Dual antiplatelet therapy (DAPT) using of acetylsalicylic acid and antagonists of platelet’s P2Y12 receptors is included in standards for treatment of patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Clopidogrel, prasugrel, and ticagrelor are the P2Y12 receptor inhibitors used as a component of DAPT. The aim of this review is to determine the most effective and the safest P2Y12 receptor inhibitor for treating patients with an invasive treatment strategy of ACS. The TRITON study compared clopidogrel and pragugrel efficacy and safety had demonstrated a significantly higher efficiency in reducing the risk of reaching the primary endpoint (including cardiovascular death, myocardial infarction and stroke) for prasugrel, but at the same time, the prasugrel group was reliably recorded higher rate of major bleeding. Comparison of the efficacy and safety of clopidogrel and ticagrelor was carried out in the PLATO study, where ticagrelor was shown to be more effective in reducing cardiovascular deaths and myocardial infarction, while the safety of the drugs was comparable. A subsequent ISAR-REACT 5 study proved higher efficacy of prasugrel compared to ticagrelor in reducing the risk of reaching a primary endpoint with comparable safety to the major bleeding risk. Baseline data represents that the most effective drug among P2Y12 receptor inhibitors as a component of DAPT for patients with an invasive treatment strategy is prasugrel, and the safest is clopidogrel, which can be considered in elderly patients.
Ankylosing spondylitis causes morphological or functional damage to the cardiovascular system in 22% of cases. Using modern methods of heart function research, such as Holter ECG monitoring, it is possible to detect rhythm and conduction disorders, long QT syndrome. Changes in the parameters of the QT interval, such as its duration and variance, can be considered as a predictor of the development of cardiovascular catastrophes and fatal arrhythmias. The article analyzes the values of QT/RR and QTc during Holter ECG monitoring in 92 patients diagnosed with Ankylosing spondylitis, depending on the stage of the disease, the activity of the pathological process, and seropositivity for HLA B27. There was a significant increase in QT/RR and QTc during the active and passive periods of Holter ECG monitoring in comparison with the control group. In patients with ankylosing spondylitis, ventricular arrhythmias were detected, which are associated with prolongation of the QT interval. Standardized Holter ECG monitoring in patients with Ankylosing spondylitis, taking into account the daily variance of the QT interval, can become a universal, minimally invasive and low-cost method for assessing the risk of cardiovascular disorders in patients with Ankylosing spondylitis.
Dual antiplatelet therapy (DAPT) using of acetylsalicylic acid and antagonists of platelet’s P2Y12 receptors is included in standards for treatment of patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Clopidogrel, prasugrel, and ticagrelor are the P2Y12 receptor inhibitors used as a component of DAPT. The aim of this review is to determine the most effective and the safest P2Y12 receptor inhibitor for treating patients with an invasive treatment strategy of ACS. The TRITON study compared clopidogrel and pragugrel efficacy and safety had demonstrated a significantly higher efficiency in reducing the risk of reaching the primary endpoint (including cardiovascular death, myocardial infarction and stroke) for prasugrel, but at the same time, the prasugrel group was reliably recorded higher rate of major bleeding. Comparison of the efficacy and safety of clopidogrel and ticagrelor was carried out in the PLATO study, where ticagrelor was shown to be more effective in reducing cardiovascular deaths and myocardial infarction, while the safety of the drugs was comparable. A subsequent ISAR-REACT 5 study proved higher efficacy of prasugrel compared to ticagrelor in reducing the risk of reaching a primary endpoint with comparable safety to the major bleeding risk. Baseline data represents that the most effective drug among P2Y12 receptor inhibitors as a component of DAPT for patients with an invasive treatment strategy is prasugrel, and the safest is clopidogrel, which can be considered in elderly patients.
Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was voluntary without restrictions on sex. All participants were over 18 years of age. During the screening, blood pressure (BP) was measured three times using automatic and mechanical BP monitors. In addition, a questionnaire was filled out on behavioral risk factors, comorbidities and therapy. HTN was diagnosed with systolic BP ≥140 mmHg and/ or diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. The questionnaire included questions about prior COVID-19, vaccinations and their impact on the intake of antihypertensive drugs.Results. The analysis included data from 2461 respondents aged 18 to 92, of which 963 were men (39,1%). The proportion of hypertensive patients was 41,0%, while among them 59,0% took antihypertensives and 30,9% were effectively treated. In comparison with pre-pandemic period according to MMM2018-2019, the higher proportion of HTN patients in the Russian sample was revealed during MMM2021 (41,0% vs 31,3%, p<0,001) with a comparable proportion of patients receiving antihypertensive therapy (60,7% vs 59,0%, p=0,05) and treatment efficacy (28,7% vs 30,9%, p=0,36). Monotherapy was received in 44,7% of cases, while dual and triple combination therapy — in 30,9% and 14,1%, respectively. The majority of respondents (~90%) did not adjust their antihypertensive therapy during the COVID-19 pandemic.Conclusion. According to HTN screening in Russia, there is persistent ineffective control of HTN, which may be due to both the worsening pattern of behavioral risk factors, limited access to healthcare during COVID-19, and the inertia of physicians and low adherence of patients due to the asymptomatic HTN course in the majority.
Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was voluntary without restrictions on sex. All participants were over 18 years of age. During the screening, blood pressure (BP) was measured three times using automatic and mechanical BP monitors. In addition, a questionnaire was filled out on behavioral risk factors, comorbidities and therapy. HTN was diagnosed with systolic BP ≥140 mmHg and/ or diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. The questionnaire included questions about prior COVID-19, vaccinations and their impact on the intake of antihypertensive drugs.Results. The analysis included data from 2461 respondents aged 18 to 92, of which 963 were men (39,1%). The proportion of hypertensive patients was 41,0%, while among them 59,0% took antihypertensives and 30,9% were effectively treated. In comparison with pre-pandemic period according to MMM2018-2019, the higher proportion of HTN patients in the Russian sample was revealed during MMM2021 (41,0% vs 31,3%, p<0,001) with a comparable proportion of patients receiving antihypertensive therapy (60,7% vs 59,0%, p=0,05) and treatment efficacy (28,7% vs 30,9%, p=0,36). Monotherapy was received in 44,7% of cases, while dual and triple combination therapy — in 30,9% and 14,1%, respectively. The majority of respondents (~90%) did not adjust their antihypertensive therapy during the COVID-19 pandemic.Conclusion. According to HTN screening in Russia, there is persistent ineffective control of HTN, which may be due to both the worsening pattern of behavioral risk factors, limited access to healthcare during COVID-19, and the inertia of physicians and low adherence of patients due to the asymptomatic HTN course in the majority.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.