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1.
Kardiologiia ; 61(4): 4-14, 2021 Mar 23.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-33998403

RESUMO

Aim    To study the etiology and the dynamics of prevalence and mortality of CHF; to evaluate the treatment coverage of such patients in a representative sample of the European part of the Russian Federation for a 20-year period. Material and methods    A representative sample of the European part of the Russian Federation followed up for 2002 through 2017 (n=19 276); a representative sample of the population of the Nizhny Novgorod region examined in 1998 (n=1922).Results    During the observation period since 2002, the incidence of major CHF symptoms (tachycardia, edema, shortness of breath, weakness) tended to decrease while the prevalence of cardiovascular diseases has statistically significantly increased. During the period from 1998 through 2017, the prevalence of I-IV functional class (FC) CHF increased from 6.1 % to 8.2 % whereas III-IV FC CHF increased from 1.8 % to 3.1 %. The main causes for the development of CHF remained arterial hypertension and ischemic heart disease; the role of myocardial infarction and diabetes mellitus as causes for CHF was noted. For the analyzed period, the number of treatment components and the coverage of basic therapy for patients with CHF increased, which probably accounts for a slower increase in the disease prevalence by 2007-2017. The prognosis of patients was unfavorable: in I-II FC CHF, the median survival was 8.4 (95 % CI: 7.8-9.1) years and in III-IV FC CHF, the median survival was 3.8 (95 % CI: 3.4-4.2) years.


Assuntos
Diabetes Mellitus , Insuficiência Cardíaca , Doença Crônica , Seguimentos , Insuficiência Cardíaca/epidemiologia , Humanos , Federação Russa/epidemiologia
2.
Kardiologiia ; 60(5): 25-34, 2020 Jun 03.
Artigo em Russo | MEDLINE | ID: mdl-32515701

RESUMO

Aim      To evaluate compliance with self-monitoring and drug and non-drug treatment of patients after ADHF during the management at a specialized center for CHF treatment (CCHF) or in real-life clinical practice.Material and methods  The study included 942 CHF patients after ADHF. In two years, the entire sample of patients was retrospectively divided into 4 groups based on their compliance with the management at the CCHF: group 1, 313 patients who were managed at the CCHF continuously for two years; group 2, 383 patients who choose the management at district outpatient clinics after discharge from a hospital; group 3, 197 patients who visited the CCHF for one year but then stopped the management; and group 4, 49 patients who initially preferred the management at district clinics but then switched to constant management at the CCHF. Compliance with recommendations was analyzed by data of outpatient clinical records or by data of structured telephone calls for patients who did not visit the CCHF or did not follow the visit schedule. Statistics was performed with a Statistica 7.0 for Windows software package.Results Patients of groups 2 (72.4 %) and 3 (88.3 %) performed self-monitoring less frequently whereas patients of groups 1 (94.6 %) and 4 (87.8 %) performed self-monitoring more frequently (р1 / 3=0.01, р1 / 2<0.001, р1 / 4=0.07, р2 / 4=0.02, р2 / 3<0.001, р4 / 3=0.9). Patients of group 2 (58.1 %) performed self-monitoring of heart rate less frequently than patients of groups 1, 3, and 4 (90.7 %, 81.7 %, and 87.8 %; р1 / 3=0.003, р1 / 2<0.001, р1 / 4=0.5, р2 / 4<0.001, р2 / 3<0.001, and р4 / 3=0.3). Patients of group 2 performed body weight self-monitoring less frequently than patients of groups 1, 3, and 4 (78.6 %, 67.9 %, and 72.9 %; р1 / 3=0.008, р1 / 2<0.001, р1 / 4=0.4, р2 / 4=0.002, р2 / 3<0.001, and р4 / 3=0.5). Compliance with the diet and restriction of salt consumption was 32.3 % and 37.5 % in groups 1 and 4, and 24.9 % and 19.9 % in groups 2 and 3 (р1 / 3=0.002, р1 / 2=0.03, р1 / 4=0.5, р2 / 4=0.02, р2 / 3=0.2, and р4 / 3=0.009). Compliance with recommendations on physical rehabilitation was 44.7% in group 1, which was better than in groups 2, 3, and 4 (8.2 %, 21.6 %, and 9.1 %; р1 / 2<0.001, р1 / 3=0.0003, р1 / 4=0.002, р2 / 4=0.9, р2 / 3=0.0006, and р4 / 3=0.2). At the end of the second year of follow-up, the actual proportion of patients taking ACE inhibitors/angiotensin receptor antagonists was low in groups 2, 3, and 4 (43.2 %, 45 %, and 66.7 %) and satisfactory in group 1 (92.4 %; р1 / 2<0.001, р1 / 3<0.001, р1 / 4<0.001, р2 / 3=0.6, р2 / 4=0.05, and р3 / 4=0.05). Proportion of patients taking beta-blockers was greater in group 1 (97.2 %) than in groups 2, 3. and 4 (73.2 %, 71.1 %, and 90.5 %; р1 / 2<0.001, р1 / 3<0.001, р1 / 4=00.08, р2 / 3=0.6, р2 / 4=0.1, and р3 / 4=0.06). Patients of group 1 (96.2 %) showed good compliance with the mineralocorticoid receptor antagonist treatment compared to groups 2, 3, and 4 (58.8 %, 55.4 %, and 81.2 %; р1 / 2<0.001, р1 / 3<0.001, р1 / 4<0.001, р2 / 3=0.5, р2 / 4=0.1, and р3 / 4=0.Conclusion      Only scheduled management by a cardiologist of the specialized CCHF provided sufficient compliance with self-monitoring and drug and non-drug treatment of CHF during the long-term follow-up.


Assuntos
Insuficiência Cardíaca , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Humanos , Monitorização Ambulatorial , Estudos Retrospectivos
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