CONTENTS
СОДЕРЖАНИЕ
Address to the readers
Russ J Cardiol 2015, 2 (118): 5
CLINICAL GUIDELINES
2014 ESC/EACTS GUIDELINES ON MYOCARDIAL REVASCULARIZATION
The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)
Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)Russ J Cardiol 2015, 2 (118): 5–81
http://dx.doi.org/10.15829/1560-4071-2015-02-5-81Key words: Acute coronary syndromes, Bare-metal stents, Coronary artery bypass grafting, Coronary artery disease, Drug-eluting stents, EuroSCORE, Guidelines, Heart Team, Myocardial infarction, Myocardial ischaemia, Myocardial revascularization, Medical therapy, Percutaneous coronary intervention, Recommendation, Revascularisation, Risk stratification, Stents, Stable angina, Stable coronary artery disease, ST-segment elevation myocardial infarction, SYNTAX score.
CLINICAL MEDICINE NEWS
Clinical medicine updates: a review of international news
Russ J Cardiol 2015, 2 (118): 82
ORIGINAL ARTICLES
THE INFLUENCE OF MULTIFOCAL ATHEROSCLEROSIS ON LONG-TERM OUTCOMES AFTER ENDOVASCULAR REVASCULARIZATION IN MYOCARDIAL INFARCTION
Tarasov R. S.
Abstract
Aim. To study the results of primary percutaneous coronary intervention in ST elevation myocardial infarction patients (STE MI) in multivessel disease (MD) according to the multifocal disease (MFA) (peripheral lesion ≥30%).
Material and methods. Current study concerns on the evaluation of hemodynamically significant and nonsignificant lesion influence on the prevalence of cardiovascular adverse events in 227 patients during 12 months after primary percutaneous intervention (PCI). The first group consisted of STEMI patients, MD of coronary vessels and MFA, underwent primary PCI (n=63) (STEMI+MFA), second group consisted of patients without MFA (n=164) (STEMI).
Results. In STEMI+MFA patients comparing to those without MFA (peripheral arteries lesions more than 30%) there were worse in-hospital and long term outcomes of primary PCI by the prevalence of combined endpoint (death, MI, culprit lesion intervention): 17,4% vs. 6,7% and 30,2% vs. 13,4%, resp. (p <0,05).
Conclusion. The prognostic significance of MFA (peripheral arteries lesions more than 30%) after primary PCI in the cohort of patients with STEMI and MD remains underexplored. Current study has shown that presence MFA after primary PCI is a negative prognostic factor in patients with STEMI and MD.
Russ J Cardiol 2015, 2 (118): 83–88
http://dx.doi.org/10.15829/1560-4071-2015-02-83-88Key words: multifocal atherosclerosis, myocardial infarction with ST elevation, multivessel disease, primary percutaneous intervention
FSBI Scientific-Research Institute of Complex Problems of Cardiovascular Diseases of SD RAMS, Kemerovo, Russia.
SURGICAL SPECIFICS OF OFF-PUMP MYOCARDIAL REVASCULARIZATION BY OPCAB METHOD
Rukosujew A., Martens S.
Abstract
OPCAB (Off-pump coronary artery bypass) remains nowadays an alternative method to traditional on-pump technique of the myocardial revascularization especially in high-risk and elderly patients. A successful adoption of this technique depends on a surgeon’s experience, a cooperative team and standardization of all steps in anesthesiological and surgical procedures in perioperative period. This article describes the perioperative policy adopted in our institution and our view on the role and place of OPCAB in the treatment of patients with coronary heart disease.
Russ J Cardiol 2015, 2 (118): 89–94
http://dx.doi.org/10.15829/1560-4071-2015-02-89-94Key Words: OPCAB, total arterial revascularization, T-graft anastomosis
Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany
CLINIC AND PHARMACOTHERAPY
COGNITIVE IMPAIRMENT TREATMENT IN ARTERIAL HYPERTENSION WITH DIABETES MELLITUS 2ND TYPE
Tyukalova L. A., Lukyanova М. А.
Abstract
Aim. To develop the method and media for cognitive impairment correction in patients with arterial hypertension, combined with diabetes mellitus 2nd type.
Material and methods. Totally 120 included with essential arterial hypertension (EAH), associated with diabetes 2nd type, with insufficient blood pressure (BP) level control. Patients with AH had 2nd grade of BP increase with mild of moderate compensated DM 2nd type with the level of glycosylated hemoglobin about 6,25%. The patients had quite high number of concomitant diseases and risk factors. All patients received basic antihypertensive therapy (beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor inhibitors). Also the patients took the drugs for concomitant pathology (hypolipidemic drugs, nitrates, glucose lowering drugs). The necessary criteria for inclusion was informed consent. At outpatient stage of the study, first visit and in a year the complex of events was done: anamnesis and complaints clarification; palpation and auscultation of the heart and major vessels; BP measurement on upper extremities by Korotkov; ECG registration, Echocardiography. The biochemical sampling of fasting plasma was done: the level of glucose was measured, of glycosylated hemoglobin, lipid profile (cholesterol, triglycerides, LDL, HDL), clotting parameters (INR, APTT, fibrinogen), electrolytes (K, Mg). Also the patients completed medical questionnaires of a specific purpose. The score of psychic status was used: MINI-MENTAL STATE EXAMINATION (MMSE) M.F. FOLSTEIN, S.E. FOLSTEIN, P.R. HUGH, 1975. And if there were prominent cognitive disorders Kudesan® was prescribed — mitochondrial coenzyme Q10 — at the dosage of 60 mg per day during the next 2 months. Dosage of the drug used according to medical instructions.
Results. The data witnesses that clinical effect was achieved in patients with Kudesan®: the significant improvement of cognitive functions in patients by MMSE score. The effectiveness of Q10 compound was measured by the clinical properties matching after the treatment. Before the treatment the clinical data compared were identical with the absence of statistical significance among them (p>0,01).
Conclusion. The positive influence of complex therapy is shown on the cognitive functions in patients with AH at the background of diabetes 2 type. The study showed that the inclusion of Q10 compound into the standard treatment of arterial hypertension with diabetes 2nd type is associated with positive clinical effect, especially in relevant cognitive function improvement, significant decrease of systolic and diastolic BP, relevant decrease of blood pressure variability, significant of glucose and glycosylated hemoglobin level decrease, significant Mg level increase.
Russ J Cardiol 2015, 2 (118): 95–99
http://dx.doi.org/10.15829/1560-4071-2015-02-95-99Key words: arterial hypertension, diabetes, blood pressure, cognitive disorders, Kudesan®.
SBEI HPE Siberian State Medical University of the Ministry of Healthcare, Tomsk, Russia.
OPINION ON A PROBLEM
EXPERT CONSENSUS. THE CURRENT POSITION ON BIVALIRUDIN
Russ J Cardiol 2015, 2 (118): 100–102
http://dx.doi.org/10.15829/1560-4071-2015-02-100-102
LITERATURE REVIEWS
OPINIONS ABOUT THE INFLUENCE OF PRELIMINAL CORONARY REVASCULARIZATION ON THE PREVALENCE OF CARDIAL COMPLICATIONS IN NONCARDIAC SURGERY
Surkova Е. А., Shchukin Yu. V.
Abstract
Prognosis and prevention of cardiac complications of non-cardiac surgery is an important clinical task. Currently quite a lot is known on various scales of myocardial infarction risk prognosis and the death in perioperational period, as on drug treatment and prevention. The issue whether to perform coronary arteriography and preventive coronary revascularization before noncardiac surgical interventions in patients with high cardiological risk score remains controversial. Current review concerns on the perspectives of perioperational myocardial infarction pathogenesis and also analyses in details the results of current retro- and prospective studies of efficacy and safety of various types of preventive coronary revascularization with the aim to reduce the prevalence of extracardiac surgery.
Russ J Cardiol 2015, 2 (118): 104–109
http://dx.doi.org/10.15829/1560-4071-2015-02-104-109Key words: extracardiac surgery, coronary revascularization, cardiac complications, myocardial infarction
SBEI HPE Samara State Medical University of the Ministry of Healthcare, Samara, Russia.
CALCIUM ANTAGONISTS IN ARTERIAL HYPERTENSION TREATMENT: SPECIFICS OF LERCANIDIPINE
Minushkina L. O.
Abstract
Lercanidipine is a dihydropyridine calcium antagonist of the 3rd generation, with high level of vasoselectivity, long lasting effect and good antihypertensive effectiveness. The review shows the main specifics of pharmacokinetics and mechanism of action of the drug. It is known that lercanidipine supports renoprotection, left ventricle hypertrophy reduction, improvement of elastic properties of the vessels and central blood pressure decrease. Sympathetic activation in lercanidipine is almost absent, that makes up its good tolerability and improves patients’ compliance.
Russ J Cardiol 2015, 2 (118): 110–114
http://dx.doi.org/10.15829/1560-4071-2015-02-110-114Key words: lercanidipine, arterial hypertension.
FSBI Studying-Scientific Medical Centre of the President PA, Moscow, Russia.
NOVEL ANTICOAGULANTS FOR THROMBOEMBOLIC COMPLICATIONS PREVENTION IN NONVALVULAR ATRIAL FIBRILLATION
Itkin D. A.1, Moiseeva Yu. N.2, Libov I. A.1
Abstract
The article takes into consideration practical issues of novel oral anticoagulants (factor Xa inhibitors) usage with the aim of prevention of thromboembolic complications in nonvalvular atrial fibrillation. A clinical case presented the patient with this pathology under high risk of thromboembolic complications with several years follow-up.
Russ J Cardiol 2015, 2 (118): 115–122
http://dx.doi.org/10.15829/1560-4071-2015-02-115-122Key words: atrial fibrillation, thromboembolic complications, anticoagulant treatment, rivaroxaban.
1Russian Medical Academy of Postgraduate education of the Healthcare Ministry, Moscow; 2CCH n. a. S. P . Botkin, Moscow, Russia.
