Russian Journal of Cardiology 2020, 25 (9)
СтатьиОглавление
EDITORIAL
SOCIOCULTURAL FACTORS IN CARDIOLOGY: PREVIOUS KNOWLEDGE DE NOVO
Taratukhin E. O.
Abstract
Despite the progression in cardiovascular biomedicine, the issue of a person’s social life and his social relations remains relevant. The impact on adherence to lifestyle changes and therapy, on risk factors such as stress or physical inactivity, is imperative and cannot be realized through biomedical methods alone. In the modification of sociocultural and psychosocial risk factors, the work of a doctor with a patient is the interaction of two subjects, who have experience in their lives. The article provides a brief analysis of the modern understanding of sociocultural aspects of cardiovascular processes and proposes the concept of identity as a unit
of meaning in such a coordinate system. The modern understanding of the biosocial structure of a person makes it possible to move from the declarative principles of “treating the patient — not just the disease” to a scientific interdisciplinary and practical concept. The inclusion of a humanitarian knowledge about the structure of culture and society in modern biomedicine will provide a novel, constructive understanding of doctor-patient relationship.
Key words: psychosomatics, patient-centered care, burnout, risk factors, communication, adherence, social identity.
Relationships and Activities: none.
Pirogov Russian National Research Medical University, Moscow, Russia.
Taratukhin E. O. ORCID: 0000-0003-2925-0102.
Corresponding author: cardio03@list.ru
Received: 17.08.2020
Revision Received: 21.08.2020
Accepted: 26.08.2020
For citation: Taratukhin E. O. Sociocultural factors in cardiology: previous knowledge de novo. Russian Journal of Cardiology. 2020;25(9):4072. doi:10.15829/1560-4071-2020-4072
ORIGINAL ARTICLES
TESTING THE EDUCATIONAL PROGRAM “PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES” ON THE BASIS OF SOCIAL NETWORKING SERVICE INSTAGRAM
Demkina A. E.1,2, Ryabinina M. N.3, Aksenova G. A.4, Benimetskaya K. S.5, Vasilyeva I. A.6, Isaeva A. V.7, Lobzhanidze F. A.8, Novikova D. S.9, Pivenshtein A. L.10, Savonina O. A.11
Abstract
Aim. To study the possibility of conducting an educational program “Primary and Secondary Prevention of Cardiovascular Diseases (CVD)”, aimed at increasing health literacy among followers of cardiology blogs on Instagram.
Material and methods. The methodology for conducting an educational program on Instagram included following items: the choice of agents of influence and the forms of engagement with audience; development of evaluation metric; carrying out the program; evaluation of the results obtained; defining a scaling strategy. The educational program was conducted daily from March 19 to March 30, 2020 on Instagram in following medical accounts: @doc_4_you, @zdorovye_serdtsa, @doctor_isaeva_cardio, @dr_cardioann, @doctor_savonina, @cardiolog.novikova, @doctor_lobzhanidze, @dnevnik.doctora, @doc.for.health, @aksenova_doctor. The format is publications of up to 4 thousand characters dedicated to informing people about primary (proper nutrition, quitting smoking, physical activity, obesity, vegetarianism) and secondary prevention (drug treatment) of CVD. The assessment of the results was carried out using descriptive statistics.
Results. The total number of followers of cardiology blogs is 367,727. The audience of professional doctors’ accounts is mostly female (from 89 to 95%), the 25 to 34 age group accounts for 40 to 47% of followers. The total number of followers who read 10 publications of the educational program was 104 794; the total audience involvement (comments, reposts, likes, saves) was 9,692 people. The greatest involvement of people was revealed in the following topics — consumption of vegetables, salt and sugar, physical activity, obesity (1146, 1100, 2195, 1052, 1534 people, respectively).
Conclusion. The social networking service Instagram can be used to conduct educational programs aimed at improving the health literacy of Russian people. It is necessary to further improve the methodology for conducting research in social networks, in order to select the most effective technologies in this topic.
Key words: cardiovascular disease, prevention, social media, Instagram.
Relationships and Activities: none.
1Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Moscow; 2National Medical Research Center of Cardiology, Moscow; 3Sanatorium “Yuzhnoe Vzmorye”, Sochi; 4European Medical Center, Moscow; 5Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk; 6S. M. Kirov Military Medical Academy, St. Petersburg; 7Central City Hospital № 20, Yekaterinburg; 8Stavropol Regional Clinical Hospital, Stavropol; 9A. S. Loginov Moscow Clinical Scientific Center, Moscow; 10LLC Novaya bol’nica, Yekaterinburg; 11LLC TRI POKOLENIYA clinic, Moscow, Russia.
Demkina A. E.* ORCID: 0000-0001-8004-9725, Ryabinina M. N. ORCID: 0000-0002-2905-7989, Aksenova G. A. ORCID: 0000-0003-0449-1655, Benimetskaya K. S. ORCID: 0000-0002-0043-1113, Vasilyeva I. A. ORCID: 0000-0002-5698-9423, Isaeva A. V. ORCID: 0000-0003-0634-9759, Lobzhanidze F. A. ORCID: 0000-0002-4927-4390, Novikova D. S. ORCID: 0000-0003-0840-1649, Pivenshtein A. L. ORCID: 0000-0002-8102-6792, Savonina O. A. ORCID: 0000-0002-9713-3760.
*Corresponding author: ademkina@bk.ru
Received: 29.05.2020
Revision Received: 29.06.2020
Accepted: 06.08.2020
For citation: Demkina A. E., Ryabinina M. N., Aksenova G. A., Benimetskaya K. S., Vasilyeva I. A., Isaeva A. V., Lobzhanidze F. A., Novikova D. S., Pivenshtein A. L., Savonina O. A. Testing the educational program “Primary and secondary prevention of cardiovascular diseases” on the basis of social networking service Instagram. Russian Journal of Cardiology. 2020;25(9):3932. (In Russ.) doi:10.15829/1560-4071-2020-3932
EXPERIENCE IN TEACHING DEONTOLOGY TO STUDENTS BY MANAGING PATIENTS WITH CARDIOVASCULAR DISEASES
Shaposhnik I. I.1, Bogdanov D. V.1, Genkel V. V.1, Kolyadich M. I.1,2
Abstract
Aim. To present the methodological techniques for teaching deontology to students in modern clinical practice on the example of managing patients with cardiovascular diseases.
Material and methods. We outlined the lectures and practical classes introduced into teaching fourth-year students within the educational program of the course “Practical issues of medical deontology”. Methods of practical classes included solving 50 case problem in all course sections with their subsequent analysis and interactive discussion, watching and discussing videos, students’ individual work with developing own case problems with further analysis in classes. Students also assessed the course by anonymous questionnaire survey.
Results. Every case problem has three questions for students. The discussion of videos is also carried out with posing a question and discussing the opinions expressed by students. A total of 151 students were surveyed. All students noted that there is a need for this course. One hundred eighteen (78%) students answered that they were satisfied with this course; 33 (22%) students noted that it is necessary to discuss legal aspects of the case problems. Students rated the content and quality of the lectures given at 4,68 points, practical classes — at 4,63 points.
Conclusion. Thus, the introduction of deontological education of students will help to improve understanding the meaning of deontology and develop the abilities of congruent behavior in various clinical and life situations, using the example of cardiovascular patients.
Key words: deontological skills, case problems, videos.
Relationships and Activities: none.
1South Ural State Medical University, Chelyabinsk; 2City Clinical Hospital № 1, Chelyabinsk, Russia.
Shaposhnik I. I. ORCID: 0000-0002-7731-7730, Bogdanov D. V.* ORCID: 0000-0002-6641-6178, Genkel V. V. ORCID: 0000-0001-5902-3803, Kolyadich M. I. ORCID: 0000-0002-0168-1480.
*Corresponding author: dmitrchel@mail.ru
Received: 21.05.2020
Revision Received: 31.05.2020
Accepted: 03.06.2020
For citation: Shaposhnik I. I., Bogdanov D. V., Genkel V. V., Kolyadich M. I. Experience in teaching deontology to students by managing patients with cardiovascular diseases. Russian Journal of Cardiology. 2020;25(9):3922. (In Russ.) doi:10.15829/1560-4071-2020-3922
PSYCHOSOCIAL FACTORS, ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH CORONARY ARTERY DISEASE: PROBLEMS OF COMORBIDITY AND PROGNOSIS
Garganeeva N. P.1, Kornetov N. A.1, Belokrylova M. F.1,2
Abstract
Aim. To assess the significance of psychosocial factors, anxiety and depressive disorders in predicting the comorbidities in patients with coronary artery disease (CAD).
Material and methods. The study included 132 patients aged 37 to 66 years with CAD and anxiety-depressive disorders. Depression was found in 42% of patients, anxiety — in 25%; combination of anxiety, depression — in 33%. The assessment of the significance of cardiovascular and psychosocial factors in predicting comorbidities in patients with CAD was carried out using the logistic regression.
Results. The total prognosis percentage was 95,4% in the general group of patients (Somers’D — 0,910). In the group of men, it was 95,5% (Somers’D –0,912); in the group of women — 93,1% (Somers’D — 0,877). The predictors with a high significance level (p=0,0001) were following cardiovascular risk factors: patient age, hypertension, diabetes, dyslipidemia, left ventricular hypertrophy, arrhythmias, smoking, positive family history of cardiovascular diseases and others. Following psychosocial factors were also significant: stress and characteristics of stressors, active psychopathological syndrome with leading anxiety and/or depressive symptoms, the patient age at the onset of mental disorder diagnosis, duration of the mental disorder, and psychological characteristics of patients. The age of the mental disorder onset was found to be related to the previous stressful events (p=0,0001).
A relationship was found between the age of patients with the onset of mental disorder and the severity of CAD (p=0,0001), as well as with the age of CAD onset and the sex of patients (p=0,0007). The contribution of stressful events before anxiety and depressive disorders to the development of predictors effecting the course and diagnosis of CAD was shown.
Conclusion. Logistic regression showed a relevant relationship of cardiovascular risk factors, psychosocial factors, anxiety and depressive disorders, included in the list of significant predictors of comorbidities and the progression of CAD. The results obtained serve as a guideline for an interdisciplinary approach to the treatment and prevention of comorbidities.
Key words: cardiovascular risk factors, coronary disease, psychosocial factors, stress, anxiety, depression, comorbidity.
Relationships and Activities: none.
1Siberian State Medical University, Tomsk; 2Mental Health Research Institute, Tomsk National Research Medical Center, Tomsk, Russia.
Garganeeva N. P.* ORCID: 0000-0002-7353-7154, Kornetov N. A. ORCID: 0000-0001-6141-2410, Belokrylova M. F. ORCID: 0000-0003-2497-6684.
*Corresponding author: garganeeva@gmail.com
Received: 30.07.2020
Revision Received: 10.08.2020
Accepted: 17.08.2020
For citation: Garganeeva N. P., Kornetov N. A., Belokrylova M. F. Psychosocial factors, anxiety and depressive disorders in patients with coronary artery disease: problems of comorbidity and prognosis. Russian Journal of Cardiology. 2020;25(9):4040. (In Russ.) doi:10.15829/1560-4071-2020-4040
VALIDITY AND RELIABILITY OF THE RUSSIAN-LANGUAGE VERSION OF THE SELF-CARE OF CORONARY HEART DISEASE INVENTORY IN PATIENTS WITH CHRONIC CORONARY SYNDROMES
Kabargina A. I.1,2, Lopatin Yu. M.1,2
Abstract
Aim. To assess the validity and psychometric properties of the Russian version of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI) in patients with chronic coronary syndromes (CCS).
Material and methods. The study was performed on 100 patients with stable coronary artery disease, who were sequentially admitted to the cardiology departments in December 2019. All patients admitted to the clinic underwent standard examination and treatment for patients with CCS. We have also evaluated socio-demographic properties (family status, educational level, profession, disability, income), quality of life (using questionnaires SF-36 and SAQ), levels of anxiety and depression (HADS), type D personality (DS-14 questionnaire), medication adherence (four-item Morisky-Green Medication Adherence Scale), Charlson comorbidity index. Self-care skills were assessed with the Self Care of Coronary Heart Disease Inventory.
Results. Test-retest reliability of the questionnaire scales ranged from 0,79 to 0,85, while Cronbach’s alpha varied from 0,738 for the entire questionnaire and from 0,649 to 0,716 for each of the scales, which indicates its sufficient reliability. The confirmatory factor analysis confirmed the correspondence of the obtained model to the experimental one. The criterion-related validity revealed correlation between the scales with the SF-36 physical functioning scale (r=-0,212, p<0,05), Charlson comorbidity index (r=0,282, p<0,01), physical activity restriction (r=-0,218, p<0,05) and the frequency of angina episodes (r=-0,340, p<0,05) of the SAQ questionnaire, duration of CCS (r=0,354, p<0,01) and Morisky-Green scale value (r=0.25, p<0,05).
Conclusion. The Russian-language version of the Self-Care of Coronary Heart Disease Inventory showed sufficient psychometric properties and is a valid tool for assessing the self-care skills in patients with CCS.
Key words: chronic coronary syndromes, coronary artery disease, self-care, quality of life.
Acknowledgements. The team of authors is gratitude to Zhura Viktoriya Valentinovna, Doctor of Philology, Associate Professor, head of the department of foreign languages at Volgograd State Medical University for the help in translation and development of the Russian-language version of the SC-CHDI questionnaire.
1Volgograd State Medical University, Volgograd; 2Volgograd Regional Clinical Cardiology Center, Volgograd, Russia.
Relationships and Activities: none.
Kabargina A. I.* ORCID: 0000-0003-4322-8112, Lopatin Yu. M. ORCID: 0000-0003-1943-1137.
*Corresponding author: kabargina.a.i@gmail.com
Received: 10.06.2020
Revision Received: 13.07.2020
Accepted: 01.08.2020
For citation: Kabargina A. I., Lopatin Yu. M. Validity and reliability of the Russianlanguage version of the Self-Care of Coronary Heart Disease Inventory in patients with chronic coronary syndromes. Russian Journal of Cardiology. 2020;25(9):3961. (In Russ.) doi:10.15829/1560-4071-2020-3961
PROBLEMATIC ARTICLE
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR: DECISION-MAKING ON TURNING OFF IN PATIENTS WITH END-STAGE HEART FAILURE
Lebedeva V. K., Lebedev D. S.
Abstract
The use of implantable cardioverter defibrillators has become a common standard method of primary and secondary prevention of sudden cardiac death, prolonging the life of patients with cardiomyopathy. At the same time, with the disease and comorbidity progression, at the final stages of life, a difficult decision arises to turn off the device due to a shift in priorities from extending life to maintaining its quality. Heart failure patients eventually die due to the progression of the underlying disease, despite currently available advanced technologies. Whether certain lifesustaining treatment methods are still appropriate in the final stages of life is an important topic of discussion in this article. Palliation for patients with implantable cardioverter-defibrillators is a challenging issue for both patients and medical professionals. This article describes the different ways to turn off defibrillation devices based on patient status.
Key words: implantable cardioverter defibrillator, shock, terminal illness patient, death, heart failure.
Relationships and Activities: none.
Almazov National Medical Research Center, St. Petersburg, Russia.
Lebedeva V. K.* ORCID: 0000-0002-0507-0960, Lebedev D. S. ORCID: 0000-0002-2334-1663.
*Corresponding author: lebedevavikt@gmail.com
Received: 29.04.2020
Revision Received: 17.05.2020
Accepted: 06.06.2020
For citation: Lebedeva V. K., Lebedev D. S. Implantable cardioverter defibrillator: decision-making on turning off in patients with end-stage heart failure. Russian Journal of Cardiology. 2020;25(9):3868. (In Russ.) doi:10.15829/1560-4071-2020-3868
ROLE OF SPIRITUALITY AND RELIGIOSITY IN CLINICAL PRACTICE: PROBLEM CONCEPTUALIZATION
Rodionova Yu. V.1, Chasovskikh G. A.2,3, Taratukhin E. O.2
Abstract
The concepts of spirituality and religiosity are studied in the context of cardiac disease and prevention. In psychology, psychosomatics, psychocardiology, spirituality is studied as a feature of human experience, attributed to certain transcendental ideas. Religiosity is a part of a person’s self-identification, influencing his experience of interaction with medicine, and more broadly, in general, his worldview and conceptualizations. Spirituality and religiosity are culturally specific, in particular, in Russia, where society has historically formed stereotypes of attitudes on God and other inaccessible ideas. Thus, the Russian society is characterized by lay religiosity, which includes Eastern Orthodox metaphysics along with paganism. In practical cardiology, the concepts of spirituality and religiosity can be realized explicitly (manifestation of faith by a patient and a doctor) and implicitly, without manifestation. Spirituality and religiosity can influence patient adherence, decision making, and more complex psychosomatic processes. Spirituality and religiosity can be a salutogenic factor, which promotes health, improves the psychological and physical state. But they can also mediate morbid effects if a doctor incorrectly addresses them during communication with a patient. Spirituality and religiosity are a part of complex downward system of somatic manifestation of cultural and social factors, the study and consideration of which is obvious in practice.
Key words: psychosomatics, upward communication, downward communication, experience, risk factors, patient-centered care, communication, spirituality, religiosity.
Relationships and Activities: none.
1N. N. Blokhin National Medical Research Center of Oncology, Moscow; 2Pirogov Russian National Research Medical University, Moscow; 3National Research University Higher School of Economics, Moscow, Russia.
Rodionova Yu. V. ORCID: 0000-0002-6378-6317, Chasovskikh G. A. ORCID: 0000-0001-5405-2875, Taratukhin E. O.* ORCID: 0000-0003-2925-0102.
*Corresponding author: cardio03@list.ru
Received: 01.08.2020
Revision Received: 14.08.2020
Accepted: 20.08.2020
For citation: Rodionova Yu. V., Chasovskikh G. A., Taratukhin E. O. Role of spirituality and religiosity in clinical practice: problem conceptualization. Russian Journal of Cardiology. 2020;25(9):4041. (In Russ.) doi:10.15829/1560-4071-2020-4041
PATIENT-CENTERED PALLIATIVE CARE IN PEDIATRIC CARDIOLOGY: A CARDIOPHENOMENOLOGICAL APPROACH
Miroshnichenko M. D., Nozdrachev D. I.
Abstract
Despite the success of pediatric cardiology and cardiac surgery in the treatment of severe heart diseases in children, a significant increase in the average life expectancy and quality of life of patients, cardiovascular diseases remain common reasons leading to the need for palliative care. A number of psychological and ethical aspects in pediatric palliative care in cardiology are not sufficiently developed. Cardiac diseases requiring palliative care affect the physiological, psychological and social aspects of patients’ lives, and require special attention. It is proposed to use the second-person methods in clinical communication based on the biopsychosocial approach of cardiophenomenology in order to provide a patient-centered environment in palliative care for children with severe heart diseases. Cardiophenomenology can provide non-paternalistic relationships in palliative care for pediatric patients with cardiovascular disease to improve health-related quality of life (HRQoL).
Key words: congenital heart defects, quality of life, patient-centered care, doctorpatient relationship, palliative care for children, cardiophenomenology.
Relationships and Activities. The study was supported by a grant from the Russian Science Foundation № 20-78-10117 on the topic “Models of interaction between doctors and patients in palliative care centers for children”.
Pirogov Russian National Research Medical University, Moscow, Russia.
Miroshnichenko M. D.* ORCID: 0000-0003-1374-1599, Nozdrachev D. I. ORCID: 0000-0003-3269-7917.
*Corresponding author: jaberwokky@gmail.com
Received: 04.08.2020
Revision Received: 14.08.2020
Accepted: 20.08.2020
For citation: Miroshnichenko M. D., Nozdrachev D. I. Patient-centered palliative care in pediatric cardiology: a cardiophenomenological approach. Russian Journal of Cardiology. 2020;25(9):4047. (In Russ.) doi:10.15829/1560-4071-2020-4047
RESEARCH ON THE EVOLUTION OF MORALITY AS A COMMUNICATION TOOL IN THE DOCTOR-PATIENT RELATIONSHIP
Chasovskikh G. A.
Abstract
In the biosocial paradigm of human nature, we can consider not only the concept of health, as it is derived from the definition of the World health organization, but also the socio-cultural aspects of life. Ethics is an integral part of society, and it is all the more critical for medicine. Studies of the evolution of morality contain not only and not so much information about the behavior of our ancestors, but also about the nature of our behavior, and the mechanisms of choice regarding the phenomena of cooperation, trust, mutual assistance, justice, and others. Some of them are directly related to the doctorpatient relationship. The nature of these phenomena is described from the perspective of different disciplines: ethology, neurophysiology, evolutionary psychology, and game theory. All these disciplines in total can indeed form recommendations for interaction with patients and can be useful to a doctor, especially those who need to maximize the effectiveness of their communication while saving resources. A patient is alsointerested in the treatment and saving of his emotional resource, which defines the doctor-patient relationship as an interaction with a common interest or a non-zerosum game. Behavioral economics is also included in this interaction, considered in the context of strategy choice by agents (in this case, doctor and patient), but not in the context of resource allocation. This is of practical significance in the context of working with psychosocial risk factors.
Key words: morality evolution, patient-centered care, communication, trust, empathy, framing effect.
Relationships and Activities: none.
Pirogov Russian National Research Medical University, Moscow, Russia.
Chasovskikh G. A. ORCID: 0000-0001-5405-2875.
Corresponding author: 19sub@mail.ru
Received: 24.08.2020
Revision Received: 28.08.2020
Accepted: 31.08.2020
For citation: Chasovskikh G. A. Research on the evolution of morality as a communication tool in the doctor-patient relationship. Russian Journal of Cardiology. 2020;25(9):4073. (In Russ.) doi:10.15829/1560-4071-2020-4073
CLINIC AND PHARMACOTHERAPY
INCREMENT OF THE EFFECTIVENESS OF TREATING HYPERTENSION AND DYSLIPIDEMIA USING A TRIPLE FIXED-DOSE COMBINATION AND THE VASCULAR AGE CONCEPT
Tsygankova O. V.1,2, Batluk T. I.2, Latyntseva L. D.2
Abstract
Aim. To study the efficacy, safety and effect on vascular age of free-equivalent and fixed-dose combinations of amlodipine, a renin–angiotensin–aldosterone system blockers and rosuvastatin in patients with high and very high cardiovascular risk with uncontrolled hypertension and concomitant dyslipidemia.
Material and methods. This open-label case series study included 148 men and women (mean age 60,63Ѓ}8,16 years). The patients were randomly divided into 2 groups: group 1 (n=76) received a triple fixed-dose combination of amlodipine, lisinopril, rosuvastatin; group 2 (n=72) received a dual free-equivalent antihypertensive combination (amlodipine/losartan) and rosuvastatin. The doses were selected by the attending physician and were not regulated by the researchers. The study included an assessment of blood pressure, lipid profile (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides), biochemical profile, ASCORE value, medication adherence, changes in the augmentation index (AI) at baseline and after 6 months of therapy (first and second visits, respectively). The results were considered significant at p<0,05.
Results. After 6 months of therapy, significant intragroup differences were noted in comparison with the baseline values. In group 1, the levels of TC (p=0,002), LDL-C (p=0,001), ASCORE value (p=0,01), and vascular age (p=0,01) significantly decreased; in group 2 — TC (p=0,03), LDL-C (p=0,005). In the group of triple fixeddose therapy, the values of AI (p=0,04), TC (p=0,012), LDL-C (p=0,024), ASCORE value (p=0,02) and vascular age (p=0,01) were significantly lower than in the freeequivalent group.
Conclusion. The fixed-dose combination of amlodipine, lisinopril and rosuvastatin, is more effective and equally safe relative to the free-equivalent combination of amlodipine/losartan and rosuvastatin, not only in terms of effect on LDL-C and AI, but also on vascular age parameters calculated using the ASCORE scale. This can serve as an additional motivating factor for patients to receive therapy.
Key words: vascular age, hypertension, dyslipidemia, cardiovascular risk.
Relationships and Activities. The study was partially carried out under the State Assignment within the budget theme № АААА-А17-117112850280-2.
1Novosibirsk State Medical University, Novosibirsk; 2Research Institute of Therapy and Preventive Medicine, branch of the Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia.
Tsygankova O. V. ORCID: 0000-0003-0207-7063, Batluk T. I.* ORCID: 0000-0002-0210-2321, Latyntseva L. D. ORCID: 0000-0003-1913-5231.
*Corresponding author: novagirl@mail.ru
Received: 11.06.2020
Revision Received: 19.07.2020
Accepted: 01.08.2020
For citation: Tsygankova O. V., Batluk T. I., Latyntseva L. D. Increment of the effectiveness of treating hypertension and dyslipidemia using a triple fixed-dose combination and the vascular age concept. Russian Journal of Cardiology. 2020;25(9):4026. (In Russ.) doi:10.15829/1560-4071-2020-4026
LITERATURE REVIES
UP-TO-DATE POTENTIAL OF ANTITHROMBOTIC THERAPY IN PATIENTS WITH CORONARY ARTERY DISEASE AND DIABETES
Ostroumova O. D.1,2, Kochetkov A. I.1, Kirichenko A. A.1, Klepikova M. V.1, Golovina O. V.1, Alyautdinova I. A.1
Abstract
Almost half of patients with coronary artery disease (CAD) have concomitant diabetes, and this, in turn, significantly increases cardiovascular risk. Modern approaches to the treatment of patients with CAD and comorbid diabetes are aimed at reducing cardiovascular risk, and acetylsalicylic acid remains the basis of antithrombotic therapy for such patients. Combined therapy with rivaroxaban and acetylsalicylic acid reduces risk of significant events in different categories of patients. The safety profile of dual antithrombotic therapy remains invariably optimal, regardless of comorbidities.
Relationships and Activities. The publication of the article was supported by Bayer, which in not influenced the authors’ own opinions.
Key words: antithrombotic therapy, coronary artery disease, diabetes, rivaroxaban.
1Russian Medical Academy of Continuous Professional Education, Moscow; 2I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
Ostroumova O. D.* ORCID: 0000-0002-0795-8225, Kochetkov A. I. ORCID: 0000-0001-5801-3742, Kirichenko A. A. ORCID: 0000-0001-8364-7472, Klepikova M. V. ORCID: 0000-0003-4258-1889, Golovina O. V. ORCID: 0000-0001-8579-7167, Alyautdinova I. A. ORCID: 0000-0003-3076-2180.
*Corresponding author: ostroumova.olga@mail.ru
Received: 28.08.2020
Revision Received: 07.09.2020
Accepted: 09.09.2020
For citation: Ostroumova O. D., Kochetkov A. I., Kirichenko A. A., Klepikova M. V., Golovina O. V., Alyautdinova I. A. Up-to-date potential of antithrombotic therapy in patients with coronary artery disease and diabetes. Russian Journal of Cardiology. 2020;25(9):4077. (In Russ.) doi:10.15829/1560-4071-2020-4077
IS THE CONCEPT OF TYPE D PERSONALITY A COMPONENT OF PERSONALIZED MEDICINE OR A PROGNOSTIC FACTOR IN THE TREATMENT OF CARDIOVASCULAR DISEASES?
Sumin A. N., Shcheglova A. V.
Abstract
The study of a patient’s personal traits is reasonable and relevant in the implementation of personalized medicine in cardiology. The use of type D personality concept seems suitable for such aims. Type D personality refers to chronic psychosocial risk factors,which associated with a decrease in the quality of life, and is recommended for screening. Additional analysis showed the heterogeneity of type D effect on prognosis depending on the stage of disease (coronary artery disease or heart failure), age, and endpoints used. In addition, ethnic, geographic and socio-economic factors, differences in the mentality can also affect the predictive value of type D personality. Possible mechanisms of its influence on the prognosis are maladaptive response to stress, as well as the behavioral characteristics of such patients. In assessing the type D effect, it has recently been proposed to use additional calculations with an estimate of the addictive and synergistic effects. In clinical practice and screening studies, conventional assessment of type D personality using the DS-14 questionnaire seems reasonable. Until now, the question of influencing persons with type D personality remains unstudied. The following treatment strategies look promising: change of excessive responses to stress; the influence on inadequate stress coping strategies. The ultimate goal of such interventions should be not only to improve the psychological functioning of patients, but also to slow down the progression of the physical illness and improve the prognosis.
Key words: type D personality, personalized medicine, prognostic value.
Relationships and Activities: none.
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.
Sumin A. N.* ORCID: 0000-0002-0963-4793, Shcheglova A. V. ORCID: 0000-0002-4108-164X.
*Corresponding author: an_sumin@mail.ru
Received: 06.07.2020
Revision Received: 14.07.2020
Accepted: 01.08.2020
For citation: Sumin A. N., Shcheglova A. V. Is the concept of type D personality a component of personalized medicine or a prognostic factor in the treatment of cardiovascular diseases? Russian Journal of Cardiology. 2020;25(9):3996. (In Russ.) doi:10.15829/1560-4071-2020-3996
EXPERT CONSENSUS
RESOLUTION OF THE INTERNATIONAL MEETING OF EXPERTS ON THE EXCHANGE OF SCIENTIFIC EXPERIENCE IN THE USE OF ANTICOAGULANTS IN PATIENTS WITH COVID-19
Experts: Avdeev S. N., Bazarova A. V., Baranova E. I., Esayan A. M., Zhusupova G. K., Zamyatin M. N., Zotova I. V., Kasenova S. L., Matskeplishvili S. T., Miller O. N., Pak A. M., Salukhov V. V., Tyrenko V. V., Khasanova D. R., Shamalov N. A., Yanishevsky S. N.
Key words: COVID-19, anticoagulants, anticoagulant therapy, prognosis.
Relationships and Activities. The resolution was created with the support of Boehringer Ingelheim.
Corresponding author: stasya71@yandex.ru (Yanishevsky S. N.)
Received: 07.09.2020
Accepted: 09.09.2020
For citation: Resolution of the International meeting of experts on the exchange of scientific experience in the use of anticoagulants in patients with COVID-19. Russian Journal of Cardiology. 2020;25(9):4099. (In Russ.) doi:10.15829/1560-4071-2020-4099
