Pub Date : 2024-05-15DOI: 10.15829/1560-4071-2024-5851
V. Genkel, A. Kuznetsova, A. Savochkina, I. Baturina, K. Nikushkina, A. Minasova, L. Pykhova, V. Sumerkina, Yana Kudrinskaya, I. Shaposhnik, I. I. Dolgushin
Aim. To evaluate the diagnostic and prognostic value of circulating mature and aging neutrophils in relation to hypoechoic carotid plaques and short-term progression of carotid and multifocal atherosclerosis.Material and methods. The study included 200 patients (89 males and 111 females), aged 40-64 years. All patients underwent duplex ultrasound of the carotid and lower extremity arteries at the first visit and at a repeat visit after 12-24 months. Ultrasound morphology of carotid plaques was assessed using greyscale median analysis. Phenotyping and differentiation of neutrophil subpopulations was carried out using flow cytometry.Results. The absolute and relative number of mature neutrophils directly correlated with ultrasound indicators of carotid atherosclerosis, while the number of aging neutrophils — with the degree of lower extremity artery stenosis. Patients with hypoechoic carotid plaques were characterized by a significantly higher absolute number of mature neutrophils (p=0,0340). An increase in the number of mature neutrophils over 3023,0 cells/μL made it possible to predict the hypoechoic carotid plaques with a sensitivity of 75,0% and a specificity of 69,5%. Patients with carotid atherosclerosis progression had a higher absolute number of mature neutrophils (p=0,0140), as did patients with progression of multifocal atherosclerosis (p=0,0162). An increase in the number of mature neutrophils more than 3223,0 cells/μL was associated with an increase in the relative risk of polyvascular disease progression by 3,09 times (95% confidence interval, 1,34-7,17; p=0,0082) after adjustment for baseline cardiovascular disease risk.Conclusion. Among patients aged 40-64 years, increased numbers of circulating mature neutrophils are associated with an increased carotid plaque burden and hypoechoic carotid plaques. An increase in the number of mature neutrophils over 3223,0 cells/μL was associated with a 3,09-fold increase in the relative risk of polyvascular disease after adjustment for baseline cardiovascular risk.
{"title":"Mature neutrophils as a marker of hypoechoic carotid plaques and a predictor of polyvascular disease progression","authors":"V. Genkel, A. Kuznetsova, A. Savochkina, I. Baturina, K. Nikushkina, A. Minasova, L. Pykhova, V. Sumerkina, Yana Kudrinskaya, I. Shaposhnik, I. I. Dolgushin","doi":"10.15829/1560-4071-2024-5851","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5851","url":null,"abstract":"Aim. To evaluate the diagnostic and prognostic value of circulating mature and aging neutrophils in relation to hypoechoic carotid plaques and short-term progression of carotid and multifocal atherosclerosis.Material and methods. The study included 200 patients (89 males and 111 females), aged 40-64 years. All patients underwent duplex ultrasound of the carotid and lower extremity arteries at the first visit and at a repeat visit after 12-24 months. Ultrasound morphology of carotid plaques was assessed using greyscale median analysis. Phenotyping and differentiation of neutrophil subpopulations was carried out using flow cytometry.Results. The absolute and relative number of mature neutrophils directly correlated with ultrasound indicators of carotid atherosclerosis, while the number of aging neutrophils — with the degree of lower extremity artery stenosis. Patients with hypoechoic carotid plaques were characterized by a significantly higher absolute number of mature neutrophils (p=0,0340). An increase in the number of mature neutrophils over 3023,0 cells/μL made it possible to predict the hypoechoic carotid plaques with a sensitivity of 75,0% and a specificity of 69,5%. Patients with carotid atherosclerosis progression had a higher absolute number of mature neutrophils (p=0,0140), as did patients with progression of multifocal atherosclerosis (p=0,0162). An increase in the number of mature neutrophils more than 3223,0 cells/μL was associated with an increase in the relative risk of polyvascular disease progression by 3,09 times (95% confidence interval, 1,34-7,17; p=0,0082) after adjustment for baseline cardiovascular disease risk.Conclusion. Among patients aged 40-64 years, increased numbers of circulating mature neutrophils are associated with an increased carotid plaque burden and hypoechoic carotid plaques. An increase in the number of mature neutrophils over 3223,0 cells/μL was associated with a 3,09-fold increase in the relative risk of polyvascular disease after adjustment for baseline cardiovascular risk.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" May","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141127742","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 : 2024-04-20DOI: 10.15829/1560-4071-2024-5577
E. G. Skorodumova, O. Rubanenko, A. Rubanenko, S. Enginoev, M. Kercheva, E. Zaslavskaya, E. V. Efremova, E. Y. Gubareva, I. N. Lyapina, R. M. Velieva, E. Skorodumova, A. Siverina
Aim. To compare the effectiveness and safety of direct oral anticoagulants (DOACs) with a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) and stage 4 and 5 chronic kidney disease (CKD).Material and methods. We searched in the PubMed, Google Scholar, and Web of Science databases from 1990 to 2022 for studies that compared DOACs with VKAs in patients with AF and stage 4 and 5 CKD. The patient, intervention, comparison, outcome (PICO) search strategy was used. Data were extracted by independent researchers and meta-analyzed.Results. A total of 6 studies were included in this meta-analysis. In terms of effectiveness, DOACs were comparable to VKAs. In terms of safety, DOACs and VKAs also had no statistical differences in hemorrhagic stroke, minor/gastrointestinal bleeding, overall mortality, but there was statistical significance in major bleeding. Conclusion. In terms of efficacy and safety, in general, DOACs were comparable to VKAs, but there were a number of following differences: the administration of DOACs to patients with stage 4 and 5 CKD, as well as those on hemodialysis, was accompanied by a significant reduction in the number of major bleedings, compared with warfarin therapy.
{"title":"Oral anticoagulants versus vitamin K antagonists in the treatment of non-valvular atrial fibrillation in patients with stage 4-5 chronic kidney disease","authors":"E. G. Skorodumova, O. Rubanenko, A. Rubanenko, S. Enginoev, M. Kercheva, E. Zaslavskaya, E. V. Efremova, E. Y. Gubareva, I. N. Lyapina, R. M. Velieva, E. Skorodumova, A. Siverina","doi":"10.15829/1560-4071-2024-5577","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5577","url":null,"abstract":"Aim. To compare the effectiveness and safety of direct oral anticoagulants (DOACs) with a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) and stage 4 and 5 chronic kidney disease (CKD).Material and methods. We searched in the PubMed, Google Scholar, and Web of Science databases from 1990 to 2022 for studies that compared DOACs with VKAs in patients with AF and stage 4 and 5 CKD. The patient, intervention, comparison, outcome (PICO) search strategy was used. Data were extracted by independent researchers and meta-analyzed.Results. A total of 6 studies were included in this meta-analysis. In terms of effectiveness, DOACs were comparable to VKAs. In terms of safety, DOACs and VKAs also had no statistical differences in hemorrhagic stroke, minor/gastrointestinal bleeding, overall mortality, but there was statistical significance in major bleeding. Conclusion. In terms of efficacy and safety, in general, DOACs were comparable to VKAs, but there were a number of following differences: the administration of DOACs to patients with stage 4 and 5 CKD, as well as those on hemodialysis, was accompanied by a significant reduction in the number of major bleedings, compared with warfarin therapy.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"118 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680466","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5619
N. B. Lebedeva, I. W. Talibullin, P. G. Parfenov, A. P. Egle, O. Barbarash
Aim. To analyze clinical and anamnestic factors associated with the risk of acute decompensated heart failure (ADHF) in patients with an implanted cardioverter-defibrillator (ICD) with the development of a prognostic model based on the Kuzbass registry of patients with ICD.Material and methods. Prospective follow-up of 260 patients with reduced left ventricular ejection fraction (age 59 (53; 66) years, 214 (82,3%) men) from the Kuzbass registry of patients with ICD. Of them, 156 (60%) patients had ischemic cardiomyopathy, while the rest had non-ischemic cardiomyopathy. The mean follow-up period was 4,2±2,3 years after ICD implantation. The following basic information about patients were assessed: demographic data, social status, history of the underlying disease, concomitant diseases, vital signs, standard clinical and paraclinical parameters, drug therapy. During the follow-up period, all cases of ADHF and death were analyzed.Results. A total of 54 (20,8%) patients died, of which 48 (88,9%) died due to ADHF. During the follow-up period, 34 patients were hospitalized for ADHF, of which 13 (38,2%) died. Thirty-five (13,5%) patients died in the prehospital stage due to ADHF that developed against the background of the underlying disease (10 (27%) had dilated cardiomyopathy, 1 (2,8%) — rheumatic mitral valve disease, 24 (68,6%) — ischemic cardiomyopathy). Thus, a total of 69 cases of ADHF were registered, which accounted for 26,5% of the total group. Mortality in general group from ADHF was 18,5%. According to the Kaplan-Meier curve, most deaths occurred during the first 1,5 years of follow-up.The regression model for predicting the ADHF risk included left atrium size (p=0,05), male sex (p=0,001), NYHA class (p=0,0001), left ventricular ejection fraction <40% (p=0,0001), no intake of renin-angiotensin-aldosterone system inhibitors (p=0,007) and amiodarone (p=0,028). The area under the ROC curve (AUC), sensitivity and specificity of the created model was 0,8, 69,2% and 80%, respectively.Conclusion. A set of routine clinical and anamnestic factors has been identified that makes it possible to predict the risk of ADHF in patients with ICDs, which must be taken into account before making a decision to implant the device. Particular attention should be paid to mandatory therapy for heart failure, as the main modifiable risk factor for ADHF.
{"title":"Factors associated with the risk of progression and decompensation of heart failure in patients with an implantable cardioverter-defibrillator","authors":"N. B. Lebedeva, I. W. Talibullin, P. G. Parfenov, A. P. Egle, O. Barbarash","doi":"10.15829/1560-4071-2024-5619","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5619","url":null,"abstract":"Aim. To analyze clinical and anamnestic factors associated with the risk of acute decompensated heart failure (ADHF) in patients with an implanted cardioverter-defibrillator (ICD) with the development of a prognostic model based on the Kuzbass registry of patients with ICD.Material and methods. Prospective follow-up of 260 patients with reduced left ventricular ejection fraction (age 59 (53; 66) years, 214 (82,3%) men) from the Kuzbass registry of patients with ICD. Of them, 156 (60%) patients had ischemic cardiomyopathy, while the rest had non-ischemic cardiomyopathy. The mean follow-up period was 4,2±2,3 years after ICD implantation. The following basic information about patients were assessed: demographic data, social status, history of the underlying disease, concomitant diseases, vital signs, standard clinical and paraclinical parameters, drug therapy. During the follow-up period, all cases of ADHF and death were analyzed.Results. A total of 54 (20,8%) patients died, of which 48 (88,9%) died due to ADHF. During the follow-up period, 34 patients were hospitalized for ADHF, of which 13 (38,2%) died. Thirty-five (13,5%) patients died in the prehospital stage due to ADHF that developed against the background of the underlying disease (10 (27%) had dilated cardiomyopathy, 1 (2,8%) — rheumatic mitral valve disease, 24 (68,6%) — ischemic cardiomyopathy). Thus, a total of 69 cases of ADHF were registered, which accounted for 26,5% of the total group. Mortality in general group from ADHF was 18,5%. According to the Kaplan-Meier curve, most deaths occurred during the first 1,5 years of follow-up.The regression model for predicting the ADHF risk included left atrium size (p=0,05), male sex (p=0,001), NYHA class (p=0,0001), left ventricular ejection fraction <40% (p=0,0001), no intake of renin-angiotensin-aldosterone system inhibitors (p=0,007) and amiodarone (p=0,028). The area under the ROC curve (AUC), sensitivity and specificity of the created model was 0,8, 69,2% and 80%, respectively.Conclusion. A set of routine clinical and anamnestic factors has been identified that makes it possible to predict the risk of ADHF in patients with ICDs, which must be taken into account before making a decision to implant the device. Particular attention should be paid to mandatory therapy for heart failure, as the main modifiable risk factor for ADHF.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140690055","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5603
M. Terenicheva, R. Shakhnovich, O. V. Stukalova, D. V. Pevzner, I. Yavelov, Y.O. Shalaginova, S. K. Ternovoy
Aim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study included 50 patients with a first STEMI who underwent PPCI on the infarct-related artery. After 3-7 days and 12 months, contrast-enhanced cardiac magnetic resonance imaging was performed to assess left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and MVOs. After 12 months, patients were rehospitalized and prognosis was assessed based on data on cardiovascular events.Results. Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. MVOs was associated with post-infarction LV aneurysm. An increase in MVO size correlated with a decrease in LVEF and an increase in LVEDV both in the acute period and one year after MI.
{"title":"The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction","authors":"M. Terenicheva, R. Shakhnovich, O. V. Stukalova, D. V. Pevzner, I. Yavelov, Y.O. Shalaginova, S. K. Ternovoy","doi":"10.15829/1560-4071-2024-5603","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5603","url":null,"abstract":"Aim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study included 50 patients with a first STEMI who underwent PPCI on the infarct-related artery. After 3-7 days and 12 months, contrast-enhanced cardiac magnetic resonance imaging was performed to assess left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and MVOs. After 12 months, patients were rehospitalized and prognosis was assessed based on data on cardiovascular events.Results. Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. MVOs was associated with post-infarction LV aneurysm. An increase in MVO size correlated with a decrease in LVEF and an increase in LVEDV both in the acute period and one year after MI.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 0","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689626","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5813
A. Sapina, A. Y. Lebedeva, P. P. Savvinova, E. A. Zorina, E. S. Kolosova, E. Y. Vasilyeva
Aim. To assess the rate of adverse cardiovascular events (a combination of non-fatal myocardial infarction (MI), non-fatal stroke, cardiovascular death) within 12 months after MI in patients who were followed up in outpatient clinics in Moscow after the hospital discharge, as well as its association with antiplatelet therapy.Material and methods. This observational multicenter, open-label, prospective study that consecutively included patients after MI and came for further treatment and observation to the clinic after the hospital discharge, subject to providing informed consent. Data were obtained at four scheduled visits (an inclusion visit and 3 follow-up visits — 3, 6 and 12 months after the event). An analysis was carried out in the context of various antiplatelet therapy.Results. The study included 1576 patients in 27 Moscow clinics (mean age, 62,2±11,1 years; men — 69%; ST-segment elevation MI — 57,7%, non-ST elevation MI — 42,3%). At the time of study inclusion, 47,2% of patients received dual antiplatelet therapy with clopidogrel, 4,2% — prasugrel, 48,6% — ticagrelor, with a mean duration of 11,2 months. Incidence of adverse cardiovascular events over 12-month follow-up rate was low and amounted to 3,4% (cumulative incidence, 0,038). This indicator was significantly lower in the subgroup of patients who underwent percutaneous coronary intervention compared with patients who received conservative therapy for MI (p=0,0002).Conclusion. The study demonstrated a low incidence of adverse cardiovascular events over 12 months in patients followed up in outpatient clinics in Moscow after an MI, while percutaneous coronary intervention for MI was associated with a lower incidence of adverse cardiovascular events compared with conservative therapy.
{"title":"Use of antiplatelet agents in patients after myocardial infarction followed up in Moscow outpatient clinics. Results of a non-interventional prospective study","authors":"A. Sapina, A. Y. Lebedeva, P. P. Savvinova, E. A. Zorina, E. S. Kolosova, E. Y. Vasilyeva","doi":"10.15829/1560-4071-2024-5813","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5813","url":null,"abstract":"Aim. To assess the rate of adverse cardiovascular events (a combination of non-fatal myocardial infarction (MI), non-fatal stroke, cardiovascular death) within 12 months after MI in patients who were followed up in outpatient clinics in Moscow after the hospital discharge, as well as its association with antiplatelet therapy.Material and methods. This observational multicenter, open-label, prospective study that consecutively included patients after MI and came for further treatment and observation to the clinic after the hospital discharge, subject to providing informed consent. Data were obtained at four scheduled visits (an inclusion visit and 3 follow-up visits — 3, 6 and 12 months after the event). An analysis was carried out in the context of various antiplatelet therapy.Results. The study included 1576 patients in 27 Moscow clinics (mean age, 62,2±11,1 years; men — 69%; ST-segment elevation MI — 57,7%, non-ST elevation MI — 42,3%). At the time of study inclusion, 47,2% of patients received dual antiplatelet therapy with clopidogrel, 4,2% — prasugrel, 48,6% — ticagrelor, with a mean duration of 11,2 months. Incidence of adverse cardiovascular events over 12-month follow-up rate was low and amounted to 3,4% (cumulative incidence, 0,038). This indicator was significantly lower in the subgroup of patients who underwent percutaneous coronary intervention compared with patients who received conservative therapy for MI (p=0,0002).Conclusion. The study demonstrated a low incidence of adverse cardiovascular events over 12 months in patients followed up in outpatient clinics in Moscow after an MI, while percutaneous coronary intervention for MI was associated with a lower incidence of adverse cardiovascular events compared with conservative therapy.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687435","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5629
I. E. Tishkina, T. M. Kuleshova, M. A. Frolova, K. Pereverzeva, S. Yakushin
Aim. To identify factors influencing inhospital mortality in patients with myocardial infarction aged ≥75.Material and methods. We performed a retrospective analysis of medical records of all patients aged ≥75 years hospitalized from January 1, 2020 to December 31, 2021 with a diagnosis of myocardial infarction (I21, ICD-10), assessment of comorbidities, clinical performance, laboratory and treatment data and their impact on the outcome of hospitalization.Results. Inhospital mortality was 22,2%. The mean age of discharged and deceased patients was 81 [79; 84] and 82 [79; 85] years, respectively (p=0,12). Cardiogenic shock on admission (hazard ratio (HR) 31,28; 95% confidence interval (CI) 5,7-171,53; p<0,001), degree 2-3 atrioventricular block (HR 4,67; 95% CI 1,02-21,38; p=0,04), as well as a GRACE score ≥166 for non-ST-segment elevation acute coronary syndrome (HR 7,19; 95% CI 1,01-51,43; p<0,001) showed an unfavorable effect on prognosis.Conclusion. Cardiogenic shock, degree 2-3 atrioventricular block, and a GRACE score ≥166 for patients with non-ST-segment elevation acute coronary syndrome are factors that increase inhospital mortality in patients aged ≥75 years.
{"title":"Myocardial infarction in persons aged ≥75 years: factors influencing inhospital mortality","authors":"I. E. Tishkina, T. M. Kuleshova, M. A. Frolova, K. Pereverzeva, S. Yakushin","doi":"10.15829/1560-4071-2024-5629","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5629","url":null,"abstract":"Aim. To identify factors influencing inhospital mortality in patients with myocardial infarction aged ≥75.Material and methods. We performed a retrospective analysis of medical records of all patients aged ≥75 years hospitalized from January 1, 2020 to December 31, 2021 with a diagnosis of myocardial infarction (I21, ICD-10), assessment of comorbidities, clinical performance, laboratory and treatment data and their impact on the outcome of hospitalization.Results. Inhospital mortality was 22,2%. The mean age of discharged and deceased patients was 81 [79; 84] and 82 [79; 85] years, respectively (p=0,12). Cardiogenic shock on admission (hazard ratio (HR) 31,28; 95% confidence interval (CI) 5,7-171,53; p<0,001), degree 2-3 atrioventricular block (HR 4,67; 95% CI 1,02-21,38; p=0,04), as well as a GRACE score ≥166 for non-ST-segment elevation acute coronary syndrome (HR 7,19; 95% CI 1,01-51,43; p<0,001) showed an unfavorable effect on prognosis.Conclusion. Cardiogenic shock, degree 2-3 atrioventricular block, and a GRACE score ≥166 for patients with non-ST-segment elevation acute coronary syndrome are factors that increase inhospital mortality in patients aged ≥75 years.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686163","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5653
I. Tarasova, I. Kukhareva, T. Temnikova, D. S. Kupriyanova, I. Syrova, А. S. Sosnina, O. Trubnikova, O. Barbarash
Aim. To compare the incidence of postoperative cognitive dysfunction and neuropsychological changes in the early postoperative period of coronary artery bypass grafting (CABG) in patients who underwent two versions of multitask cognitive training, which involved various cognitive and motor tasks, as well as in a control group.Material and methods. The study included 100 patients after elective CABG. All patients were randomly divided into three following groups: cognitive training (CT) 1 (postural balance combined with mental arithmetic, verbal fluency, and unusual object use tasks) (n=30), CT 2 (simple visual-motor response combined with task on mental arithmetic, verbal fluency and unusual object use) (n=35) and without training (standard postoperative therapy) (n=35). All patients underwent extensive neuropsychological testing before CABG. Reexamination with assessment of postoperative cognitive dysfunction (POCD) was carried out on days 2-3 and upon completion of 5-7 days of training or on days 11-12 after CABG.Results. The presence of POCD on days 2-3 was found in 100% of patients in the study groups. On days 11-12 of CABG, POCD persisted in 17 people (56,7%) from the CT 1 group, in 24 (68,6%) from the CT 2 group, and in 28 (80%) patients in the control group. Significant differences were obtained in the POCD prevalence in the CT 1 and control groups (odds ratio =3,06; 95% confidence interval: 1,02-9,18, p=0,04), but not CT 2 and control groups (odds ratio =1,83; 95% confidence interval: 0,64-5,47, p=0,28).Conclusion. Multitask training using a combination of postural balance and mental arithmetic tasks, verbal fluency, and unusual object use had a greater effect in reducing the POCD incidence in patients after CABG compared with standard postoperative care. The results of this study may be used to develop cognitive rehabilitation programs in cardiology and cardiac surgery.
{"title":"Comparative analysis of two multitask approaches to cognitive training in cardiac surgery patients","authors":"I. Tarasova, I. Kukhareva, T. Temnikova, D. S. Kupriyanova, I. Syrova, А. S. Sosnina, O. Trubnikova, O. Barbarash","doi":"10.15829/1560-4071-2024-5653","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5653","url":null,"abstract":"Aim. To compare the incidence of postoperative cognitive dysfunction and neuropsychological changes in the early postoperative period of coronary artery bypass grafting (CABG) in patients who underwent two versions of multitask cognitive training, which involved various cognitive and motor tasks, as well as in a control group.Material and methods. The study included 100 patients after elective CABG. All patients were randomly divided into three following groups: cognitive training (CT) 1 (postural balance combined with mental arithmetic, verbal fluency, and unusual object use tasks) (n=30), CT 2 (simple visual-motor response combined with task on mental arithmetic, verbal fluency and unusual object use) (n=35) and without training (standard postoperative therapy) (n=35). All patients underwent extensive neuropsychological testing before CABG. Reexamination with assessment of postoperative cognitive dysfunction (POCD) was carried out on days 2-3 and upon completion of 5-7 days of training or on days 11-12 after CABG.Results. The presence of POCD on days 2-3 was found in 100% of patients in the study groups. On days 11-12 of CABG, POCD persisted in 17 people (56,7%) from the CT 1 group, in 24 (68,6%) from the CT 2 group, and in 28 (80%) patients in the control group. Significant differences were obtained in the POCD prevalence in the CT 1 and control groups (odds ratio =3,06; 95% confidence interval: 1,02-9,18, p=0,04), but not CT 2 and control groups (odds ratio =1,83; 95% confidence interval: 0,64-5,47, p=0,28).Conclusion. Multitask training using a combination of postural balance and mental arithmetic tasks, verbal fluency, and unusual object use had a greater effect in reducing the POCD incidence in patients after CABG compared with standard postoperative care. The results of this study may be used to develop cognitive rehabilitation programs in cardiology and cardiac surgery.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687161","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5585
Z. Tatarintseva, E. Kosmacheva, O. V. Babicheva
Aim. To analyze the relationship of low blood potassium concentration before surgery with the risk of postoperative atrial fibrillation (POAF).Material and methods. Data were collected and analyzed from patients admitted to the intensive care unit after cardiac surgery between January 2023 and June 2023. During the study period, 691 patients were operated on. Of these, 96 (13,9%) patients developed POAF, which made up group A (mean age 68,3±10,0). Control group B of patients with sinus rhythm was formed using a random generator and consisted of 96 patients with a mean age of 63,5±8,3.Results. The median time to onset of arrhythmia was 39,0 (29,2-51,0) hours. The blood potassium concentration one hour before surgery was significantly reduced in patients who developed arrhythmia compared with the control group (p<0,001) and averaged 3,4±0,4 mmol/L. To determine the sensitivity and specificity of the association of hypokalemia with POAF, we used a confirmatory statistical method, namely constructing ROC curves (AUC 0,640 (95% confidence interval: 0,562-0,718; p<0,001)).Conclusion. This study demonstrated the association of low preoperative blood potassium concentrations with the risk of POAF. Electrolyte concentrations alone cannot fully explain the risk of arrhythmia. However, optimizing electrolyte balance and, in particular, maintaining potassium concentrations >4,5 mmol/L may prevent the atrial fibrillation in some patients.
{"title":"Influence of blood electrolyte levels on the risk of atrial fibrillation after cardiac surgery","authors":"Z. Tatarintseva, E. Kosmacheva, O. V. Babicheva","doi":"10.15829/1560-4071-2024-5585","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5585","url":null,"abstract":"Aim. To analyze the relationship of low blood potassium concentration before surgery with the risk of postoperative atrial fibrillation (POAF).Material and methods. Data were collected and analyzed from patients admitted to the intensive care unit after cardiac surgery between January 2023 and June 2023. During the study period, 691 patients were operated on. Of these, 96 (13,9%) patients developed POAF, which made up group A (mean age 68,3±10,0). Control group B of patients with sinus rhythm was formed using a random generator and consisted of 96 patients with a mean age of 63,5±8,3.Results. The median time to onset of arrhythmia was 39,0 (29,2-51,0) hours. The blood potassium concentration one hour before surgery was significantly reduced in patients who developed arrhythmia compared with the control group (p<0,001) and averaged 3,4±0,4 mmol/L. To determine the sensitivity and specificity of the association of hypokalemia with POAF, we used a confirmatory statistical method, namely constructing ROC curves (AUC 0,640 (95% confidence interval: 0,562-0,718; p<0,001)).Conclusion. This study demonstrated the association of low preoperative blood potassium concentrations with the risk of POAF. Electrolyte concentrations alone cannot fully explain the risk of arrhythmia. However, optimizing electrolyte balance and, in particular, maintaining potassium concentrations >4,5 mmol/L may prevent the atrial fibrillation in some patients.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688164","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5632
V. Podzolkov, A. E. Bragina, A. Tarzimanova, I. Shvedov, E. S. Ogibenina, M. A. Avanesyan, A. S. Fomin
Aim. To evaluate cardiovascular risk factors as predictors of the post-coronavirus disease 2019 (COVID-19) syndrome.Material and methods. This prospective cohort study included adult patients admitted to a university hospital with a clinically or laboratory-confirmed diagnosis of COVID-19. A number of cardiovascular risk factors were assessed at admission, including the Cardio-Ankle Vascular Index (CAVI). After hospital discharge, patients were observed for 6 months. Then, data on the course of the post-COVID-19 period was collected from electronic medical records and discharge summaries. Two following outcomes were assessed: the development of post-COVID-19 syndrome and the development of newly diagnosed diseases or worsening of existing chronic diseases in the post-COVID-19 period.Multivariable logistic regression was used to assess the association between potential predictors and outcomes, and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated to assess the association strength. The statistical significance level was p<0,05.Results. The final analysis included 125 patients (68 (54,4%) women). The median age was 59,0 [50,5, 71,0] years. Post-COVID-19 syndrome was diagnosed in 32,8% of patients. The most common symptoms were weakness (19,2%), headaches (11,2%) and shortness of breath (10,4%). In multivariate analysis, CAVI ≥9,5, increased systolic blood pressure (SBP) and glomerular filtration rate (GFR) on admission were associated with the post-COVID-19 syndrome, with an OR of 2,415 (95% CI 1,174-2,846), 1,045 (95% CI 1,010-1,082), 0,971 (95% CI 0,946-0,998), respectively. Age (OR 1,056, 95% CI 1,009-1,105) and body mass index (OR 1,132, 95% CI 1,027-1,248) were associated with newly diagnosed diseases or worsening of existing chronic diseases in the post-COVID-19 period.Conclusion. Objective indicators such as SBP, CAVI and GFR may be predictors of post-COVID-19 syndrome, and age and body mass index are associated with the unfavorable course of chronic diseases in the post-COVID-19 period.
目的评估作为2019年冠状病毒病（COVID-19）后综合征预测因素的心血管风险因素。这项前瞻性队列研究纳入了经临床或实验室确诊为COVID-19的大学医院收治的成年患者。入院时评估了一系列心血管风险因素，包括心-踝血管指数（CAVI）。出院后，对患者进行了为期 6 个月的观察。然后，从电子病历和出院摘要中收集 COVID-19 后的病程数据。采用多变量逻辑回归评估潜在预测因素与结果之间的关联，并计算赔率（OR）和 95% 置信区间（95% CI）以评估关联强度。统计显著性水平为P<0.05。最终分析包括 125 名患者（68 名女性，占 54.4%）。中位年龄为 59.0 [50.5, 71.0]岁。32.8%的患者被诊断为 COVID-19 后综合征。最常见的症状是乏力（19.2%）、头痛（11.2%）和气短（10.4%）。在多变量分析中，CAVI ≥9.5、入院时收缩压（SBP）和肾小球滤过率（GFR）升高与 COVID-19 后综合征相关，OR 值分别为 2,415 (95% CI 1,174-2,846), 1,045 (95% CI 1,010-1,082), 0,971 (95% CI 0,946-0,998) 。年龄（OR 1,056，95% CI 1,009-1,105）和体重指数（OR 1,132，95% CI 1,027-1,248）与COVID-19后新诊断的疾病或现有慢性病的恶化有关。结论：SBP、CAVI 和 GFR 等客观指标可能是后 COVID-19 综合征的预测指标，而年龄和体重指数与后 COVID-19 期间慢性疾病的不良病程有关。
{"title":"Cardiovascular predictors of the post-COVID-19 course: results of a cohort study","authors":"V. Podzolkov, A. E. Bragina, A. Tarzimanova, I. Shvedov, E. S. Ogibenina, M. A. Avanesyan, A. S. Fomin","doi":"10.15829/1560-4071-2024-5632","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5632","url":null,"abstract":"Aim. To evaluate cardiovascular risk factors as predictors of the post-coronavirus disease 2019 (COVID-19) syndrome.Material and methods. This prospective cohort study included adult patients admitted to a university hospital with a clinically or laboratory-confirmed diagnosis of COVID-19. A number of cardiovascular risk factors were assessed at admission, including the Cardio-Ankle Vascular Index (CAVI). After hospital discharge, patients were observed for 6 months. Then, data on the course of the post-COVID-19 period was collected from electronic medical records and discharge summaries. Two following outcomes were assessed: the development of post-COVID-19 syndrome and the development of newly diagnosed diseases or worsening of existing chronic diseases in the post-COVID-19 period.Multivariable logistic regression was used to assess the association between potential predictors and outcomes, and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated to assess the association strength. The statistical significance level was p<0,05.Results. The final analysis included 125 patients (68 (54,4%) women). The median age was 59,0 [50,5, 71,0] years. Post-COVID-19 syndrome was diagnosed in 32,8% of patients. The most common symptoms were weakness (19,2%), headaches (11,2%) and shortness of breath (10,4%). In multivariate analysis, CAVI ≥9,5, increased systolic blood pressure (SBP) and glomerular filtration rate (GFR) on admission were associated with the post-COVID-19 syndrome, with an OR of 2,415 (95% CI 1,174-2,846), 1,045 (95% CI 1,010-1,082), 0,971 (95% CI 0,946-0,998), respectively. Age (OR 1,056, 95% CI 1,009-1,105) and body mass index (OR 1,132, 95% CI 1,027-1,248) were associated with newly diagnosed diseases or worsening of existing chronic diseases in the post-COVID-19 period.Conclusion. Objective indicators such as SBP, CAVI and GFR may be predictors of post-COVID-19 syndrome, and age and body mass index are associated with the unfavorable course of chronic diseases in the post-COVID-19 period.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140690086","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 : 2024-04-18DOI: 10.15829/1560-4071-2024-5759
V. Larina, V. I. Lunev
The applicability of the left ventricular global function index (LVGFI) and its derivative, determined by echocardiography, to distinguish clinical phenotypes in a cohort of patients with heart failure with preserved ejection fraction (HFpEF) is unknown.Aim. To evaluate the differential diagnostic potential of LVGFI and its derivative when phenotyping outpatients aged ≥60 years with HFpEF.Material and methods. A total of 140 outpatients (men, 43%) aged 73 (67-78) years with functional class II-IV HFpEF were included in the study. The follow-up period was 34 (22-36) months.Results. LVGFI was 22,4 (19,4-24,6)%, while derivative index of LVGFI — 283,9 (248,9-332,2) ml. There were 18 (12,9%) deaths. The threshold value for predicting death for LVGFI was ≤21,4%, for derivative index of LVGFI — ≥303,6 ml. Based on cluster membership and mortality analysis, two following risk groups for death of patients with HFpEF were identified: a relatively low-risk (group 1) and moderate (group 2) risk group (mortality within 34 months ~25%). Group 1 was represented by patients, predominantly male, with class II HFpEF, coronary artery disease (CAD) and prior myocardial infarction (MI), concentric hypertrophy, a significant LV mass increase, a high frequency of bendopnea, lower LVGFI and higher derivative index of LVGFI. Group 2 was represented by patients, predominantly female, with class II HF, a history of CAD and myocardial infarction, concentric hypertrophy and concentric remodeling, a moderate LV mass increase, a relatively low frequency of bendopnea, higher LVGFI and lower derivative index of LVGFI. Based on the data obtained, an algorithm was developed to determine the risk of death in patients with HFpEF.Conclusion. LVGFI and its derivative index can be used in phenotyping patients with HFpEF. The developed algorithm for determining the death risk makes it possible to identify outpatients with HFpEF who need intensified therapy and observation by a general practitioner and cardiologist in order to reduce the risk of an unfavorable prognosis.
{"title":"Phenotyping of outpatients with heart failure with preserved ejection fraction and poor prognosis","authors":"V. Larina, V. I. Lunev","doi":"10.15829/1560-4071-2024-5759","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5759","url":null,"abstract":"The applicability of the left ventricular global function index (LVGFI) and its derivative, determined by echocardiography, to distinguish clinical phenotypes in a cohort of patients with heart failure with preserved ejection fraction (HFpEF) is unknown.Aim. To evaluate the differential diagnostic potential of LVGFI and its derivative when phenotyping outpatients aged ≥60 years with HFpEF.Material and methods. A total of 140 outpatients (men, 43%) aged 73 (67-78) years with functional class II-IV HFpEF were included in the study. The follow-up period was 34 (22-36) months.Results. LVGFI was 22,4 (19,4-24,6)%, while derivative index of LVGFI — 283,9 (248,9-332,2) ml. There were 18 (12,9%) deaths. The threshold value for predicting death for LVGFI was ≤21,4%, for derivative index of LVGFI — ≥303,6 ml. Based on cluster membership and mortality analysis, two following risk groups for death of patients with HFpEF were identified: a relatively low-risk (group 1) and moderate (group 2) risk group (mortality within 34 months ~25%). Group 1 was represented by patients, predominantly male, with class II HFpEF, coronary artery disease (CAD) and prior myocardial infarction (MI), concentric hypertrophy, a significant LV mass increase, a high frequency of bendopnea, lower LVGFI and higher derivative index of LVGFI. Group 2 was represented by patients, predominantly female, with class II HF, a history of CAD and myocardial infarction, concentric hypertrophy and concentric remodeling, a moderate LV mass increase, a relatively low frequency of bendopnea, higher LVGFI and lower derivative index of LVGFI. Based on the data obtained, an algorithm was developed to determine the risk of death in patients with HFpEF.Conclusion. LVGFI and its derivative index can be used in phenotyping patients with HFpEF. The developed algorithm for determining the death risk makes it possible to identify outpatients with HFpEF who need intensified therapy and observation by a general practitioner and cardiologist in order to reduce the risk of an unfavorable prognosis.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688749","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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