Assessment of Outcomes and Treatment Tactics in Patients With Non-ST-Elevation Acute Coronary Syndrome: Data of Five-Year Follow-up

Бернс, С. А.; Шмидт, Е. А.; Nagirnyak, O. A.; Klimenkova, A V; Litvinova, M. N.; Sergeeva, T. Yu.; Barbarash, O. L.

doi:10.18087/cardio.2018.7.10141

Cited by 3 publications

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“…Следует отметить тенденцию к росту как числа пациентов, госпитализированных в РСЦ по поводу ОКС, так и количества срочных эндоваскулярных вмешательств. Это значимый показатель, поскольку выполнение ЧКВ пациентам, переносящим ОКС, приводит не только к уменьшению риска госпитальной леталь-ности, но и к улучшению отдаленного прогноза [10,11]. Объем ТЛТ в РСЦ минимален ввиду круглосуточной возможности выполнения ЧКВ (рис.…”

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Treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia: 10-years registry results

et al. 2021

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Aim. To present the treatment of Acute coronary syndrome (ACS) in clinical practice in the Republic of Karelia and the results of Cardiovascular centers working. Material and methods. The prospective study included 9949 patients successively hospitalized from 01.01.2020 to 01.01.2020 in the Regional cardiovascular center (Petrozavodsk, Russia), 6335 were included in Federal register. Risk factors, clinical features, reperfusion strategy as well as the rate of clinical complications, drug therapy and outcomes were assessed. Results. 9949 patients were treated in Regional cardiovascular center from 01.01.2010 to 01.01.2020 due to acute coronary syndrome, and 6335 were included to the Federal registry. 40.2% of patients had ST-elevation Myocardial Infarction and 59.8% ACS without ST elevation. The first group was younger (the average age was 69) than the second (the average age was 74). The drug therapy of ACS in the hospital was following: 98.7% of patients took aspirin; b-blockers 92.3%, statins 97.4%. The outcomes of ACS during the hospital discharge were following: Q-wave myocardial infarction (MI) was diagnosed in 34.2% cases, non-Q-wave MI in 23.4%, unstable angina 20.5%, repeated MI 18.7% and 2.5% MI unspecified localization. The analysis of the clinical features of ACS shows that significant number of patients (24.8%) had severe complications. So, ventricle arrhythmias were diagnosed in 17.3% of cases, acute left ventricle insufficiency in 7.6%, cardiogenic shock in 3.0%, cardiac arrest in 1.9%, myocardial rupture in 0.4%. The hospital mortality rate reached 6.38%. Conclusion. The article presents data about treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia based on 10-years register. Difficulties of management and reperfusion interventions, the volume of drug therapy, the frequency of complications, as well as outcomes and hospital mortality are discussed. The presented data show the results of modernization of the medical care program for patients with acute coronary syndrome in practical healthcare in the region.

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Treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia: 10-years registry results

et al. 2021

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“…В этом аспекте результаты нашего исследования, показывающие высокую частоту развития повторных нефатальных кардиоваскулярных событий в первый год после ОКСбпST, согласуются с рядом регистровых наблюдений больных с ОКСбпST европейской популяции [7,8]. В опубликованном ранее исследовании, посвященном анализу частоты и сроков развития НКС, нами были представлены подробные данные о наблюдении пациентов с ОКСбпST в течение пяти лет после включения в исследование [9]. Внимание привлекает тот факт, что наибольшая частота случаев ишемического инсульта наблюдалась на шестом году наблюдения, что может быть обусловлено наличием значимого атеросклеротического поражения в брахиоцефальном бассейне и его прогрессированием в течение всего периода наблюдения.…”

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Predicting the development of adverse events in patients with acute coronary syndrome including genetics in the long-term follow-up

et al. 2020

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Aim To study a relationship of several factors (clinical and genetical markers) with unfavorable outcomes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in long-term follow-up.Material and methods This full-design, prospective study included 415 patients with NSTE-ACS. 266 patients were evaluated for the presence of multifocal atherosclerosis (MFA). Typing of polymorphic variants rs1041981 LTA, rs1800629 TNF, rs4986790, and rs498679 TLR4, and also rs3024491 and rs1800872 IL10 was performed. Follow-up period lasted for 67±4 months. By the end of this period, information about clinical outcomes for 396 patients became available.Results During the entire follow-up period, unfavorable outcomes were observed in 239 (57.5 %) patients with NSTE-ACS. The following clinical signs were associated with unfavorable outcomes: history of myocardial infarction, age >56 years, left ventricular ejection fraction (LV EF) ≤50 % and GRACE score ≥100, significant stenosis of brachiocephalic arteries, MFA, carriage of genotype А / А rs1041981 LTA (OR, 6.1; р=0.02) and allele А (OR, 1.9; р=0.01). According to results of a multifactorial analysis, the most significant predictors included LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.Conclusion Stratification of patients with NSTE-ACS into groups of high or low risk for having an unfavorable outcome within the next 6 years is possible using the prognostic model developed and presented in this study. The model includes the following signs: LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.

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When to evaluate the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes?

Zhou

2019

International Journal of Cardiology

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Assessment of Outcomes and Treatment Tactics in Patients With Non-ST-Elevation Acute Coronary Syndrome: Data of Five-Year Follow-up

Cited by 3 publications

References 12 publications

Treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia: 10-years registry results

Treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia: 10-years registry results

Predicting the development of adverse events in patients with acute coronary syndrome including genetics in the long-term follow-up

When to evaluate the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes?

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