Outpatient Follow-Up of the Lower Extremities Atherosclerosis Patients From Cardiologist Point of View

Sumin, А. N.; Косова, М. А.; Medvedeva, Yu. D.; Щеглова, А. В.; Макаров, С. А.; Артамонова, Г. В.; Ls, Barbarash

doi:10.15829/1560-4071-2016-12-58-63

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…Сумина и соавт. [14] у 456 пациентов (372 мужчин и 84 женщин, средний возраст -63 года) с облитерирующим атеросклерозом нижних конечностей проведен осмотр кардиологом, направленный на оценку риска кардиальных событий и соответствия клиническим рекомендациям фактически назначенной медикаментозной терапии. Обследованные пациенты имели экстремально высокий сердечно-сосудистый риск: у 40% пациентов выявлены клинические проявления стабильной стенокардии II функционального класса, у 37% -анамнестические признаки перенесенного ИМ.…”

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“…Статины назначены 68% пациентов, однако у большинства из обследованных пациентов регистрировался уровень ХС ЛПНП >2,5 ммоль/л, т. е. целевые значения не достигнуты. Ни у одного из пациентов не достигнуты целевые значения ХС ЛПНП <1,8 ммоль/л [14], это свидетельствует о том, что данная группа пациентов не получает в полном объеме терапию, влияющую на прогноз.…”

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Do the patients with peripheral atherosclerosis need to a medical therapy before the revascularization?

Барбараш

Кашталап

2019

Terapevticheskii arkhiv

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In the review article are provided the approaches to the therapy for improvement of prognosis in patients with peripheral and multifocal atherosclerosis which are available now; some limitations and a real situation are designated for the antithrombotic therapy in this category of patients. According to the clinical trial COMPASS the prospects of wide use of a combination of acetylsalicylic acid and a rivaroxsaban of 2.5 mg 2 times a day in the patients with chronic coronary heart disease and/or symptom peripheral atherosclerosis are designated.

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Do the patients with peripheral atherosclerosis need to a medical therapy before the revascularization?

Барбараш

Кашталап

2019

Terapevticheskii arkhiv

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Telemedicine technologies in improving the effectiveness of follow-up monitoring of patients with lower extremity peripheral artery disease during the COVID-19 pandemic

Макаров¹,

Smirnov²,

Danilchenko³

2023

Cardiovasc Ther Prev

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Aim. To evaluate the effectiveness of a novel approach to follow-up monitoring of patients with lower extremity peripheral artery disease (PAD) using telemedicine technologies.Material and methods. The study included 175 patients (mean age, 68,1±7,7 years). Two following groups of patients were formed: the main group (n=86), which used an optimized monitoring program using telemedicine techniques, and the control group (n=89), which assumed traditional monitoring by a cardiologist and a vascular surgeon. The mean follow-up period was 11,77±1,5 months. The optimized monitoring program included the implementation of audio communication with patients by an employee with a secondary medical education with an assessment of the current health status according to original unified questionnaire, with the definition of personalized management tactics. At the primary and final stages, the patient underwent an assessment of clinical and anamnestic data, mental and cognitive status, and compliance.Results. At the final stage, uncompensated hypertension was revealed in 36,0% and 49,4% (p=0,0001), smoking — in 30,6% and 42,9% (p=0,05) in the main and control group, respectively. In the main group, a greater pain-free walking distance was revealed — 625,8±395,3 m (control group — 443±417 m (p=0,013)). The average systolic blood pressure was 125,2±10,2 mm Hg and 138,8±15,8 mm Hg (p=0,0001) in the main and control group, respectively. In the control group, a greater number of patients with a high level of personal and situational anxiety were revealed (p=0,05). In the main group, a higher level of adherence to therapy was established at the final study stage (p=0,001).Conclusion. The optimized monitoring program for patients with limited mobility is effective and can be implemented in practical healthcare for patients with lower extremity PAD.

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Prevalence of lesions and risk factors in patients with lower extremities atherosclerosis referred for surgical intervention: gender differences

et al. 2021

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Background. Atherosclerotic disease of the arteries of the lower extremities or peripheral arterial disease (PAD) affects both men and women. PAD can be combined with the damage of other vascular regions, which is defined as multifocal atherosclerosis (MFA) and suggests the most severe course of the disease and an unfavorable prognosis of patients. The high risk of cardiovascular complications determines the importance of active secondary prevention in patients with PAD and MFA. Data on the frequency of MFA, characteristics of risk factors (RF) and their treatment depending on gender are limited in the literature.Objective. To study the prevalence of atherosclerotic lesions, RF for atherosclerosis and their treatment at out-patient stage in men and women with PAD referred for surgical treatment. Design and methods. According to medical records analyzed the results of a survey of 65 men and 26 women consecutively admitted to the department of cardiosurgery of the Almazov National Medical Research Center from January 2018 to January 2019 for surgical treatment. All patients underwent duplex scanning (DS), X-ray or CT-angiography of the arteries of the lower extremities, 49 patients underwent coronary angiography, and 72 patients underwent DS or CT-angiography of the brachiocephalic arteries (BCA).Results. The average age of men and women did not differ significantly. The most common RF were hypertension and current smoking or the PAD. Smoking was observed less frequently in women. Data on lipid profile were available in 62 patients (68 %), the level of low-density lipoproteins (LDL) was determined in 22 subjects (24 %). The incidence of dyslipidemia and diabetes mellitus did not differ significantly in both groups, however, fasting hyperglycemia was found in 9 women without diabetes mellitus (50 %). The target LDL level was achieved only in 3 men. Two or more RF were detected in 87 % of patients; the groups of men and women did not differ in the number of RF. Signs of involvement of one arterial region were found in 18% of patients, two regions — in 48%, three regions — in 28% without differences in men and women (p > 0,05). In combination with PAD, men were more likely to have coronary artery (CA) disease than women (p < 0,05); the incidence of BCA lesions did not differ significantly (p = 0,02). Women less often, although not significant, received statins (69% versus 84%), beta-blockers (46% versus 66%), antiplatelet agents (77 % versus 84,6%).Conclusions. Both men and women hospitalized for surgical treatment of PAD have multiple RF of comparable frequency, with the exception of smoking. Regardless of gender, the majority of patients show signs of MFA with predominant CA disease in men. The absence of significant differences in the number of RF and the frequency of MFA in men and women may be associated with the presence of comparable severe clinical manifestations of PAD, which determine the indications for revascularization of the lower extremities. The evaluation of patients is inadequate: not all patients have controlled cholesterol and LDL levels, tests are not performed in women with fasting hyperglycemia to exclude diabetes mellitus and prediabetes. There is a clear trend towards less active secondary prevention in women.

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Outpatient Follow-Up of the Lower Extremities Atherosclerosis Patients From Cardiologist Point of View

Cited by 6 publications

References 10 publications

Do the patients with peripheral atherosclerosis need to a medical therapy before the revascularization?

Do the patients with peripheral atherosclerosis need to a medical therapy before the revascularization?

Telemedicine technologies in improving the effectiveness of follow-up monitoring of patients with lower extremity peripheral artery disease during the COVID-19 pandemic

Prevalence of lesions and risk factors in patients with lower extremities atherosclerosis referred for surgical intervention: gender differences

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