04-3,56)). Inhospital mortality was higher in the control group: 6 (7,0%) vs 1 in the main group (1,2%) (p=0,120, OR (95% CI) — 0,17 (0,02-1,47)).Conclusion. The use of atorvastatin at a dose of 80 mg immediately before emergency coronary angiography in patients with STEMI, in comparison with the traditional statin prescription in the postoperative period, reduces the risk of AKI according to the CIN criteria, and also improves renal function.
{"title":"Nephroprotective effect of atorvastatin at a dose of 80 mg in patients with ST-segment elevation myocardial infarction with an invasive treatment strategy","authors":"A. D. Gavrilko, E. Mezhonov, S. Shalaev, D. V. Krasheninin","doi":"10.20996/1819-6446-2023-2953","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2953","url":null,"abstract":"Aim. To study the effectiveness of atorvastatin 80 mg, prescribed immediately prior emergency endovascular intervention, in reducing the incidence of acute kidney injury (AKI) defined by сontrast-induced nephropathy (CIN) and by Kidney Disease: Improving Global Outcomes (KDIGO) criteria in patients with ST-segment elevation myocardial infarction (STEMI).Material and methods. The study included 386 patients with STEMI. Main group patients immediately prior to sheath insertion took atorvastatin at a high dose (80 mg). The control group was not prescribed statins before the intervention. In both groups, further statin therapy in the postoperative period was not regulated by the study protocol and was prescribed taking into account current guidelines. In order to equalize the groups according to the main clinical indicators, propensity score matching was carried out, as a result of which new comparison groups of 86 patients each were formed. In order to assess the nephroprotective properties, the following end points were selected: the incidence of AKI according to the CIN and KDIGO criteria, the frequency of serum creatinine level recovery to initial values on the 7th day.Results. In the study sample, the median glomerular filtration rate (GFR) on admission was 86,5 [70,0-97,0] ml/min/1,73 m2. There were 22 (12,7%) and 15 (8,7%) patients with GFR<60 ml/1,73 m2 at admission and kidney pathology, respectively. The median volume of contrast injected during coronary angiography (CAG) and percutaneous coronary intervention (PCI) was 100 [90-200] ml, while there were 8 (4,7%) patients in whom the volume of contrast injected exceeded 3,7xGFR. In the group of patients receiving atorvastatin before the intervention, the incidence of AKI was significantly lower according to CIN criteria as follows: 9 (10,5%) vs 21 (24,4%) (p=0,016, odds ratio (OR) (95% confidence interval (CI) — 0,36 (0,16-0,85)), while in case of diagnosis according to KDIGO criteria there was no significant difference: 6 (7,0%) vs 13 (15,1%) (p=0,143, OR (95% CI) — 0,42 (0,15-1,17)).The frequency of serum creatinine level recovery to initial values on the 7th day was higher in the main group: 57 (66,3%) vs 43 (50,6%) (p=0,037, OR (95% CI) — 1,92 (1,04-3,56)). Inhospital mortality was higher in the control group: 6 (7,0%) vs 1 in the main group (1,2%) (p=0,120, OR (95% CI) — 0,17 (0,02-1,47)).Conclusion. The use of atorvastatin at a dose of 80 mg immediately before emergency coronary angiography in patients with STEMI, in comparison with the traditional statin prescription in the postoperative period, reduces the risk of AKI according to the CIN criteria, and also improves renal function.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"229 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139287492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2945
V. V. Yakusevich, V. V. Yakusevich, S. Martsevich, M. M. Lukyanov, O. Drapkina
Aim. To present clinical characteristics and assess serious adverse outcomes (death, acute cardiovascular events) in outpatients with atrial fibrillation (AF) in one of the Yaroslavl clinics for 10 years.Material and methods. A total of 212 patients with AF aged from 23 to 94 years were included in the REQUAZA AF registrу — Yaroslavl at the first visit to the clinic in 2013. Their health status was monitored over 10,5 years through in-person visits, phone contacts with patients, their relatives, and treating physicians. Recorded data included the AF type, comorbid conditions, extent and quality of examinations and treatments, development of serious adverse events, and mortality. Statistical processing was carried out using the Microsoft Office 365 application software package.Results. Most patients (66,5%) were diagnosed with persistent AF. Paroxysmal, persistent, and newly detected forms were observed in 26,4%, 3,8%, and 3,3% of patients, respectively. Most AF patients had concomitant cardiovascular diseases, most frequently hypertension (96,7%), heart failure (91,6%), and coronary artery disease (91,2%). A total of 54 patients (25,5%) had prior stroke or transient ischemic attack. Complete information was obtained for 203 patients (95,8%), of which 164 (78,5%) passed away during the follow-up period. The leading death cause was cardiovascular disease, particularly cerebrovascular events (n=111; 67,7%). The highest mortality was recorded within the first two years of follow-up, during which more than a quarter (25,1%) of the registered patients had died. The COVID-19 pandemic did not significantly affect the mortality rates. The most common AF complications were stroke and transient ischemic attack, with a total of 74 episodes in the history and follow-up period, including 7 recurrences.Conclusion. Ambulatory AF patients represent a group with a high frequency of cardiovascular events and fatal outcomes. In the observed group of ambulatory AF patients, annual mortality exceeded 10%, and over 3/4 of patients died within 10 years. The leading death cause was cardiovascular disease, primarily cerebrovascular events.
{"title":"Patients with atrial fibrillation in outpatient practice: clinical characteristics and outcomes over a 10-year observation period (data from the REQUAZA AF registrу — Yaroslavl)","authors":"V. V. Yakusevich, V. V. Yakusevich, S. Martsevich, M. M. Lukyanov, O. Drapkina","doi":"10.20996/1819-6446-2023-2945","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2945","url":null,"abstract":"Aim. To present clinical characteristics and assess serious adverse outcomes (death, acute cardiovascular events) in outpatients with atrial fibrillation (AF) in one of the Yaroslavl clinics for 10 years.Material and methods. A total of 212 patients with AF aged from 23 to 94 years were included in the REQUAZA AF registrу — Yaroslavl at the first visit to the clinic in 2013. Their health status was monitored over 10,5 years through in-person visits, phone contacts with patients, their relatives, and treating physicians. Recorded data included the AF type, comorbid conditions, extent and quality of examinations and treatments, development of serious adverse events, and mortality. Statistical processing was carried out using the Microsoft Office 365 application software package.Results. Most patients (66,5%) were diagnosed with persistent AF. Paroxysmal, persistent, and newly detected forms were observed in 26,4%, 3,8%, and 3,3% of patients, respectively. Most AF patients had concomitant cardiovascular diseases, most frequently hypertension (96,7%), heart failure (91,6%), and coronary artery disease (91,2%). A total of 54 patients (25,5%) had prior stroke or transient ischemic attack. Complete information was obtained for 203 patients (95,8%), of which 164 (78,5%) passed away during the follow-up period. The leading death cause was cardiovascular disease, particularly cerebrovascular events (n=111; 67,7%). The highest mortality was recorded within the first two years of follow-up, during which more than a quarter (25,1%) of the registered patients had died. The COVID-19 pandemic did not significantly affect the mortality rates. The most common AF complications were stroke and transient ischemic attack, with a total of 74 episodes in the history and follow-up period, including 7 recurrences.Conclusion. Ambulatory AF patients represent a group with a high frequency of cardiovascular events and fatal outcomes. In the observed group of ambulatory AF patients, annual mortality exceeded 10%, and over 3/4 of patients died within 10 years. The leading death cause was cardiovascular disease, primarily cerebrovascular events.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"32 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139283315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2962
M. G. Chashchin, A. Gorshkov, O. Drapkina
Aim. To evaluate the clinical course and inhospital outcomes of myocardial infarction (MI) in patients receiving continuous direct oral anticoagulant (DOAC) therapy.Material and methods. Data from 390 patients treated for MI were included in the analysis. The mean age was 64.1±12.8 years. The majority were men (61,5%; n=240). All patients underwent standard diagnostic and therapeutic procedures according to clinical guidelines, including coronary angiography and percutaneous coronary intervention when indicated. Clinical, anamnestic and laboratory data (including C-reactive protein level, troponin I, coagulation test) were analysed. The inhospital course of MI, mortality and incidence of complications were evaluated.Results. Patients were divided into two groups according to DOAC therapy received. The main group included 41 patients with constant DOAC intake, while the control group consisted of 349 patients not receiving DOAC. Patients aged 65 years and older accounted for 68,3% (n=28) of the main group (p=0,0033), with a high proportion of cerebral circulation disorders and venous thrombosis (p<0,01). Atrial fibrillation was diagnosed in 75,6% (n=31) of patients in the main group (p<0,0001). ST elevation MI (STEMI) was seen in 39,0% (n=16) of cases in the main group and 47,3% (n=165) of cases in the control group (p=0,3161). As a result, 85,4% (n=35) of patients in the main group had a high GRACE-1 risk, compared to 50,4% (n=176) in the control group (p<0,0001). The two groups did not differ significantly in the severity of heart failure (p=0,1549). ST-segment resolution on admission electrocardiogram was observed in 43,8% (n=7) of the main group and 18,1% (n=30) of the control group (p=0,0238). According to coronary involvement severity and the type of antegrade flow in the infarct-related artery, patients in both groups were comparable (p>0,05). Prior DOAC administration had no significant effect on the incidence of gastrointestinal bleeding (odds ratio (OR), 3,96 (95% Confidence Interval (CI) 0,76–20,66)) and mortality (OR 1,47 (95% CI 0,37-5,85)) during hospitalization.Conclusion. Patients with MI who received continuous DOAC therapy had significantly more frequent ST-segment resolution at hospital admission compared with patients who did not receive DOAC. DOAC administration had no significant effect on mortality and incidence of inhospital complications of MI.
目的评估接受连续直接口服抗凝剂（DOAC）治疗的心肌梗死（MI）患者的临床过程和院内预后。分析纳入了 390 名接受心肌梗死治疗的患者的数据。平均年龄为 64.1±12.8 岁。大多数为男性（61.5%；n=240）。所有患者均根据临床指南接受了标准诊断和治疗程序，包括冠状动脉造影术和经皮冠状动脉介入治疗。对临床、病理和实验室数据（包括 C 反应蛋白水平、肌钙蛋白 I、凝血试验）进行了分析。结果。根据接受 DOAC 治疗的情况，患者被分为两组。主组包括41名持续服用DOAC的患者，对照组包括349名未服用DOAC的患者。65 岁及以上的患者占主组的 68.3%（28 人）（P=0,0033），其中脑循环障碍和静脉血栓比例较高（P0,05）。之前服用 DOAC 对住院期间消化道出血的发生率（几率比（OR）3.96（95% 置信区间（CI）0.76-20.66））和死亡率（OR 1.47（95% CI 0.37-5.85））没有明显影响。与未接受 DOAC 治疗的患者相比，持续接受 DOAC 治疗的心肌梗死患者在入院时 ST 段缓解的频率明显更高。服用 DOAC 对死亡率和 MI 住院并发症的发生率没有明显影响。
{"title":"Inhospital outcomes of myocardial infarction in patients receiving direct oral anticoagulants","authors":"M. G. Chashchin, A. Gorshkov, O. Drapkina","doi":"10.20996/1819-6446-2023-2962","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2962","url":null,"abstract":"Aim. To evaluate the clinical course and inhospital outcomes of myocardial infarction (MI) in patients receiving continuous direct oral anticoagulant (DOAC) therapy.Material and methods. Data from 390 patients treated for MI were included in the analysis. The mean age was 64.1±12.8 years. The majority were men (61,5%; n=240). All patients underwent standard diagnostic and therapeutic procedures according to clinical guidelines, including coronary angiography and percutaneous coronary intervention when indicated. Clinical, anamnestic and laboratory data (including C-reactive protein level, troponin I, coagulation test) were analysed. The inhospital course of MI, mortality and incidence of complications were evaluated.Results. Patients were divided into two groups according to DOAC therapy received. The main group included 41 patients with constant DOAC intake, while the control group consisted of 349 patients not receiving DOAC. Patients aged 65 years and older accounted for 68,3% (n=28) of the main group (p=0,0033), with a high proportion of cerebral circulation disorders and venous thrombosis (p<0,01). Atrial fibrillation was diagnosed in 75,6% (n=31) of patients in the main group (p<0,0001). ST elevation MI (STEMI) was seen in 39,0% (n=16) of cases in the main group and 47,3% (n=165) of cases in the control group (p=0,3161). As a result, 85,4% (n=35) of patients in the main group had a high GRACE-1 risk, compared to 50,4% (n=176) in the control group (p<0,0001). The two groups did not differ significantly in the severity of heart failure (p=0,1549). ST-segment resolution on admission electrocardiogram was observed in 43,8% (n=7) of the main group and 18,1% (n=30) of the control group (p=0,0238). According to coronary involvement severity and the type of antegrade flow in the infarct-related artery, patients in both groups were comparable (p>0,05). Prior DOAC administration had no significant effect on the incidence of gastrointestinal bleeding (odds ratio (OR), 3,96 (95% Confidence Interval (CI) 0,76–20,66)) and mortality (OR 1,47 (95% CI 0,37-5,85)) during hospitalization.Conclusion. Patients with MI who received continuous DOAC therapy had significantly more frequent ST-segment resolution at hospital admission compared with patients who did not receive DOAC. DOAC administration had no significant effect on mortality and incidence of inhospital complications of MI.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"5 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139286001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2926
G. Andreeva, V. M. Gorbunov, D. N. Antipushina, E. Platonova
The article is devoted to various aspects of white coat effect (WCE) in patients with hypertension (HTN). WCE is due to the patient’s anxious response to office blood pressure (BP) measurement and is characterized by a BP increase. In patients with HTN, WCE is detected with a high frequency. Pronounced WCE in hypertensive patients is associated with worsening the HTN course and the prognosis of all-cause and cardiovascular mortality. In addition, BP increase in these patients during a doctor’s visit may lead to additional prescription of antihypertensive drugs, increasing costs and side effects. To identify WCE, a large number of methods are used, which can be divided into following groups: I – data from clinical and daytime ambulatory blood pressure measurement, II – clinical and home BP assessment, III – only ambulatory BP measurement, IV – clinical and laboratory BP data, and V – only clinical BP measurement. There are following WCE in patients with HTN: female sex, age, never smoking, as well as anxiety, introversion, etc. WCE is due to the patient’s anxiety state during office BP measurement and a conditioned reflex BP increase associated both with the physician presence and medical background. Severe WCE in some groups of patients with HTN may be associated with a worse prognosis compared with other hypertensive patients as follows: in individuals with a significant difference between clinical and ambulatory blood pressure levels or between the first and third BP office data, with a combination of resistant HTN and WCE, with WCE increasing from visit to visit, etc.
{"title":"White coat effect in patients with hypertension","authors":"G. Andreeva, V. M. Gorbunov, D. N. Antipushina, E. Platonova","doi":"10.20996/1819-6446-2023-2926","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2926","url":null,"abstract":"The article is devoted to various aspects of white coat effect (WCE) in patients with hypertension (HTN). WCE is due to the patient’s anxious response to office blood pressure (BP) measurement and is characterized by a BP increase. In patients with HTN, WCE is detected with a high frequency. Pronounced WCE in hypertensive patients is associated with worsening the HTN course and the prognosis of all-cause and cardiovascular mortality. In addition, BP increase in these patients during a doctor’s visit may lead to additional prescription of antihypertensive drugs, increasing costs and side effects. To identify WCE, a large number of methods are used, which can be divided into following groups: I – data from clinical and daytime ambulatory blood pressure measurement, II – clinical and home BP assessment, III – only ambulatory BP measurement, IV – clinical and laboratory BP data, and V – only clinical BP measurement. There are following WCE in patients with HTN: female sex, age, never smoking, as well as anxiety, introversion, etc. WCE is due to the patient’s anxiety state during office BP measurement and a conditioned reflex BP increase associated both with the physician presence and medical background. Severe WCE in some groups of patients with HTN may be associated with a worse prognosis compared with other hypertensive patients as follows: in individuals with a significant difference between clinical and ambulatory blood pressure levels or between the first and third BP office data, with a combination of resistant HTN and WCE, with WCE increasing from visit to visit, etc.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"75 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139285923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.20996/1819-6446-2023-2973
O. B. Shvabskaia, N. S. Karamnova, O. Drapkina
The increase in the prevalence of dietary risk factors and non-communicable diseases over the past decades has led to the search for new predictors, one of which is skipping breakfast. The article examines the potential of using the "daily breakfast"/"skipping breakfast" criterion as a prognostic marker. The results of studies on the correlation of daily breakfast with dietary risk factors (obesity and hypertension), type 2 diabetes, cardiovascular diseases and the risk of cardiovascular death are presented and analyzed. The effect of breakfast on the depression risk, which is an independent marker of cardiovascular diseases, is being studied. Also, possible pathogenetic mechanisms linking skipping breakfast with increased blood pressure are discussed. Research data is provided confirming the importance of morning meals for health. The article presents data on the prevalence of daily breakfast in the Russian population and in the populations of other countries with developed economies. Information is provided on the history of studying the effect of daily breakfast on health. Also, controversial scientific data is provided on the effect of skipping breakfast on body weight and its effective control. The role of morning meals in weight reduction programs is fully discussed. The issues of connection between the morning meal and daily calorie intake, the nutritional value of consumption of total protein, vitamins and minerals, as well as the uniform meal distribution across the day are considered. Data from a scientific discussion on the criteria for an "ideal" breakfast are presented, and general recommendations on the energy and nutritional value of a morning meal and the optimal composition of food are outlined.
{"title":"Daily breakfast: will skipping a morning meal become a new prognostic marker?","authors":"O. B. Shvabskaia, N. S. Karamnova, O. Drapkina","doi":"10.20996/1819-6446-2023-2973","DOIUrl":"https://doi.org/10.20996/1819-6446-2023-2973","url":null,"abstract":"The increase in the prevalence of dietary risk factors and non-communicable diseases over the past decades has led to the search for new predictors, one of which is skipping breakfast. The article examines the potential of using the \"daily breakfast\"/\"skipping breakfast\" criterion as a prognostic marker. The results of studies on the correlation of daily breakfast with dietary risk factors (obesity and hypertension), type 2 diabetes, cardiovascular diseases and the risk of cardiovascular death are presented and analyzed. The effect of breakfast on the depression risk, which is an independent marker of cardiovascular diseases, is being studied. Also, possible pathogenetic mechanisms linking skipping breakfast with increased blood pressure are discussed. Research data is provided confirming the importance of morning meals for health. The article presents data on the prevalence of daily breakfast in the Russian population and in the populations of other countries with developed economies. Information is provided on the history of studying the effect of daily breakfast on health. Also, controversial scientific data is provided on the effect of skipping breakfast on body weight and its effective control. The role of morning meals in weight reduction programs is fully discussed. The issues of connection between the morning meal and daily calorie intake, the nutritional value of consumption of total protein, vitamins and minerals, as well as the uniform meal distribution across the day are considered. Data from a scientific discussion on the criteria for an \"ideal\" breakfast are presented, and general recommendations on the energy and nutritional value of a morning meal and the optimal composition of food are outlined.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"26 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139287613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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