Cardiovascular Therapy and Prevention

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ISSN / EISSN : 1728-8800 / 2619-0125
Published by: Silicea - Poligraf, LLC (10.15829)
Total articles ≅ 1,255
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, Н. А. Араблинский, S. A. Mironov, M. A. Umetov, , ,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3306

Abstract:
The review presents up-to-date information on the physiological and pathophysiological aspects of short-term middle-altitude adaptation in healthy individuals and patients with various chronic diseases. Unlike acute mountain sickness, which develops going to ≥3000, the physiological aspects of human adaptation to 2000-2500 m remain insufficiently studied. However, these altitudes are the most visited among tourist groups and individually.
, А. В. Загребельный, M. I. Chernysheva, , , , O. V. Lerman, Yu. V. Lukina, S. V. Blagodatskikh, , et al.
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3288

Abstract:
Aim. To study two-year survival and factors affecting it in patients with cerebrovascular accident (CVA) with prior coronary artery disease (CAD).Material and methods. The outpatient stage of the REGION-M registry included 684 patients assigned to the Moscow City Polyclinic № 64, discharged from the F.I. Inozemtsev City Clinical Hospital in the period from January 1, 2012 to April 30, 2017 with a verified diagnosis of stroke or transient ischemic attack. Of these, 423 (61,8%) patients had a diagnosis of CAD in the outpatient records.Results. Patients with CAD were significantly older, more often had comorbidities, disability, and were monitored in the polyclinic before the stroke and after hospital discharge than patients without CAD. During the follow-up period, mortality among patients with CAD (34,3%) was significantly higher than without CAD (19,9%) (p< 0,01), At the same time, mortality in CAD was 2,6 times lower among patients who applied to the polyclinic at least once after discharge (28%) than those who never applied after discharge — 72,9% (p< 0,001), Multivariate analysis confirmed this positive effect (relative risk, 0,998; confidence interval: 0,983-0,992, p< 0,0001).Conclusion. Mortality in patients with stroke and CAD was significantly higher than in those without CAD, while it was significantly lower among patients monitored in the polyclinic in the post-hospital period of stroke.
D. V. Pevsner, Yu. K. Rytova, И. А. Меркулова, E. V. Merkulov
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3353

Abstract:
Aim. To evaluate the efficacy and safety of various antithrombotic regimens after left atrial appendage occlusion (LAAO) in real clinical practice.Material and methods. This prospective observational study included 90 patients with nonvalvular atrial fibrillation and a high risk of ischemic stroke/systemic embolism who underwent endovascular LAAO using the Watchman device. The primary endpoint was the cumulative incidence of ischemic stroke/transient ischemic attack/systemic embolism, major and clinically relevant bleeding according to the Global Anticoagulant Registry in the Field-Atrial Fibrillation (GARFIELD) criteria, and all-cause mortality.Results. Patients were divided into subgroups depending on the antithrombotic therapy carried out after LAAO: 1) direct oral anticoagulants (DOACs) ± antiplatelet agents; 2) warfarin ± antiplatelet agents; 3) dual antiplatelet therapy (aspirin + clopidogrel). Multivariate analysis showed a trend toward a lower incidence of the primary endpoint in the DOAC group compared with both warfarin (hazard ratio, 8,49; 95% confidence interval: 2,0-36,15; p=0,004) and antiplatelet agents (hazard ratio, 4,34; 95% confidence interval: 1,08-17,36; p=0,038). At the same time, there were no significant differences in the prevalence of primary endpoint between the warfarin and antiplatelet groups. There was no relationship between device-related thrombosis and postoperative antithrombotic regimen.Conclusion. Endovascular LAAO is an effective and safe alternative to anticoagulant therapy. The present real-world evidence study revealed that the administration of DOACs after LAAO is associated with a greater efficacy and safety profile compared to warfarin and dual antiplatelet therapy.
V. G. Vilkov,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3304

Abstract:
Aim. To study trends in the prevalence of hypertension (HTN), obesity, elevated non-high-density lipoprotein cholesterol (non-HDL cholesterol) levels in Russia and the USA from 1975 to 2014.Material and methods. According to the data of cross-sectional population studies in Russia and the USA in 1975-1982 and 2007-2014, the prevalence of risk factors (RFs) in men and women aged 25-64 was studied. The data of Lipid Research Clinics studies, Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study, as well as data from National Health And Nutrition Examination Survey (NHANES) studies (USA) were used. The total number of persons analyzed was 41268. The proportion of individuals with risk factors and 95% confidence interval were calculated.Results. In the 1980s, the prevalence of studied RFs in Russia and the United States did not differ in most sex and age groups. Over the next 30 years, both populations are characterized by a decrease in the prevalence of HTN and elevated non-HDL cholesterol (≥ 3.7 mmol/l) and an increase in the prevalence of obesity. In 2012, HTN in men and women in Russia occurred more frequently than in the United States. Obesity was less common in men and women 25-44 years old in Russia and in women >54 years old in the USA. The prevalence of non-HDL cholesterol ≥3,7 mmol/l in Russia compared with the United States was higher in people >44 years old and lower in women 25-34 years old.Conclusion. In the 1980s, there were no differences in the prevalence of cardiometabolic risk factors in Russia and the United States. In the 2010s, HTn and partly dyslipidemia were more common in Russia, and the prevalence of obesity in young and middle-aged people was higher in the United States.
, Н. А. Араблинский, S. A. Mironov, M. A. Umetov, , ,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-20223306

Abstract:
The review presents up-to-date information on the physiological and pathophysiological aspects of short-term middle-altitude adaptation in healthy individuals and patients with various chronic diseases. Unlike acute mountain sickness, which develops going to ≥3000, the physiological aspects of human adaptation to 2000-2500 m remain insufficiently studied. However, these altitudes are the most visited among tourist groups and individually.
O. A. Trubnikova, , I. N. Kukhareva, T. B. Temnikova, A. S. Sosnina, I. D. Syrova, D. S. Kupriyanova,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3320

Abstract:
Aim. To evaluate the effectiveness of dual-task computerized cognitive training (CCT) in the prevention of postoperative cognitive dysfunction in patients after on-pump coronary artery bypass grafting (CABG).Material and methods. This cohort prospective study included 68 patients (median age, 64 years [54; 69]) admitted for elective on-pump CABG. In addition to the standard preoperative examination, all patients underwent advanced neuropsychological and neurophysiological examination. Starting from 3-4 days of the postoperative period, all patients underwent dual-task CCT.Results. After 8-10 days, early postoperative cognitive dysfunction was observed in 37 (54,4%) patients from CCT group, while in patients without training in 69,3% of cases (n=79). The best results of cognitive functioning were achieved in neurodynamics and short-term memory. In addition, in patients who completed the training course, a postoperative increase in the frontooccipital gradient of theta rhythm was observed.Conclusion. Neuropsychological and neurophysiological assessment have demonstrated the limited effectiveness of a short-term dual task CCT using in the prevention of early postoperative cognitive dysfunction in patients after on-pump CABG. The dual task method can be an additional preventive intervention in the development of a personalized approach to cognitive rehabilitation therapy in cardiac surgery patients.
E. K. Shavarova, I. A. Khomova, Zh. D. Kobalava, E. I. Kirpichnikova, N. E. Ezhova, E. I. Bazdyreva
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3282

Abstract:
Aim. To evaluate the association of a high normal blood pressure (BP) with the risk of early hypertension-mediated organ damage (HMOD) in young adults.Material and methods. Medical screening of population aged 18-45 years (n=987) revealed that in 173 persons, office BP corresponded to a high normal level or hypertension (HTN). Echocardiography (GE Healthcare Vivid 9, using EchoPAC Software) was performed when HTN was confirmed by office BP measurement and/or according to 24-hour ambulatory BP monitoring (ABPM) (n=127). In addition, creatinine and albumin-to-creatinine ratio in spot urine were measured.Results. The median age was 23 [21; 25] years. The median systolic (SBP) and diastolic BP (DBP) was 129 [121; 137] and 75±12 mm Hg, respectively. The detection rate of LV geometry abnormalities was 3,3 times higher in the high normal BP group [95% CI, 1,06-6,28, p=0,02], and 10,7 times higher in the HTN group [95% CI, 2,32-16,49, p=0,04] compared with the optimal+normal BP group. In a multivariate analysis, the independence of associations with the LV mass index (LVMI) was confirmed only for the mean nighttime DBP, left atrial volume index, and the ratio of LV peak early diastolic velocity to the average septal and lateral peak early diastolic mitral annular velocity.Conclusion. In young people, the prevalance of HMOD is comparable in the groups with high normal BP and HTN, while significant differences were found between the group with optimal+normal BP levels and patients with HTN and high normal BP. An independent association of elevated LVMI with mean nighttime DBP was found.
, E. Yu. Fedorova,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3263

Abstract:
Some national guidelines since 2017 considered the most common method for diagnosing and controlling hypertension (HTN) (office blood pressure (OBP) measurement) as screening only. Automated OBP (AOBP) measurement claims to be a unique method by obtaining a standardized result, even in primary health care. AOBP improves the reliability of data by reducing the influence of various errors on result. However, although the level of AOBP is on average lower than similar OBP in clinical and research practice and is comparable to the mean 24-hour BP monitoring, at present, all international guidelines emphasize the mandatory use of ambulatory BP measurements for diagnostic purposes. Whether the results of AOBP and the reference level ≥130/80 mm Hg are equivalent with the same OBP level, the use of which is associated with an increase in the prevalence of hypertension and insufficient control of antihypertensive therapy, is a question for research. Compared with conventional OBP, the use of AOBP in conjunction with outpatient measurement leads to a reduction in the proportion and timing of initiation of treatment in patients with masked HTN, whose cardiovascular risk is similar to that of patients with stable HTN. However, the widespread implementation of AOBP is hindered by the high cost and lack of accumulated data. The review analyzes in detail the limitations and advantages of various types of BP measurement, as well as the potential of using AOBP in modern clinical and research practice.
I. A. Abdullaev, S. V. Abasova, L. B. Danilchuk, V. A. Shramko, E. V. Sokolova, , , R. V. Kokaya,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3305

Abstract:
Aim. Comparative analysis of inhospital outcomes after open thrombectomy versus conservative in patients with acute lower limb artery thrombosis and coronavirus disease 2019 (COVID-19).Material and methods. In this retrospective, comparative study for the period from April 1, 2020 to December 1, 2021, 167 patients with acute lower limb artery thrombosis and COVID-19 were included. Depending on the treatment strategy, two following groups were formed: group 1 — open thrombectomy (n=136) + drug treatment (anticoagulant (unfractionated heparin) and antiplatelet (acetylsalicylic acid 125 mg 1 time per day) therapy; group 2 — only drug therapy (n=31). This group consisted of patients who refused surgical revascularization. In all cases, a psychiatrist examined for personality disorders that did not allow a critical assessment of their condition and the consequences of refusing surgical treatment. At admission to the hospital, all patients received prophylactic-dose unfractionated heparin (5000 IU 3 times/day). In the development of acute arterial thrombosis, 80 IU/kg (maximum 5000 IU) of unfractionated heparin was administered intravenously, followed by transfer to intravenous infusion at an initial rate of 18 IU/kg per hour with the partial thromboplastin time monitoring. Analgesic and antiplatelet therapy (acetylsalicylic acid 125 mg 1 time/day) was also prescribed.Results. Myocardial infarctions, ischemic strokes were not recorded. There were no significant intergroup differences in mortality rates (group 1: n=52, 38,2%; group 2: n=7, 22,6%; p=0,09; odds ratio (OR)=2,12; 95% confidence interval (CI): 0,85-5,27), limb amputation (group 1: n=63, 46,3%; group 2: n=9, 29,0%; p=0,07; OR=2,11; 95% CI: 0,9-4,91). However, there was a trend towards a decrease in the frequency of these events in the conservative therapy group. After open thrombectomy, retrombosis developed in 50,7% (n=69) of cases, whilethrombosis after retrombectomy followed by amputation — in 46,3% (n=63). There were no hemorrhagic complications in both groups.Conclusion. Open thrombectomy with concomitant medical therapy and single conservative therapy without surgical revascularization in the present study showed comparable rates of death and lower limb amputations in patients with COVID-19.
, A. I. Ershova, , N. M. Akhmedzhanov, , K. A. Guseinova, , O. A. Litinskaya, ,
CARDIOVASCULAR THERAPY AND PREVENTION, Volume 21; https://doi.org/10.15829/1728-8800-2022-3369

Abstract:
Aim. To monitor the scope and effectiveness of lipid-lowering therapy (LLT) in the out- and inpatient settings among people hospitalized at the National Medical Research Center for Therapy and Preventive Medicine.Material and methods. Retrospective analysis of randomly selected case records for April-May 2012, 2015 and 2022 (n=658).Results. From 2012 to 2022, the proportion of outpatients taking statins increased as follows: from 28,8 to 60,4% (from 22,2 to 73,3% for high cardiovascular risk (CVR) and from 34,8 to 91,7% for very high CVR). Patients with very high CVR were significantly more likely to be prescribed high-intensity statin therapy (from 3,8 to 45,8%). Inpatients with high CVR were prescribed statins less often (74,3%) than patients with very high CVR (93,6%). In 2022, compared to 2015, the proportion of inpatients who received combined LLT increased as follows — 8,9 vs 0,5% (p< 0,001). Target low-density lipoprotein cholesterol <1,4 mmol/l in 2022 was achieved in 18,2 and 13,6% of outpatients with high and very high CVR, respectively.Conclusion. Despite increase in the frequency of prescribing and the intensity of statin therapy, by 2022 there remains a large proportion of patients with high and very high CVR who do not receive adequate LLT, which allows them to achieve the target low-density lipoprotein cholesterol. It is important to note that modern LLT provides great opportunities for the implementation of clinical guidelines in practice.
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