Кардиоваскулярная терапия и профилактика (Dec 2016)

THE FACTORS ASSOCIATED WITH PRESCRIPTION OF CARDIOVASCULAR PREVENTIVE TREATMENT IN PATIENTS WITH LOWER EXTREMITIES ATHEROSCLEROSIS

  • A. N. Sumin,
  • М. A. Kosova,
  • Yu. D. Medvedeva,
  • A. V. Scheglova,
  • S. A. Makarov,
  • G. V. Artamonova,
  • L. S. Barbarash

DOI
https://doi.org/10.15829/1728-8800-2016-6-31-38
Journal volume & issue
Vol. 15, no. 6
pp. 31 – 38

Abstract

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Aim. To assess the factors associated with combination cardio protection therapy intake in patients with atherosclerotic lesion of lower extremities. Material and methods. Totally, 436 patients studied: 372 (82,3%) males and 64 (14,7%) females at the age 45-81 (mediana 63) year old with obliteration atherosclerosis of lower extremities >50%. Patients were investigated under the framework of the registry in Kemerovo cardiological center in 2009-2013 y. The study included a dynamic follow-up of vascular surgeon and cardiologist, instrumental and laboratory investigation. Depending on the regularity of cardioprotection therapy, two groups were shaped: group 1 (n=226) taking full combination cardioprotection therapy: antiplatelets, inhibitors of angiotensin-converting enzyme or angiotensin receptor blockers and statins, group 2 (n=210) did not take at least one of the listed drug groups.Results. The intake of combination cardioprotection therapy was associated with higher prevalence of arterial hypertension (95,1%), myocardial infarction (46,5%), coronary bypass and percutaneous coronary intervention (21,1% and 32,3%, resp.), as interventions on extracranial arteries (12,8%). Patients from this group had angina presentation more often and the diagnosed coronary heart disease — 68,1% and 83,2%, resp. Almost 60% of patients with adequately prescribed treatment were followed-up by cardiologist. In laboratory data of this group there was lower level of total cholesterol. Patients had significantly larger left ventricle and lower ejection fraction.Conclusion. The factors associated with optimal medication treatment were ischemic heart disease (p<0,001), cardiologist follow-up (p<0,001), decrease of total cholesterol (p=0,02). To increase the effectiveness of secondary prevention in obliteration atherosclerosis of lower extremities it is worthy to apply novel organizational approaches during outpatient period, particularly, dispensary follow-up in cardiologist practice.

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