18 research outputs found
Use of pharmacoinvasive approach to the treatment of patients with ST segment elevation acute coronary syndrome: state of the problem
Role of pharmacoinvasive tactics in the treatment of patients with ST-segment elevation acute myocardial infarction is considered. The expert opinions reflected in the final versionΒ of the guideline are given, as well as the results of clinical trials in which the efficacy of thrombolytic therapy at early stage after acute myocardial infarction onset comparedwith primary percutaneous coronary intervention. The place of pharmacoinvasive tactics in real clinical practice is discussed
Therapeutic Options for the Single Pill Combination of Lisinopril, Amlodipine and Rosuvastatin: a Systematic Review
Aim. To evaluate the effect of taking a single pill combination of amlodipine, lisinopril and rosuvastatin on blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) in hypertensive patients with or without severe hypercholesterolemia.Material and methods. Articles published in Russian were selected for analysis. Six articles that met the criteria for inclusion in a systematic review were found by searching the eLibrary database for the keyword "equamer". The results of 5 observational clinical studies were presented in these articles. The effectiveness of the fixed combination of amlodipine, lisinopril and rosuvastatin was assessed mainly by changes in the level of systolic and diastolic blood pressure, the concentration of LDL cholesterol. In addition, the effects of fixed-dose amlodipine, lisinopril, and rosuvastatin on central aortic pressure and its increment index, as well as carotid-femoral pulse wave velocity, were studied in part of the studies. The effect of the fixed combination of amlodipine, lisinopril and rosuvastatin on blood pressure and LDL-C concentration, as well as on these additional indicators, in patients who had a coronavirus infection with severe lung damage was studied in one study.Results. Evidence from a systematic review demonstrates the efficacy of single pill combination amlodipine, lisinopril and rosuvastatin in reducing blood pressure and LDL-C in a wide range of patients with different baseline risk of developing cardiovascular complications and different baseline levels of blood pressure and LDL-C.Conclusion. The data obtained confirm the feasibility of more frequent prescription of the single pill combination of amlodipine, lisinopril and rosuvastatin in clinical practice for the treatment of hypertensive patients with high or moderate risk of developing cardiovascular diseases, including patients with concomitant hypercholesterolemia
ΠΠ½Π΅ΠΌΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ Ρ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ: ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ
The article reports the modern tactics of treating patients with chronic heart failure and concomitant anemia. The results of the most important randomized clinical trials that are the basis for developing approaches to the treatment of anemia in such cases are discussed. Attention is also paid to unresolved problems in the treatment of anemia in patients with heart failure. The data on the intravenous administration of iron preparations as the most effective approach to the treatment of anemia in patients with heart failure in the presence of iron defciency are given. The main provisions of modern clinical guidelines on the management of patients with heart failure and anemia are considered.Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Π° ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ ΡΠ°ΠΊΡΠΈΠΊΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ ΠΈ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠ΅ΠΉ Π°Π½Π΅ΠΌΠΈΠ΅ΠΉ. ΠΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²Π°ΠΆΠ½ΡΡ
ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΊΠΎΡΠΎΡΡΠ΅ ΡΡΠ°Π»ΠΈ ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π»Ρ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ² ΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°Π½Π΅ΠΌΠΈΠΈ Π² ΡΠ°ΠΊΠΈΡ
ΡΠ»ΡΡΠ°ΡΡ
. Π£Π΄Π΅Π»ΡΠ΅ΡΡΡ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΈ Π½Π΅ΡΠ΅ΡΠ΅Π½Π½ΡΠΌ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°Π½Π΅ΠΌΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ (Π‘Π). ΠΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π²Π½ΡΡΡΠΈΠ²Π΅Π½Π½ΠΎΠΌ Π²Π²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΆΠ΅Π»Π΅Π·Π° ΠΊΠ°ΠΊ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π΅ ΠΊ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°Π½Π΅ΠΌΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Π΄Π΅ΡΠΈΡΠΈΡΠ° ΠΆΠ΅Π»Π΅Π·Π°. Π Π°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΡΠ°ΠΊΡΠΈΠΊΠ΅ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π‘Π ΠΈ Π°Π½Π΅ΠΌΠΈΠ΅ΠΉ
Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠΎΠ΄Ρ ΠΎΠ΄Ρ ΠΊ Π²ΡΠ±ΠΎΡΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠΎΡΠΌΡ Π°ΡΠ΅ΡΠΈΠ»ΡΠ°Π»ΠΈΡΠΈΠ»ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ Π² ΠΊΠ°ΡΠ΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ
The article is devoted to modern approaches to the selection of optimal dosage forms of acetylsalicylic acid (ASA), which ensure high bioavailability of ASA drugs. The relevance of improving the tactics of ASA use for both primary and secondary prevention of cardiovascular diseases is discussed. Changes in the role of ASA in the prevention of cardiovascular disease complications are discussed, including as part of combined antithrombotic therapy, including ASA and either P2Y12 inhibitor or low-dose rivaroxaban. Evidence is presented that has led to doubts about the sufficient bioavailability of the enteric form of ASA, as well as the predictability of the response to therapy. A separate part of the article is devoted to the safety of different forms of ASA, in particular - the effect on the mucosa of the small intestine. The results of clinical studies evaluating the effect of ASA intake in enteric-soluble and buffered forms on the small intestinal mucosa and the risk of bleeding are presented. In addition, the problem of decreased effectiveness of ASA intake in overweight or obese individuals is considered. The article provides information on ongoing randomized trials to assess the effectiveness of increasing the frequency of ASA intake, as well as the effectiveness of chronopharmacological approaches to optimize the use of ASA. The analysis performed leads it to conclude that the buffer form can now be considered the preferred acetylsalicylic acid (ASA) dosage form, which, on the one hand, exerts a less pronounced effect on the gastric and small intestinal mucosa, and on the other hand, ensures high bioavailability, as well as minimal variability of treatment response.Π‘ΡΠ°ΡΡΡ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π° ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΌ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°ΠΌ ΠΊ Π²ΡΠ±ΠΎΡΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΠΎΡΠΌ Π°ΡΠ΅ΡΠΈΠ»ΡΠ°Π»ΠΈΡΠΈΠ»ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ (ΠΠ‘Π), ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°ΡΡ Π²ΡΡΠΎΠΊΡΡ Π±ΠΈΠΎΠ΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΠ‘Π. Π Π°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°ΠΊΡΠΈΠΊΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΠ‘Π Ρ ΡΠ΅Π»ΡΡ ΠΊΠ°ΠΊ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ, ΡΠ°ΠΊ ΠΈ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. ΠΠ±ΡΡΠΆΠ΄Π°Π΅ΡΡΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠΎΠ»ΠΈ ΠΠ‘Π Π² ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π² Ρ. Ρ. Π² ΡΠΎΡΡΠ°Π²Π΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ, Π²ΠΊΠ»ΡΡΠ°ΡΡΠ΅ΠΉ ΠΠ‘Π, Π° ΡΠ°ΠΊΠΆΠ΅ Π»ΠΈΠ±ΠΎ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡ P2Y12, Π»ΠΈΠ±ΠΎ Π½ΠΈΠ·ΠΊΡΡ Π΄ΠΎΠ·Ρ ΡΠΈΠ²Π°ΡΠΎΠΊΡΠ°Π±Π°Π½Π°. ΠΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ Π΄ΠΎΠΊΠ°Π·Π°Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅, ΠΊΠΎΡΠΎΡΡΠ΅ ΡΡΠ°Π»ΠΈ ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π»Ρ ΡΠΎΠΌΠ½Π΅Π½ΠΈΠΉ Π² Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ Π±ΠΈΠΎΠ΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΠΈ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΡΠ°ΡΡΠ²ΠΎΡΠΈΠΌΠΎΠΉ ΡΠΎΡΠΌΡ ΠΠ‘Π, Π° ΡΠ°ΠΊΠΆΠ΅ Π² ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·ΡΠ΅ΠΌΠΎΡΡΠΈ ΠΎΡΠ²Π΅ΡΠ½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡ. ΠΡΠ΄Π΅Π»ΡΠ½Π°Ρ ΡΠ°ΡΡΡ ΡΡΠ°ΡΡΠΈ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π° Π²ΠΎΠΏΡΠΎΡΠ°ΠΌ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌ ΠΠ‘Π, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ β Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° ΡΠ»ΠΈΠ·ΠΈΡΡΡΡ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΡ ΡΠΎΠ½ΠΊΠΎΠ³ΠΎ ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°. ΠΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π² Ρ
ΠΎΠ΄Π΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΊΠΎΡΠΎΡΡΡ
ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΏΡΠΈΠ΅ΠΌΠ° ΠΠ‘Π Π² ΠΊΠΈΡΠ΅ΡΠ½ΠΎΡΠ°ΡΡΠ²ΠΎΡΠΈΠΌΠΎΠΉ ΠΈ Π±ΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΌΠ΅ Π½Π° ΡΠ»ΠΈΠ·ΠΈΡΡΡΡ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΡ ΡΠΎΠ½ΠΊΠΎΠ³ΠΎ ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ. ΠΡΠΎΠΌΠ΅ ΡΠΎΠ³ΠΎ, ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΈΠ΅ΠΌΠ° ΠΠ‘Π Ρ Π»ΠΈΡ Ρ ΠΈΠ·Π±ΡΡΠΎΡΠ½ΠΎΠΉ ΠΌΠ°ΡΡΠΎΠΉ ΡΠ΅Π»Π° ΠΈΠ»ΠΈ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΠΎΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΎ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ°ΡΡΠΈΡ
ΡΡ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΏΠΎ ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΊΡΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠ΅ΠΌΠ° ΠΠ‘Π, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Ρ
ΡΠΎΠ½ΠΎΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ² ΠΊ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΠ‘Π. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π΄Π΅Π»Π°Π΅ΡΡΡ Π²ΡΠ²ΠΎΠ΄ ΠΎ ΡΠΎΠΌ, ΡΡΠΎ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠΎΡΠΌΠΎΠΉ ΠΠ‘Π ΠΌΠΎΠΆΠ½ΠΎ ΡΡΠΈΡΠ°ΡΡ Π±ΡΡΠ΅ΡΠ½ΡΡ ΡΠΎΡΠΌΡ, ΠΊΠΎΡΠΎΡΠ°Ρ, Ρ ΠΎΠ΄Π½ΠΎΠΉ ΡΡΠΎΡΠΎΠ½Ρ, ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ ΠΌΠ΅Π½Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π° ΡΠ»ΠΈΠ·ΠΈΡΡΡΡ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΡ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈ ΡΠΎΠ½ΠΊΠΎΠ³ΠΎ ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°, Π° Ρ Π΄ΡΡΠ³ΠΎΠΉ β ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ Π²ΡΡΠΎΠΊΡΡ Π±ΠΈΠΎΠ΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΌΠΈΠ½ΠΈΠΌΠ°Π»ΡΠ½ΡΡ Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΡΠ²Π΅ΡΠ½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅
Modern strategy of treating patients with coronary artery disease: complementarity principle in therapy and new ideas about its role and components
The article discusses modern ideas about the role of mechanical revascularization and anti-ischemicΒ therapyΒ in the treatment of patientsΒ with stableΒ coronary heart disease (CAD). ModernΒ dataΒ on theΒ comparativeΒ effectivenessΒ of anti-ischemic drugsΒ areΒ presented, which became the basisΒ for the developmentΒ ofΒ βdiamond approachβΒ in the treatment of stable CAD. It is proposed instead of standard tactics using a hierarchical approach to the choice of anti-ischemic drugs. The featuresΒ of the anti-ischemicΒ drugs use in certain clinical situations, in patientsΒ with the most common comorbidities or complicationsΒ of CAD, as well as in CAD variants, in the developmentΒ of which specific pathophysiological elementsΒ play a role, are considered
ROLE OF POWERFUL STATINS IN MODERN TREATMENT OF PATIENTS WITH A HIGH RISK OF COMPLICATIONS ARISING FROM ATHEROSCLEROSIS
The article discusses modern approaches to the treatment of atherogenic patients, provides data on the effectiveness of new hypolipidemic drugs and discusses the role of intensive statin use regimes at the modern stage of the lipid-lowering therapy. Evidence is provided on the effectiveness of the use of rosuvastatin to reduce blodo LDL-cholesterol and to reduce the risk of cardiovascular disease complications caused by atherosclerosis
INTEGRATION OF BIOMARKERS INTO THE PRACTICE OF TREATING PATIENTS WITH HEART FAILURE: THE ROLE OF DETERMINING THE BLOOD LEVEL OF NATRIURETIC PEPTIDES
A clinical role of biomarkers (especially, natriuretic peptides) is discussed in the article. The most important evidences of clinical effectiveness of using biomarkers in patients with suspected heart failure and in patients with confirmed diagnose of heart failure are reviewed. The need to use natriuretic peptides in patients with takotsubo syndrome is discussed. Limited diagnostic value of using natriuretic peptides in renal dysfunction, as well as in other diseases in which the concentration of natriuretic peptides may increase in the absence of heart failure, is also discussed
INNOVATIVE TECHNOLOGIES IN CARDIOLOGY: FROM SURPRISE TO HABIT OR FORGETFULNESS
Change of the status of innovative technologies depending on the received evidences is considered. Examples reflecting the initiation of interest in the new technology of treatment, the transition from innovation to standard therapies, as well as the weakening of interest in the previously introduced technology due to disappointing results of clinical trials on evaluation of its effectiveness are presented.</p
THERAPEUTIC EFFECT ON HEART RATE: VISIBLE SIMPLICITY AND REAL DIFFICULTY
The article provides discussion of the clinical importance of the increased heart rate in healthy persons and in cardiovascularΒ disease affected patients. Results of large randomized studies devoted to evaluation of ivabradine effect evaluation in patientsΒ with coronary heart disease and chronic cardiac insufficiency, as well as study results. Results of analysis evidencing positiveΒ effect of heart rate reduction due to ivabradine use on the left ventricle remodeling are discussed. Data are provided that mightΒ confirm justification of the early addition of ivabradine to Ξ²-adrenergic blocking agents at the stationary stage of the patientsΒ therapy who were hospitalized due to cardiac insufficiency aggravation
Anemia in Patients with Heart Failure: Current State of the Problem
The article reports the modern tactics of treating patients with chronic heart failure and concomitant anemia. The results of the most important randomized clinical trials that are the basis for developing approaches to the treatment of anemia in such cases are discussed. Attention is also paid to unresolved problems in the treatment of anemia in patients with heart failure. The data on the intravenous administration of iron preparations as the most effective approach to the treatment of anemia in patients with heart failure in the presence of iron defciency are given. The main provisions of modern clinical guidelines on the management of patients with heart failure and anemia are considered