Pub Date : 2023-12-29DOI: 10.15829/1560-4071-2023-5706
P. Duplyakova, T. Pavlova, D. Duplyakov
Aim. To evaluate the effectiveness and safety of an invasive approach in patients with ST-segment elevation myocardial infarction (STEMI) aged 90 years and older.Material and methods. This retrospective single-center study was conducted at the V. P. Polyakov Samara Regional Clinical Cardiology Dispensary. In 20132020, 104 patients aged 90 years and older were hospitalized with a diagnosis of STEMI. The mean age of patients was 91,7 years (90-100), while the proportion of women was 67,3%. Patients included in the analysis were divided into groups of conservative treatment (n=81, mean age, 91,9 (90-100) years, women 70,4%) and invasive management (coronary angiography + percutaneous coronary intervention (PCI)) (n=23, mean age, 91,0 (90-94) years, women, 56,5%).Results. The groups were comparable in basic characteristics. In-hospital mortality in the conservative strategy group was 48,1% vs 17,4% in the invasive management group (p=0,009; odds ratio (OR) 3,35; 95% confidence interval (CI) 1,23-9,15). During the first year after discharge, 25,9% (n=21) died in the conservative strategy group and 30,4% (n=7) in the invasive strategy group (p=0,79; OR 0,85; 95% CI 0,42-1,75). In total (during the hospitalization period and within 1 year after discharge), 60 people (74,1%) died in the conservative strategy group, while in the invasive treatment group — 11 (47,8%) (p=0,02; OR 3,11; 95% CI 1,19-8,11). Life expectancy in patients with STEMI aged 90 years and older after discharge from hospital was 83,95 days for the conservative strategy group and 103,85 days for the invasive strategy group (p=0,67).Conclusion. The data obtained in our study support primary PCI as a treatment strategy for patients with STEMI aged 90 years and older.
{"title":"Analysis of outcomes in patients with ST-segment elevation myocardial infarction aged 90 years and older: a single center experience","authors":"P. Duplyakova, T. Pavlova, D. Duplyakov","doi":"10.15829/1560-4071-2023-5706","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5706","url":null,"abstract":"Aim. To evaluate the effectiveness and safety of an invasive approach in patients with ST-segment elevation myocardial infarction (STEMI) aged 90 years and older.Material and methods. This retrospective single-center study was conducted at the V. P. Polyakov Samara Regional Clinical Cardiology Dispensary. In 20132020, 104 patients aged 90 years and older were hospitalized with a diagnosis of STEMI. The mean age of patients was 91,7 years (90-100), while the proportion of women was 67,3%. Patients included in the analysis were divided into groups of conservative treatment (n=81, mean age, 91,9 (90-100) years, women 70,4%) and invasive management (coronary angiography + percutaneous coronary intervention (PCI)) (n=23, mean age, 91,0 (90-94) years, women, 56,5%).Results. The groups were comparable in basic characteristics. In-hospital mortality in the conservative strategy group was 48,1% vs 17,4% in the invasive management group (p=0,009; odds ratio (OR) 3,35; 95% confidence interval (CI) 1,23-9,15). During the first year after discharge, 25,9% (n=21) died in the conservative strategy group and 30,4% (n=7) in the invasive strategy group (p=0,79; OR 0,85; 95% CI 0,42-1,75). In total (during the hospitalization period and within 1 year after discharge), 60 people (74,1%) died in the conservative strategy group, while in the invasive treatment group — 11 (47,8%) (p=0,02; OR 3,11; 95% CI 1,19-8,11). Life expectancy in patients with STEMI aged 90 years and older after discharge from hospital was 83,95 days for the conservative strategy group and 103,85 days for the invasive strategy group (p=0,67).Conclusion. The data obtained in our study support primary PCI as a treatment strategy for patients with STEMI aged 90 years and older.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143691","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5688
I. V. Sergienko, M. V. Ezhov
The novelty of the 2023 National Guidelines for Lipid Metabolism Disorders is presented regarding the categorization of cardiovascular risk, target and optimal levels of blood lipids, diagnosis and therapeutic approaches to the treatment of dyslipidemia.
{"title":"Review and analysis of 2023 Clinical Guidelines for Lipid Metabolism Disorders","authors":"I. V. Sergienko, M. V. Ezhov","doi":"10.15829/1560-4071-2023-5688","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5688","url":null,"abstract":"The novelty of the 2023 National Guidelines for Lipid Metabolism Disorders is presented regarding the categorization of cardiovascular risk, target and optimal levels of blood lipids, diagnosis and therapeutic approaches to the treatment of dyslipidemia.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"27 3‐4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146832","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5630
G. K. Lasynova, I. Lakman, D. Gareeva, A. A. Agapitov, L. Sadikova, А. R. Sakhautdinov, V. Pavlov, N. Zagidullin
Due to the large number of complications and decreased quality of life after coronavirus disease (COVID-19), physical and psychological rehabilitation of patients is relevant. However, the effectiveness of rehabilitation on endpoints has not yet been demonstrated.Aim. To determine the effectiveness of different rehabilitation options in hospitalized patients with COVID-19 on the development of long-term adverse cardiovascular events 1 year after discharge.Material and methods. In a single-center, non-randomized observational study, 3 groups of patients were formed after hospitalization with COVID-19: I — with telemedicine rehabilitation (n=118), II — with rehabilitation in a specialized department (n=46) and III — without rehabilitation (n=175). After 1-year followup, groups were compared regarding following endpoints: cardiovascular mortality, myocardial infarction, stroke, pulmonary embolism, atrial fibrillation and cardiovascular hospitalization. Propensity score matching analysis was used to optimize differences between comparison groups.Results. Rehabilitation after hospitalization of patients with COVID-19, both in the hospital and remotely for 1 year, helps to reduce cardiovascular hospitalization rate. In addition, remote rehabilitation reduces cardiovascular mortality.Conclusion. Both rehabilitation options reduce the incidence of cardiovascular hospitalization compared to no rehabilitation.
{"title":"Rehabilitation of COVID-19 convalescents and its impact on cardiovascular endpoints: propensity score matching analysis","authors":"G. K. Lasynova, I. Lakman, D. Gareeva, A. A. Agapitov, L. Sadikova, А. R. Sakhautdinov, V. Pavlov, N. Zagidullin","doi":"10.15829/1560-4071-2023-5630","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5630","url":null,"abstract":"Due to the large number of complications and decreased quality of life after coronavirus disease (COVID-19), physical and psychological rehabilitation of patients is relevant. However, the effectiveness of rehabilitation on endpoints has not yet been demonstrated.Aim. To determine the effectiveness of different rehabilitation options in hospitalized patients with COVID-19 on the development of long-term adverse cardiovascular events 1 year after discharge.Material and methods. In a single-center, non-randomized observational study, 3 groups of patients were formed after hospitalization with COVID-19: I — with telemedicine rehabilitation (n=118), II — with rehabilitation in a specialized department (n=46) and III — without rehabilitation (n=175). After 1-year followup, groups were compared regarding following endpoints: cardiovascular mortality, myocardial infarction, stroke, pulmonary embolism, atrial fibrillation and cardiovascular hospitalization. Propensity score matching analysis was used to optimize differences between comparison groups.Results. Rehabilitation after hospitalization of patients with COVID-19, both in the hospital and remotely for 1 year, helps to reduce cardiovascular hospitalization rate. In addition, remote rehabilitation reduces cardiovascular mortality.Conclusion. Both rehabilitation options reduce the incidence of cardiovascular hospitalization compared to no rehabilitation.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"71 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139147392","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 : 2023-12-28DOI: 10.15829/1560-4071-2023-5621
G. V. Endubaeva, A. E. Solovyova, A. E. Medvedev, M. M. Kurbanova, E. I. Kogan, T. V. Gorbacheva, A. V. Yazenok, N. Zvartau, S. Villevalde
Aim. To assess the compliance of the management of patients with heart failure (HF) with quality criteria (QC) for health care, including discharge instructions for patients.Material and methods. Hospitalizations of patients aged over 18 years with HF (ICD 10 code — I50.x) during the period from January 1, 2019 to October 1, 2020 were randomly selected from the "Chronic Heart Failure" registry of St. Petersburg. Discharge and post-mortem summaries were assessed for compliance with the quality criteria listed in the 2020 Russian Chronic Heart Failure guidelines.Results. The study included 553 patients (women, 71,1%, mean age, 82,0±9 years, comorbidities: hypertension — 99,1%, coronary artery disease — 97,6%, chronic kidney disease — 53,2%, diabetes — 32,6%). Electrocardiography (QC № 1) was performed in 94,2% of patients, chest radiography (QC № 2) 91,7%, echocardiography (QC № 3) — 81,0%, but the results were not always informative. The exact ejection fraction (EF) value was reported in 55,4% of patients. Laboratory examination corresponded to QC № 4-6 in 20,3% of cases and was performed in 53,3-94,9%. Natriuretic peptides (NPs) were not determined (QC № 7-0%).The completeness of intravenous therapy (QC № 8) was not assessed due to insufficient physical examination data.Oral therapy (QC № 9) was prescribed frequently as follows: renin-angiotensinaldosterone system inhibitors (RAASo) — 93,3%, beta blockers (BBs) — 85,4%, mineralocorticoid receptor antagonists (MRAs) — 78,7%. However, triple RAAS+BB+MRA therapy was carried out in 54,1% of HF cases with EF <50% and no contraindications.Diet was recommended in 87,1% of summaries, water-salt regimen — 53,3%, drug titration — 8,2%. The date of visit to outpatient cardiologist was indicated in 10,0%.Conclusion. With the exception of NP assessment, the scope of paraclinical studies corresponded to the QC in the majority of patients. Optimal therapy was prescribed to 54,1% of patients with EF <50%. An early outpatient visit after discharge was indicated in 10,0% of summaries.
{"title":"Compliance of the management of hospitalized patients with heart failure with the quality criteria for health care: data from the St. Petersburg registry","authors":"G. V. Endubaeva, A. E. Solovyova, A. E. Medvedev, M. M. Kurbanova, E. I. Kogan, T. V. Gorbacheva, A. V. Yazenok, N. Zvartau, S. Villevalde","doi":"10.15829/1560-4071-2023-5621","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5621","url":null,"abstract":"Aim. To assess the compliance of the management of patients with heart failure (HF) with quality criteria (QC) for health care, including discharge instructions for patients.Material and methods. Hospitalizations of patients aged over 18 years with HF (ICD 10 code — I50.x) during the period from January 1, 2019 to October 1, 2020 were randomly selected from the \"Chronic Heart Failure\" registry of St. Petersburg. Discharge and post-mortem summaries were assessed for compliance with the quality criteria listed in the 2020 Russian Chronic Heart Failure guidelines.Results. The study included 553 patients (women, 71,1%, mean age, 82,0±9 years, comorbidities: hypertension — 99,1%, coronary artery disease — 97,6%, chronic kidney disease — 53,2%, diabetes — 32,6%). Electrocardiography (QC № 1) was performed in 94,2% of patients, chest radiography (QC № 2) 91,7%, echocardiography (QC № 3) — 81,0%, but the results were not always informative. The exact ejection fraction (EF) value was reported in 55,4% of patients. Laboratory examination corresponded to QC № 4-6 in 20,3% of cases and was performed in 53,3-94,9%. Natriuretic peptides (NPs) were not determined (QC № 7-0%).The completeness of intravenous therapy (QC № 8) was not assessed due to insufficient physical examination data.Oral therapy (QC № 9) was prescribed frequently as follows: renin-angiotensinaldosterone system inhibitors (RAASo) — 93,3%, beta blockers (BBs) — 85,4%, mineralocorticoid receptor antagonists (MRAs) — 78,7%. However, triple RAAS+BB+MRA therapy was carried out in 54,1% of HF cases with EF <50% and no contraindications.Diet was recommended in 87,1% of summaries, water-salt regimen — 53,3%, drug titration — 8,2%. The date of visit to outpatient cardiologist was indicated in 10,0%.Conclusion. With the exception of NP assessment, the scope of paraclinical studies corresponded to the QC in the majority of patients. Optimal therapy was prescribed to 54,1% of patients with EF <50%. An early outpatient visit after discharge was indicated in 10,0% of summaries.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"292 8‐9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139152612","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 : 2023-12-28DOI: 10.15829/1560-4071-2023-5548
K. Petrosyan, A. Abrosimov, E. Goncharova, N. Bulaeva, B. Berdibekov, E. Z. Golukhova
Aim. To evaluate the accuracy of virtual stenting in predicting the physiological effect of percutaneous coronary intervention (PCI) for multilevel coronary artery disease (CAD).Material and methods. In order to define PCI strategy, 34 patients with multilevel CAD underwent assessment of instantaneous wave-free ratio (iFR) with mapping. Using the virtual stenting, predicted iFR (priFR) was assessed. After stent implantation, the factual iFR (fiFR) was re-assessed. A discrepancy between the priFR and fiFR by 0,03 was considered the threshold level of a significant difference and "poor agreement" criterion between measurements.Results. Mean iFR before PCI was 0,77±0,11; after PCI, this indicator increased significantly and amounted to 0,94±0,04 (p<0,001). Comparison of the predicted and factual iFR revealed that the difference did not significantly depend on the value (rxy=-0,183; p=0,300), and mean difference between measurements was 0,013 (standard deviation, ±0,019), which indicates no systematic discrepancy and good comparability of the studied methods. In addition, correlation analysis of priFR and fiFR revealed a significant strong (Chaddock scale) direct relationship (r=0,854; p<0,001). Independent predictors of "poor agreement" were heart rate and systolic blood pressure before surgery. Discrepancy in decisions on the choice of stented lesions and the required number of stents based on coronary angiography (CAG) and MRI occurred in 21 patients (62%) and 16 patients (47%), respectively. After iFR measurement, there was a significant decrease in the mean length of affected segment (from 61,82±19,68 mm (CAG) and 49,15±19,19 mm (iFR)), which made it possible to significantly reduce the number of implanted stents from 1,91±0,57 (CAG) to 1,50±0,56 (p=0,001).Conclusion. Mapping the iFR and virtual stenting technology makes it possible to revise the classification of coronary lesions by length, which leads to a significant reduction in the number of implanted stents and the length of stented segment. High correlation between priFR and fiFR achieved in our study indicates the high accuracy of virtual stenting in predicting the physiological effect of stenting.
{"title":"Virtual stenting and coregistration of instantaneous wave-free ratio to predict the physiological effect of percutaneous coronary intervention in patients with multilevel coronary artery disease","authors":"K. Petrosyan, A. Abrosimov, E. Goncharova, N. Bulaeva, B. Berdibekov, E. Z. Golukhova","doi":"10.15829/1560-4071-2023-5548","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5548","url":null,"abstract":"Aim. To evaluate the accuracy of virtual stenting in predicting the physiological effect of percutaneous coronary intervention (PCI) for multilevel coronary artery disease (CAD).Material and methods. In order to define PCI strategy, 34 patients with multilevel CAD underwent assessment of instantaneous wave-free ratio (iFR) with mapping. Using the virtual stenting, predicted iFR (priFR) was assessed. After stent implantation, the factual iFR (fiFR) was re-assessed. A discrepancy between the priFR and fiFR by 0,03 was considered the threshold level of a significant difference and \"poor agreement\" criterion between measurements.Results. Mean iFR before PCI was 0,77±0,11; after PCI, this indicator increased significantly and amounted to 0,94±0,04 (p<0,001). Comparison of the predicted and factual iFR revealed that the difference did not significantly depend on the value (rxy=-0,183; p=0,300), and mean difference between measurements was 0,013 (standard deviation, ±0,019), which indicates no systematic discrepancy and good comparability of the studied methods. In addition, correlation analysis of priFR and fiFR revealed a significant strong (Chaddock scale) direct relationship (r=0,854; p<0,001). Independent predictors of \"poor agreement\" were heart rate and systolic blood pressure before surgery. Discrepancy in decisions on the choice of stented lesions and the required number of stents based on coronary angiography (CAG) and MRI occurred in 21 patients (62%) and 16 patients (47%), respectively. After iFR measurement, there was a significant decrease in the mean length of affected segment (from 61,82±19,68 mm (CAG) and 49,15±19,19 mm (iFR)), which made it possible to significantly reduce the number of implanted stents from 1,91±0,57 (CAG) to 1,50±0,56 (p=0,001).Conclusion. Mapping the iFR and virtual stenting technology makes it possible to revise the classification of coronary lesions by length, which leads to a significant reduction in the number of implanted stents and the length of stented segment. High correlation between priFR and fiFR achieved in our study indicates the high accuracy of virtual stenting in predicting the physiological effect of stenting.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"16 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139149878","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5645
A. Gurevich, I. Emelyanov, M. Ionov, A. Vanyurkin, M. A. Chernyavsky, A. O. Conradi
Aim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material and methods. Patients ≥18 years of age without clinically significant cardiac arrhythmias were included. Before surgery and a year later, we determined peripheral blood pressure, heart rate (HR), CBP, augmentation index (AIx), pressure at the point of maximum rise of the direct pulse wave (PT1h), time to return of the reflected pressure wave (Tr) and carotid femoral pulse wave velocity (cfPWV).Results. Fifty patients were included (mean age, 68±9 years; 41 men; 16 with descending thoracic aortic aneurysm, 34 with abdominal aortic aneurysm), 23 patients were reexamined. After (T)EVAR, an increase in cfPWV (+2,6 m/s, p<0,001), PT1h (+5 mm Hg, p=0,026), peripheral pulse pressure (+7 mm Hg, p=0,039), heart rate (+5 beats/min, p=0,025). The CBP and AIx values have not changed. The dependence of Tr decrease on the stent-graft length (β=0,42) and the decrease in heart rate (β=-0,52) was found. During the year, 6 cardiovascular events were registered.Conclusion. Graft implantation is accompanied by an increase in cfPWV, regardless of aneurysm location. An increase in PT1h one year after (T)EVAR may reflect a decrease in aortic distensibility and worsening damping function. No changes of CBP and AIx is probably explained by reflected wave characteristics after surgery. Predictors of Tr are — increase in heart rate and implantation of longer stent grafts.
{"title":"Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up","authors":"A. Gurevich, I. Emelyanov, M. Ionov, A. Vanyurkin, M. A. Chernyavsky, A. O. Conradi","doi":"10.15829/1560-4071-2023-5645","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5645","url":null,"abstract":"Aim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material and methods. Patients ≥18 years of age without clinically significant cardiac arrhythmias were included. Before surgery and a year later, we determined peripheral blood pressure, heart rate (HR), CBP, augmentation index (AIx), pressure at the point of maximum rise of the direct pulse wave (PT1h), time to return of the reflected pressure wave (Tr) and carotid femoral pulse wave velocity (cfPWV).Results. Fifty patients were included (mean age, 68±9 years; 41 men; 16 with descending thoracic aortic aneurysm, 34 with abdominal aortic aneurysm), 23 patients were reexamined. After (T)EVAR, an increase in cfPWV (+2,6 m/s, p<0,001), PT1h (+5 mm Hg, p=0,026), peripheral pulse pressure (+7 mm Hg, p=0,039), heart rate (+5 beats/min, p=0,025). The CBP and AIx values have not changed. The dependence of Tr decrease on the stent-graft length (β=0,42) and the decrease in heart rate (β=-0,52) was found. During the year, 6 cardiovascular events were registered.Conclusion. Graft implantation is accompanied by an increase in cfPWV, regardless of aneurysm location. An increase in PT1h one year after (T)EVAR may reflect a decrease in aortic distensibility and worsening damping function. No changes of CBP and AIx is probably explained by reflected wave characteristics after surgery. Predictors of Tr are — increase in heart rate and implantation of longer stent grafts.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957418","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5714
B. Tsaroev, A. Bogachev-Prokofiev, R. Sharifulin, A. Afanasyev, A. Chernyavsky
This review article considers the role of sutureless aortic valve replacement in the era of transcatheter replacement. Modern data regarding the outcomes of treatment with these two methods and its comparison are considered. Their main disadvantages and the cohorts of patients suitable for each technique are determined.
{"title":"Role of sutureless aortic valve replacement in the era of transcatheter valves","authors":"B. Tsaroev, A. Bogachev-Prokofiev, R. Sharifulin, A. Afanasyev, A. Chernyavsky","doi":"10.15829/1560-4071-2023-5714","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5714","url":null,"abstract":"This review article considers the role of sutureless aortic valve replacement in the era of transcatheter replacement. Modern data regarding the outcomes of treatment with these two methods and its comparison are considered. Their main disadvantages and the cohorts of patients suitable for each technique are determined.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955902","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5672
I. Lakman, D. Gareeva, L. Sadikova, A. A. Agapitov, P. Davtyan, V. L. Kayumova, V. Timiryanova, N. Zagidullin
The viral infection and pandemic of coronavirus infection 2019 (COVID-19) was characterized not only by high morbidity and in-hospital mortality, but also by an increase in the mortality of patients after hospital discharge. At the same time, differences were noted in hospitalization rate, the number of complications and mortality of patients, and mortality rate between different pandemic waves from 2020 to 2023.Aim. To compare the 18-month post-hospital mortality rate of patients between three COVID-19 variants (Alpha, Delta and Omicron).Material and methods. In this prospective, single-center, non-randomized continuous study, 2400 medical records of patients with the Alpha variant (2020), 1826 with the Delta variant (2021) and 997 with the Omicron variant (2022) were analyzed. The end point was all-cause mortality during the follow-up period.Results. There were following differences in clinical and demographic characteristics in the context of COVID-19 strains: more women were hospitalized in the Delta and Omicron waves; in the Omicron wave, patients were older. Also, comorbid patients were more common with the Delta and Omicron variants than with the Alpha (in chronic obstructive pulmonary disease, hypertension and heart failure), but chronic kidney disease was more common with the Alpha and Omicron variants. The groups differed significantly in mortality, with the maximum being with Delta and the minimum with Omicron, and the maximum mortality with Delta was observed in the first 90 days after discharge. Between 12 and 18 months, survival estimates decreased most for patients hospitalized in the Delta wave, which is determined by the risk of long-term cardiovascular consequences.Conclusion. Clinical and demographic differences between patients with different COVID-19 variants, as well as a significant difference in the mortality rate of patients of different waves, emphasize the importance of a personalized approach to treatment and long-term post-hospital monitoring.
{"title":"Long-term mortality in different COVID-19 variants: 18-month follow-up","authors":"I. Lakman, D. Gareeva, L. Sadikova, A. A. Agapitov, P. Davtyan, V. L. Kayumova, V. Timiryanova, N. Zagidullin","doi":"10.15829/1560-4071-2023-5672","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5672","url":null,"abstract":"The viral infection and pandemic of coronavirus infection 2019 (COVID-19) was characterized not only by high morbidity and in-hospital mortality, but also by an increase in the mortality of patients after hospital discharge. At the same time, differences were noted in hospitalization rate, the number of complications and mortality of patients, and mortality rate between different pandemic waves from 2020 to 2023.Aim. To compare the 18-month post-hospital mortality rate of patients between three COVID-19 variants (Alpha, Delta and Omicron).Material and methods. In this prospective, single-center, non-randomized continuous study, 2400 medical records of patients with the Alpha variant (2020), 1826 with the Delta variant (2021) and 997 with the Omicron variant (2022) were analyzed. The end point was all-cause mortality during the follow-up period.Results. There were following differences in clinical and demographic characteristics in the context of COVID-19 strains: more women were hospitalized in the Delta and Omicron waves; in the Omicron wave, patients were older. Also, comorbid patients were more common with the Delta and Omicron variants than with the Alpha (in chronic obstructive pulmonary disease, hypertension and heart failure), but chronic kidney disease was more common with the Alpha and Omicron variants. The groups differed significantly in mortality, with the maximum being with Delta and the minimum with Omicron, and the maximum mortality with Delta was observed in the first 90 days after discharge. Between 12 and 18 months, survival estimates decreased most for patients hospitalized in the Delta wave, which is determined by the risk of long-term cardiovascular consequences.Conclusion. Clinical and demographic differences between patients with different COVID-19 variants, as well as a significant difference in the mortality rate of patients of different waves, emphasize the importance of a personalized approach to treatment and long-term post-hospital monitoring.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"45 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957306","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5709
Z. Kobalava, V. V. Tolkacheva, A. N. Kaftanov, D. Gavrilov
Aim. To evaluate the effectiveness of acetylsalicylic acid (ASA) drugs for secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in clinical practice and compare the effectiveness of the Cardiomagnyl with other ASA drugs.Material and methods. This observational, non-interventional, retrospective study included data from electronic medical records of 18199 patients with ASCVD who were divided into 2 following groups: patients who received ASA 75-100 mg (n=9784) and patients who did not receive ASA (n=8325). The prescription rate of ASA, the choice of the first drug, the duration of ASA therapy, the frequency of switching ASA during treatment, and the choice of the second ASA drug when changing therapy were assessed. Due to the heterogeneity of patients in the above groups, to assess the clinical outcomes, propensity score matching was performed and comparable groups were selected to evaluate the effectiveness of ASA drugs 75-100 mg in patients with ASCVD (n= 427) in comparison with patients not receiving ASA (n=427) and to assess the effectiveness of Cardiomagnyl 75 mg (n=1308) in comparison with enterosoluble ASA 100 mg (CRA) (n=1308) taking into account 24 parameters.Results. The average proportion of patients with ASCVD taking ASA drugs was 58%. During treatment, 54% of patients underwent a change in drug therapy from one ASA drug to another. The prescription rate of Cardiomagnyl as a first-choice drug was 33%, and as a second drug when changing therapy — 21%. The duration of Cardiomagnyl therapy was the longest compared to other ASA drugs and amounted to 16,3 months. The incidence of ischemic stroke, myocardial infarction and major adverse cardiovascular events in the group of patients who received ACS 75-100 mg was significantly lower than in patients who did not take ASA drugs and amounted to 4,7% vs 8,7%, 0,9% vs 3,3%, 5,6% vs 11,9%, respectively. Significantly lower incidence of unstable angina (0,8% vs 2,0%), myocardial infarction (1,5% vs 3,9%) and major adverse cardiovascular events (5,4% vs 7,8%) in group of patients who received Cardiomagnyl 75 mg as opposed to enterosoluble ASA.Conclusion. Significant advantages of buffered ASA (Cardiomagnyl) were revealed in comparison with enterosoluble ASA in clinical practice.
{"title":"Effectiveness of buffered acetylsalicylic acid compared to other drugs in diseases patients in clinical practice: results of the CARDINAL observational retrospective study","authors":"Z. Kobalava, V. V. Tolkacheva, A. N. Kaftanov, D. Gavrilov","doi":"10.15829/1560-4071-2023-5709","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5709","url":null,"abstract":"Aim. To evaluate the effectiveness of acetylsalicylic acid (ASA) drugs for secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in clinical practice and compare the effectiveness of the Cardiomagnyl with other ASA drugs.Material and methods. This observational, non-interventional, retrospective study included data from electronic medical records of 18199 patients with ASCVD who were divided into 2 following groups: patients who received ASA 75-100 mg (n=9784) and patients who did not receive ASA (n=8325). The prescription rate of ASA, the choice of the first drug, the duration of ASA therapy, the frequency of switching ASA during treatment, and the choice of the second ASA drug when changing therapy were assessed. Due to the heterogeneity of patients in the above groups, to assess the clinical outcomes, propensity score matching was performed and comparable groups were selected to evaluate the effectiveness of ASA drugs 75-100 mg in patients with ASCVD (n= 427) in comparison with patients not receiving ASA (n=427) and to assess the effectiveness of Cardiomagnyl 75 mg (n=1308) in comparison with enterosoluble ASA 100 mg (CRA) (n=1308) taking into account 24 parameters.Results. The average proportion of patients with ASCVD taking ASA drugs was 58%. During treatment, 54% of patients underwent a change in drug therapy from one ASA drug to another. The prescription rate of Cardiomagnyl as a first-choice drug was 33%, and as a second drug when changing therapy — 21%. The duration of Cardiomagnyl therapy was the longest compared to other ASA drugs and amounted to 16,3 months. The incidence of ischemic stroke, myocardial infarction and major adverse cardiovascular events in the group of patients who received ACS 75-100 mg was significantly lower than in patients who did not take ASA drugs and amounted to 4,7% vs 8,7%, 0,9% vs 3,3%, 5,6% vs 11,9%, respectively. Significantly lower incidence of unstable angina (0,8% vs 2,0%), myocardial infarction (1,5% vs 3,9%) and major adverse cardiovascular events (5,4% vs 7,8%) in group of patients who received Cardiomagnyl 75 mg as opposed to enterosoluble ASA.Conclusion. Significant advantages of buffered ASA (Cardiomagnyl) were revealed in comparison with enterosoluble ASA in clinical practice.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"12 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955411","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5687
A. Sapina, Y. Y. Varlamova, M. G. Papyrina, A. S. Bezymyannyy, E. Y. Vasilyeva
Aim. To evaluate the effectiveness of PCSK9 inhibitors (alirocumab, inclisiran and evolocumab) in patients with atherosclerotic cardiovascular disease (ASCVD) and failure to achieve the target low-density lipoprotein cholesterol (LDL-C) level for the period from November 21, 2022 to December 31, 2023.Material and methods. For the observational study, 50 patients were included in the inclisiran therapy group and 30 patients in the control group (patients with ASCVD receiving PCSK9 inhibitors (alirocumab, n=1; evolocumab, n=29)). All study participants had their anamnestic data analyzed, and initially underwent electrocardiography, echocardiography, extracranial and lower limb Doppler ultrasound, and laboratory tests (complete blood count, biochemical blood tests, lipid profile). Three medical organizations of the Moscow State Healthcare System participate in the study.Results. Interim data are presented to evaluate the effectiveness of PCSK9 targeted therapy in patients with ASCVD, obtained 3 months from the study start. The comparison groups were comparable in main clinical characteristics. When analyzing the lipid-lowering effect of inclisiran in the examined patients with ASCVD, LDL-C level significantly decreased from 2,53±0,10 mmol/l to 110±0,08 mmol/l (by 56,5%), p<0,0001, while the target LDL-C level <1,4 mmol/l was achieved by 77,5% of the subjects. Analysis of the lipid-lowering effect of alirocumab/evolocumab showed a significant LDL-C decrease from 2,48±0,16 mmol/l to 1,07±0,11 mmol/l (by 56,8%), p<0,0001.Conclusion. The use of PCSK9 targeted therapy (alirocumab or inclisiran or evolocumab) in patients with ASCVD in Moscow make it possible to achieve target LDL-C levels, which are indicated in clinical guidelines, by 3 months.
{"title":"Observational study of inclisiran effectiveness in Moscow healthcare","authors":"A. Sapina, Y. Y. Varlamova, M. G. Papyrina, A. S. Bezymyannyy, E. Y. Vasilyeva","doi":"10.15829/1560-4071-2023-5687","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5687","url":null,"abstract":"Aim. To evaluate the effectiveness of PCSK9 inhibitors (alirocumab, inclisiran and evolocumab) in patients with atherosclerotic cardiovascular disease (ASCVD) and failure to achieve the target low-density lipoprotein cholesterol (LDL-C) level for the period from November 21, 2022 to December 31, 2023.Material and methods. For the observational study, 50 patients were included in the inclisiran therapy group and 30 patients in the control group (patients with ASCVD receiving PCSK9 inhibitors (alirocumab, n=1; evolocumab, n=29)). All study participants had their anamnestic data analyzed, and initially underwent electrocardiography, echocardiography, extracranial and lower limb Doppler ultrasound, and laboratory tests (complete blood count, biochemical blood tests, lipid profile). Three medical organizations of the Moscow State Healthcare System participate in the study.Results. Interim data are presented to evaluate the effectiveness of PCSK9 targeted therapy in patients with ASCVD, obtained 3 months from the study start. The comparison groups were comparable in main clinical characteristics. When analyzing the lipid-lowering effect of inclisiran in the examined patients with ASCVD, LDL-C level significantly decreased from 2,53±0,10 mmol/l to 110±0,08 mmol/l (by 56,5%), p<0,0001, while the target LDL-C level <1,4 mmol/l was achieved by 77,5% of the subjects. Analysis of the lipid-lowering effect of alirocumab/evolocumab showed a significant LDL-C decrease from 2,48±0,16 mmol/l to 1,07±0,11 mmol/l (by 56,8%), p<0,0001.Conclusion. The use of PCSK9 targeted therapy (alirocumab or inclisiran or evolocumab) in patients with ASCVD in Moscow make it possible to achieve target LDL-C levels, which are indicated in clinical guidelines, by 3 months.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"68 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957124","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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