Рязанский государственный медицинский университет им. акад. И.П. Павлова, г. Рязань На основании регистрового исследования проведен анализ полноты использова-ния диагностических методов обследования у больных ИБС в амбулаторных условиях и их соответствие рекомендациям Российского кардиологического общества.В амбулаторно-поликлинический регистр были включены 3672 больных с АГ, ИБС, ХСН и ФП, обратившихся к врачу-терапевту или кардиологу.В ходе исследования была зарегистрирована высокая частота сочетания ИБС с АГ (98,9 %) и ХСН (91,3 %). Выявлено недостаточное активное наблюдение боль-ных с ИБС как врачом-терапевтом, так и врачом кардиологом, недостаточное ис-пользование инструментальных и лабораторных методов диагностики ИБС.Ключевые слова: регистр, ИБС, поликлиническая практика.
Aim. To study the specifics of follow-up, instrumental and laboratory assessment of patients with a history of acute cerebrovascular accident (ACVA), taking cardiovascular comorbidity into account. Material and methods. Within the outpatient phase of the REGION study, a register of patients with a history of ACVA of any remoteness (ACVA-AR registry, n=511), and the register of patients who had visited the outpatient clinic for the first time after cerebral stroke (ACVA-FV, n=475) were organized. The analysis of specifics of outpatient follow-up of patients during the last 12 months prior to the reference visit in the ACVA-AR registry and in the first 6 months after the reference visit in the ACVA-FV registry, depending on diagnosed concomitant cardiovascular diseases and their complications, conditions and the fact of being under dispensary observation was done. Results. During the analyzed period of follow-up in the outpatient clinic, the patients were most often examined by district therapeutists (ACVA-AR - 81.4%, ACVA-FV - 91.6%). Patients in the ACVA-AR registry had a statistically significantly higher incidence of electrocardiography, echocardiography and blood creatinine and total cholesterol results in patients with a history of myocardial infarction comparing to those who hadn’t myocardial infarction, as well as in a subset of patients who visited the clinic in comparison with those who were observed at home. Patients of the ACVA-FV registry were statistically significantly more often examined by doctors and had basic laboratory and instrumental examination methods done (except echocardiography) compared to those who were observed at home. The frequency of medical examinations, as well as the performance of instrumental and laboratory methods, was statistically significantly higher in the ACVA-FV register as a whole and in all analyzed groups comparing to the ACVA-AR registry, except for a subgroup of patients with a history of ACVA. Сonclusion. The quality of the examination of patients with a history of ACVA in the outpatient practice is inadequate; nevertheless, a comparison of the results of the ACVA-AR and ACVA-FV registers allows one to speak of its significant positive dynamics over the period of 2.3 years, which separated the reference visits in these registers.
The aim of the study was to evaluate the effect of the drug therapy assigned at the index visit on the risk of fatal outcome in outpatients with coronary heart disease within 24 months from the index visit, based on the data of registry of cardiovascular diseases (RECVASA). Follow-up feedback was 97.4%, the survival rate - 90.6%. The study found that the prescribing of angiotensin-converting enzyme (ACE) inhibitors or ACE inhibitors/angiotensin receptor blockers II (ARB) was associated with reduction of all-cause mortality by 1.6 times (p=0.016) and 2.0 times (p=0.006), respectively, statins - by 1.6 times (p=0.038). The risk of death from cardiovascular causes in the case of prescribing of ACE inhibitors or ACE inhibitors/ARBs decreased by 2.1 times (p=0.0008) and 2.3 times (p=0.0008), respectively, statins - by 1,7 times (p=0.048).
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