Management of atrial fibrillation in specific patient populations

Szymański, Filip M.; Lip, Gregory Y.H.; Filipiak‬, Krzysztof J.

doi:10.5603/kp.a2015.0223

Cited by 2 publications

(2 citation statements)

References 60 publications

(74 reference statements)

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“…Лікування хворих на РАГ повинно включати оптимізацію дозувань і призначення раціональних комбінацій антигіпертензивних препаратів з метою посилення синергічних ефектів. Серед заходів щодо подолання низької прихильності до лікування АГ слід рекомендувати: оцінка і відбір хворих з низьким комплайенсом (за шкалою Моріскі-Гріна); оптимізація фармакотерапії, за допомогою призначення препаратів з фіксованими комбінаціями; контроль прийому препаратів [15].…”

Section: метаunclassified

Biomarker Levels Dynamics of Endothelial Function in Patients with Treatment Resistant Hypertension under the Influence of Treatment

Kulbachuk¹,

Dmytrieva²,

Sid’³

et al. 2022

Ukr. ž. med. bìol. sportu

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The purpose of the study was to determine the biomarker levels dynamics of endothelial function in patients with treatment resistant hypertension under the influence of treatment. Materials and methods. A comprehensive outpatient examination was conducted in 117 patients with a preliminary diagnosis of treatment resistant hypertension. 71 patients with hypertension of the stage II and 35 practically healthy individuals were examined. The quantitative content of endothelin-1 was determined by enzyme immunoassay using a set of reagents Endothelin-1 ELISA kit (Biomedica, Austria). The method for determining stable final metabolites of nitric oxide in the blood is based on the reduction of nitrates to nitrites with the determination of the latter by reaction with the Gris reagent. Results and discussion. The level of endothelin-1 between the groups of patients was significantly higher among patients with treatment resistant hypertension than among patients with hypertension of the stage II – 1.64 [1.16; 2.18] fmol/l versus 0.98 [0.73; 1.02] fmol/l, respectively, (p<0.05). The NO2 index had the lowest value in the group of patients with treatment resistant hypertension 6.00 [5.10; 7.30] mmol/l and was significantly lower by 20.0% compared to the group of patients with hypertension of the stage II – 7.50 [6.80; 9.40] mmol/L. The NO3 level among patients with treatment resistant hypertension was 13.50 [11.20; 14.80] mmol/l, which was significantly lower by 11.8% and 18.2% compared to the group of patients with hypertension of the stage II and the group of practically healthy individuals, respectively (p<0.05). In the first group, blood pressure levels <140/90 mmHg were reached by 29 (56.9%) people, which significantly exceeded the percentage in the second group – 15 (30.6%) patients (p<0.05). Treatment of patients with treatment resistant hypertension should include optimizing dosages and prescribing rational combinations of antihypertensive drugs in order to enhance synergistic effects. Among the measures to overcome low adherence to treatment of hypertension, the following should be recommended: assessment and selection of patients with low compliance (according to the Morisky-Green scale); optimization of pharmacotherapy by prescribing drugs with fixed combinations; control of drug intake. The Morisky-Green scale test should be applied at the beginning of treatment of patients with hypertension, since it allows the doctor to understand how supportive the patient is to treatment and will correctly perform the appointment. After all, only accurate and correct execution of prescriptions can bring the maximum positive effect of therapy and prevent the development of complications. The fixed combination of amlodipine-indapamide-perindopril has one important advantage, which is to increase adherence to treatment due to the principle of "one day – one pill". Conclusion. Among patients with hypertension, the development of endothelial dysfunction is noted, which increases with treatment resistant hypertension. The combination of amlodipine-indapamide-perindopril is effective in reducing blood pressure and correcting endothelial dysfunction. The use of a fixed combination of amlodipine-indapamide-perindopril in the form of a single pill by patients is accompanied by a large percentage of those who have reached blood pressure levels <140/90 mmHg

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Section: метаunclassified

Biomarker Levels Dynamics of Endothelial Function in Patients with Treatment Resistant Hypertension under the Influence of Treatment

Kulbachuk¹,

Dmytrieva²,

Sid’³

et al. 2022

Ukr. ž. med. bìol. sportu

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“…Atrial fibrillation (AF) is the most common abnormal cardiac rhythm disease occurring in nearly 3% of the adult population, and all-cause mortality is twice as high as in non-AF patients [ 1 ]. Catheter ablation has been recommended for patients with AF who are resistant or unwilling to antiarrhythmic drugs [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Circulating Galectin-3 and Aldosterone for Predicting Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Ruan

Gao

Wang

et al. 2022

Cardiovascular Therapeutics

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Background. Circulating galectin-3 (Gal-3) and aldosterone (ALD) are involved in fibrosis and inflammation. However, their potential value as predictors of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) is unknown or controversial. Therefore, the aim of this study was to assess the relationship between baseline Gal-3, ALD levels, and AF recurrence in patients performing RFCA. Methods. 153 consecutive patients undergoing RFCA were included. Gal-3 and ALD were measured at baseline. Univariate and multivariate Cox regressions were performed to determine the predictors of AF recurrence. Receiver operating characteristic (ROC) curve and Kaplan-Meier (K-M) curve were used to assess the value of predictors. Results. There were 35 (22.88%) cases of AF recurrence after RFCA. The recurrence group had significantly higher preoperative serum levels of Gal-3 and ALD than the nonrecurrence group. Univariate and multivariate analysis showed that Gal-3 ( HR = 1.28 , 95% CI: 1.04-1.56, p = 0.02 ) and ALD ( OR = 1.02 , 95% CI: 1.00-1.03, p < 0.03 ) were significantly associated with AF recurrence after RFCA. The area under the curve (AUC) of preoperative serum Gal-3, ALD, and 2 combined to predict the recurrence of AF patients after RFCA was 0.636, 0.798, and 0.893, respectively, while sensitivity was 65.32%, 71.69%, and 88.61%, respectively and specificity was 77.46%, 78.53%, and 86.0%, respectively. Patients with Gal-3 above the cutoff value of 14.57 pg/ml had higher frequent AF recurrence than the patients with Gal − 3 ≤ 14.57 pg / ml (35% vs. 12%, p < 0.001 ) during a follow-up. Meanwhile, patients with ALD above the cutoff value of 243.61 pg/ml also had a higher AF recurrence rate than those with ALD ≤ 243.61 pg / ml (37% vs. 11%, p < 0.001 ) during a follow-up. The recurrence rate in patients with Gal − 3 > 14.57 pg / ml + ALD > 243.61 pg / ml was higher than that in patients with baseline Gal − 3 > 14.57 pg / ml or ALD > 243.61 pg / ml and patients with Gal − 3 ≤ 14.57 pg / ml + ALD ≤ 243.61 pg / ml (57% vs. 14% vs. 9%, p < 0.01 , respectively). Conclusion. AF recurrence after RFCA had higher baseline Gal-3 and ALD levels, and higher preoperative circulating Gal-3 and ALD levels were independent predictors of AF recurrence for patients undergoing RFCA, while combination of preoperative Gal-3 and ALD levels has higher prediction accuracy.

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Management of atrial fibrillation in specific patient populations

Cited by 2 publications

References 60 publications

Biomarker Levels Dynamics of Endothelial Function in Patients with Treatment Resistant Hypertension under the Influence of Treatment

Biomarker Levels Dynamics of Endothelial Function in Patients with Treatment Resistant Hypertension under the Influence of Treatment

Circulating Galectin-3 and Aldosterone for Predicting Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

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