Dynamics of clinical picture, morphofunctional parameters of myocardium and adherence to treatment at conservative and surgical treatment of chronic ischemic heart disease
Abstract
The aim of this study was to compare the dynamics of the clinical picture, morphofunctional parameters of the myocardium and adherence to treatment against the background of optimal medical therapy (OMT), including drugs that improve the prognosis, and percutaneous coronary intervention (PCI) in combination with OMT in patients with stable coronary heart disease during prospective observation. The study included 125 men aged 50-75 years. The main group (PCI with stenting + OMT) consisted of 78 people aged 61.5 ± 8.5 years; the comparison group (OMT) consisted of 47 people aged 63.5 ± 7.1 years. By age and frequency of the main cardiovascular risk factors patients did not differ significantly. Patients of both groups with a frequency of more than 90% had arterial hypertension (AH) with a history of 10.3 ± 2.5 years. Also patients of both groups did not differ significantly in functional class of angina pectoris, duration of ischemic history, frequency of myocardial infarction and functional class of chronic heart failure. After a year of observation there were no significant differences in the dynamics of morphometric and functional parameters of myocardium in both groups against the background of the treatment. The main reason for low treatment adherence was the lack of understanding of the need for taking medications (primarily statins) with good health.
About the Authors
D. A. Yakhontov
Novosibirsk State Medical University
Russian Federation
Russian Federation
Yakhontov Davyd Aleksandrovich — Dr. Sci. (Med.), Professor of the Department of Pharmacology, Clinical Pharmacology and Evidence-Based Medicine
A. V. Zvonkova
Novosibirsk State Medical University; Regional Clinical Cardiological Dispensary
Russian Federation
Russian Federation
Zvonkova Anastasiya Vladimirovna — Post-graduate Student of the Therapy, Hematology and Transfusiology Department, NSMU; Cardiologist of the Outpatient Department, NRCCD.
52, Krasny Prospect, Novosibirsk, 630091
References
1. Kannel W.B., Feinleib M. (1972). Natural history of angina pectoris in the Framingham study. Prognosis and survival. Am. J. Cardiol., 29, 154-163.
2. Murabito J.M., Evans J.C., Larson M.G., Levy D. (1993). Prognosis after the onset of coronary heart disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation. Circulation, 88, 2548-2555.
3. Rosengren A., Wilhelmsen L., Hagman M., Wedel H. (1998). Natural history of myocardial infarction and angina pectoris in a general population sample of middle-aged men: a 16-year follow-up of the Primary Prevention Study, Goteborg, Sweden. J. Intern. Med., 244, 495-505.
4. Health Care in Russia. 2017: Statistics Digest (2017). Moscow, 170 p. In Russ.
5. Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients (2002). BMJ, 324, 71-86.
6. Braunwald E., Domanski M.J., Fowler S.E. et al. Angiotensin-converting-enzyme inhibition in stable coronary artery disease (2004). N. Engl. J. Med., 351, 2058-2068.
7. Fox K.M. (2003). Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomized, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet, 362, 782-788.
8. Guidelines on the management of stable angina pectoris: executive-summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology (2006). Eur. Heart J., 27, 1341-1381.
9. Nissen S.E., Tuzcu E.M., Libby P. et al. (2004). Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA, 292, 2217-2225.
10. Patrono C. (1986). Aspirin for the prevention of coronary thrombosis: current facts and perspectives. Eur. Heart J., 7, 454-459.
11. Patrono C., Bachmann F., Baigent C. et al. (2004). Expert consensus document on the use of antiplatelet agents. The task force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European society of cardiology. Eur. Heart J., 25, 166-181.
12. Ridker P.M., Manson J.E., Gaziano J.M., Buring J.E., Hennekens C.H. (1991). Low-dose aspirin therapy for chronic stable angina. A randomized, placebo-controlled clinical trial. Ann. Intern. Med., 1114, 835839.
13. Yusuf S., Sleight P., Pogue J. et al. (2000). Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. Heart Outcomes Prevention Evaluation Study Investigators. N. Engl. J. Med., 342, 145-153.
14. European guidelines on cardiovascular disease prevention in clinical practice (2007). Eur. J. Cardio-vasc. Prev. Rehabil., 2, E1-40.
15. Kovacic J.C., Castellano J.M., Fuster V. (2012). The links between complex coronary disease, cerebrovascular disease, and degenerative brain disease. Ann. NY Acad. Sci., 1254, 99-105. doi: 10.1111/j.1749-6632.2012.06482.x.
16. O’Donnell M., Teo K., Gao P. et al. (2012). Cognitive impairment and risk of cardiovascular events and mortality. Eur. Heart J., 33, 1777-1786. doi: 10.1093/ eurheartj/ehs053.
17. Bogolepova A.N., Semushkina E.G. (2011). The role of cardiovascular pathology in appearing and progression of cognitive disorders. Neurological J., 16 (4), 27-31.
18. Trubnikova O.A., Kagan E.S., Kupriyanova T.V. et al. (2017). Neuropsychological status of patients with stable coronary artery disease and factors affecting it. Complex Issues of Cardiovascular Diseases, 6 (1), 112-121. In Russ.
19. Boden W.E., O’Rourke R.A., Teo K.K. et al. (2007). The evolving pattern of symptomatic coronary artery disease in the United States and Canada: baseline characteristics of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial. Am. J. Cardiol., 99, 208212.
20. Frye R.L., August P., Brooks M.M. et al. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARY 2D) study group. A randomized trial of therapies for type 2 diabetes and coronary artery disease (2009). N. Engl. J. Med., 360, 2503—2515.
21. Soboleva G.N., Karpov Yu.A. (2013). Recommendations of the European Society of Cardiology on stable chronic heart disease 2013: microvascular angina. Russ. Med. J. Cardiology, 27, 1284. In Russ.
22. Morisky D.E., Green L.W., Levine D.M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Med. Care, 24, 67-74.
Review
For citations:
Yakhontov D.A., Zvonkova A.V. Dynamics of clinical picture, morphofunctional parameters of myocardium and adherence to treatment at conservative and surgical treatment of chronic ischemic heart disease. Journal of Siberian Medical Sciences. 2019;(3):52-62.
Views:
194
Email this article 