Markers of early cardiotoxicity in patients with breast cancer undergoing chemotherapy depending on blood pressure level

Objective. To study the possibility of the 2D Speckle Tracking Imaging in early detection of cardiotoxicity in patients with triple negative breast cancer and arterial hypertension (AH) during anthracycline-containing chemotherapy. Materials and methods. 70 women (mean age 48.6±13.3 years) with triple negative breast cancer were enrolled. All patients underwent chemotherapy, including anthracycline, taxan, platinum-based agent. Echocardiography, including 2D Speckle Tracking Imaging, was performed on Vivid-E 9 ultrasound machine before and after 8 weeks of chemotherapy. Left ventricular ejection fraction (LVEF) (the biplane Simpson`s method) and global longitudinal strain (GLS) (mean normal GLS of -22.1±1.8 for women) were analysed. Patients were divided into two groups: group 1 - with AH (n=18) and group 2 - with normal blood pressure (n=52). Results. Before chemotherapy in group 1 GLS was lower than normal value (-19.1±2.8% vs -22.1±1.8%; p0.05). After chemotherapy in all patients GLS decrease was observed from -20.0±2.8% to -18.5±2.9% (

Медицинская помощь больным острым коронарным синдромом в 2018 году: данные федерального регистра

Aim. To evaluate the quality of reperfusion, medical therapy, as well as the short-term outcomes in patients with acute coronary syndrome (ACS) in 2018 using the data of the national ACS registry.Methods. Medical records of 30,594 ACS patients (62% - men, the mean age of 65±11,2 years) treated in 30 regions of the Russian Federation in 2018 were selected in the National ACS Registry and analyzed. The rate and timing of percutaneous coronary intervention (PCI) and fibrinolysis, prescription of aspirin, clopidogrel, beta-blockers, statins, and in-hospital mortality rate were assessed.Results. Fibrinolysis was performed in 29.9% of patients with ST-segment elevation acute coronary syndrome. 54,3% of patients with ST-segment elevation ACS underwent PCI. 47.7% and 60.5% of patients were treated within 30 minutes of first medical contact to fibrinolysis and 90 minutes to primary PCI. 95.6% of patients received aspirin, 84.9% - clopidogrel, 88.8% - beta-blockers, and 93.4% - statins. The inhospital mortality was 2.9%.Conclusion. The main clinical performance and quality measures for medical therapy in 2018 were high according to the National ACS Registry. PCI prevailed among the selected reperfusion strategies. However, the timing of both, PCI and fibrinolysis, was insufficient.Цель. Оценить качество мероприятий по реперфузии миокарда, медикаментозной терапии, а также краткосрочные исходы лечения у больных острым коронарным синдромом (ОКС) по данным Федерального регистра за 2018 г.Материалы и методы. Проанализированы данные 30 594 пациентов (62% мужчин, средний возраст 65±11,2 года) из 30 регионов Российской Федерации, полученные из Федерального регистра ОКС за 2018 г. Оценены частота и своевременность чрескожных коронарных вмешательств (ЧКВ) и тромболизиса, назначение аспирина, клопи-догрела, бета-блокаторов, статинов, уровень госпитальной летальности.Результаты. Тромболитические препараты назначали 29,9% пациентов с ОКС с подъемом сегмента ST, ЧКВ выполнено 54,3% больных ОКС с подъемом сегмента ST. Тромболизис выполнен в течение 30 мин 47,7% больных, ЧКВ в течение 90 мин - 60,5% пациентов. Характеристики медикаментозного лечения: аспирин назначали 95,6% больных, клопидогрел - 84,9%, в—блокаторы - 88,8%, статины - 93,4% пациентов с ОКС, включенных в Федеральный регистр. Госпитальная летальность составила 2,9%.Заключение. По данным Федерального регистра больных ОКС в 2018 г. отмечено высокое качество основных мероприятий медикаментозной терапии. Мероприятия по реперфузии миокарда характеризуются преобладанием ЧКВ. Своевременность выполнения реваскуляризации миокарда (как тромболизиса, так и ЧКВ) недостаточная

ARTERIAL HYPERTENSION AMONG INDIVIDUALS OF 25–64 YEARS OLD: PREVALENCE, AWARENESS, TREATMENT AND CONTROL. BY THE DATA FROM ECCD

Aim. To study prevalence of arterial hypertension (AH), mean values of systolic and diastolic blood pressure (SBP, DBP), awareness of patients about their disease, medication consumption (MC) and efficacy of treatment in several regions of Russia.Material and methods. Representative selections were made in 9 regions of Russia: men (n=5563), women (n=9737) of 25–64 y.o., studied in 2012–2013 with the response 80%. Systematic stratified multilevel random selection was formed with localilty criteria (Kisch method). The Questionnaire on the presence of AH included: awareness of the patient about his disease, drug intake. BP measurement was performed on the right arm by automatic tonometer Omron in sitting position after 5 minutes resting. The mean value of two measurements was used. BP defined as SBP ≥140 mmHg, DBP ≥90 mmHg, or if the patient had taken antihypertensive therapy. Efficacy of treatment — the part of patients (in %) who reached target BP. Control group — part of patients (in %) with BP <140/90 mmHg. Statistic data calculation was done with computer-based statistic software — SAS with standardising by age stratification of Europe.Results. Mean SBP and DBP were 130,7±0,1 mmHg and 81,6±0,1 mmHg respectively. Prevalence of AH — 44%, higher in men (p<0,001). Prevalence of AH was higher in rural area citizens in men — 51,8% vs 47,5% (р<0,02) and in women — 42,9% vs 40,2% (р<0,05). Awareness was 67,5% in men, 78,9% in women. Medications were taken by 60,9% of women and 39,5% of men. Effectively treated were 53,5% of women and 41,4% of men. With the age the part of effectively treated decreases (p<0,0005). BP is under control only in 1/3 of women and 14,4% of men.Conclusion. The role of AH as one of the main modifiable risk factors of cardiovascular diseases is proved, however it is depressing that the percent of controlled AH is low. BP control is the main task of outpatient surveillance at every local outpatient department, where now less than a half of those affected are being observed

Life quality of the Russian population by the data from ESSE-RF study

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness.Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study.Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)).Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p<0,05). Wealth level negatively associated with LQ. Most common (p<0,0005) were disorders by the components pain/discomfort and anxiety/depression. Part of those with lower LQ among males is lesser than in females, by all 5 factors of the LQ, and in all educational states. Regional specifics of LQ by EQ-5D index: from 0,82 in Vladikcaucas to 0,95 in Orenburg (p<0,0005). There was significant correlation of EQ-5D index with unemployment level (0,4) and consumer prices index (0,29) in regions.Conclusion. Monitoring of LQ is necessary condition for assessment of efficacy of population health improvement interventions, and the LQ values obtained will be useful as populational norms for health condition assessment in addition to morbidity and mortality factors