Возможности диспансерного наблюдения в снижении смертности от ишемической болезни сердца

Бойцов С.А., Проваторов С.И. Возможности диспансерного наблюдения в снижении смертности от ишемической болезни сердца. Терапевтический архив. 2023;95(1):5–10.
DOI: 10.26442/00403660.2023.01.202038

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

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Boytsov SA, Provatorov SI. Possibilities of dispensary observation in reducing mortality from coronary heart disease. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(1):5–10. DOI: 10.26442/00403660.2023.01.202038

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Аннотация

Диспансерное наблюдение пациентов с ишемической болезнью сердца дает возможность существенно снизить вероятность возникновения у них сердечно-сосудистых осложнений. Активное наблюдение за амбулаторными пациентами позволяет скорректировать основные факторы риска сердечно-сосудистых осложнений, оценить риск развития неблагоприятных сердечно-сосудистых событий и выявить пациентов, нуждающихся в проведении реваскуляризации. Внедрение комплексной оценки сердечно-сосудистого риска и развитие технологий дистанционного наблюдения позволят улучшить отдаленные результаты амбулаторного наблюдения за больными с ишемической болезнью сердца высокого сердечно-сосудистого риска.

Ключевые слова: диспансерное наблюдение, ишемическая болезнь сердца, сердечно-сосудистый риск, реваскуляризация, смертность

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Dispensary observation of patients with coronary artery disease can significantly reduce the likelihood of cardiovascular complications onset. Active outpatient monitoring allows to correct the main risk factors for cardiovascular complications, to estimate the risk of unfavorable cardiovascular events onset and to identificate patients who will get benefit of coronary revascularization. The introduction of a comprehensive assessment of cardiovascular risk and the development of remote monitoring technologies will improve the long-term results of outpatient follow-up of patients with coronary artery disease at high cardiovascular risk.

Keywords: dispensary observation, ischemic heart disease, cardiovascular risk, revascularization, mortality

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Список литературы

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17. Приказ Министерства здравоохранения Российской Федерации от 15.03.2022 №168н «Об утверждении порядка проведения диспансерного наблюдения за взрослыми». Российская газета. 22.04.2022. Режим доступа: https://rg.ru/documents/2022/04/22/minzdrav-prikaz168-site-dok.html. Ссылка активна на 14.11.2022 [Order of the Ministry of Health of the Russian Federation dated March 15, 2022 №168n “On approval of the procedure for dispensary observation of adults”. Russian newspaper. 04.22.2022. Available at: https://rg.ru/documents/2022/04/22/minzdrav-prikaz168-site-dok.html. Accessed: 14.11.2022 (in Russian)].
18. Приказ Министерства здравоохранения Российской Федерации от 29.09.2022 №639н «Об утверждении перечня лекарственных препаратов для медицинского применения в целях обеспечения в амбулаторных условиях лиц, находящихся под диспансерным наблюдением, которые перенесли острое нарушение мозгового кровообращения, инфаркт миокарда, а также которым выполнены аортокоронарное шунтирование, ангиопластика коронарных артерий со стентированием и катетерная абляция по поводу сердечно-сосудистых заболеваний, в течение 2 лет с даты постановки диагноза и (или) выполнения хирургического вмешательства». Российская газета. 28.10.2022. Режим доступа: https://rg.ru/documents/2022/10/28/minzdrav-prikaz639-site-dok.html. Ссылка активна на 14.11.2022 [Order of the Ministry of Health of the Russian Federation dated September 29, 2022 №639n “On approval of the list of drugs for medical use in order to provide outpatient care for people under dispensary observation who have suffered acute cerebrovascular accident, myocardial infarction, and who have undergone coronary artery bypass grafting, angioplasty of the coronary arteries with stenting and catheter ablation for cardiovascular diseases, within 2 years from the date of diagnosis and (or) surgical intervention”. Russian newspaper. 10.28.2022. Available at: https://rg.ru/documents/2022/10/28/minzdrav-prikaz639-site-dok.html. Accessed: 14.11.2022 (in Russian)].
19. Luiza VL, Chaves LA, Silva RM, et al. Pharmaceutical policies: effects of cap and co-payment on rational use of medicines. Cochrane Database Syst Rev. 2015;2015(5):CD007017. DOI:10.1002/14651858.CD007017.pub2
20. Mills EJ, O'Regan C, Eyawo O, et al. Intensive statin therapy compared with moderate dosing for prevention of cardiovascular events: a meta-analysis of >40 000 patients. Eur Heart J. 2011;32(11):1409-15. DOI:10.1093/eurheartj/ehr035
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23. Осокина А.К, Потехина А.В, Филатова А.Ю., и др. Возможность контроля липидного профиля у пациентов, перенесших стентирование коронарных артерий, с помощью дистанционного мониторинга по результатам наблюдения в течение 6 месяцев. Вестник Всероссийского общества специалистов по медико- социальной экспертизе, реабилитации и реабилитационной индустрии. 2020;3:56-64 [Osokina AK, Potekhina AV, Filatova AYu, et al. Possibility of lipid profile control in patients under coronary stenting using remote monitoring on the results of observation for 6 months. Vestnik of Russian Society of Specialists on Medical Social Expertise and Rehabilitation Industry. 2020;3:56-64 (in Russian)]. DOI:10.17238/issn1999-2351.2020.3.56-64
24. Alsadat N, Hyun K, Boroumand F, et al. Achieving lipid targets within 12 months of an acute coronary syndrome: an observational analysis. Med J Aust. 2022;216(9):463-8. DOI:10.5694/mja2.51442
25. Hachamovitch R, Hayes SW, Friedman JD, et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107(23):2900-7. DOI:10.1161/01.CIR.0000072790.23090.41
26. Elbez Y, Cheong AP, Fassa AA, et al. Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization. Eur Heart J Qual Care Clin Outcomes. 2016;2(1):23-32. DOI:10.1093/ehjqcco/qcv017
27. Boden WE, O'Rourke RA, Maron DJ, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007;356:1503-16. DOI:10.1056/NEJMoa070829
28. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020;382:1395-407. DOI:10.1056/NEJMoa1915922

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1. Russian statistical yearbook. 2021: Statistical collection of Rosstat. Moscow, 2021 Available at: https://rosstat.gov.ru/storage/mediabank/Ejegodnik_2021.pdf. Accessed: 14.11.2022 (in Russian).
2. Sorbets E, Fox KM, Elbez Y, et al. CLARIFY investigators. Long-term outcomes of chronic coronary syndrome worldwide: insights from the international CLARIFY registry. Eur Heart J. 2020;41(3):347-56. DOI:10.1093/eurheartj/ehz660
3. Rapsomaniki E, Shah A, Perel P, et al. Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients. Eur Heart J. 2014;35(13):844-52. DOI:10.1093/eurheartj/eht533
4. Shalnova SA, Oganov RG, Deev AD, et al. Comorbidities of ischemic heart disease with other non-communicable diseases in adult population: age and risk factors association. Cardiovascular Therapy and Prevention. 2015;14(4):44-51 (in Russian). DOI:10.15829/1728-8800-2015-4-44-51
5. Bauters C, Tricot O, Meurice T, et al. Long-term risk and predictors of cardiovascular death in stable coronary artery disease: the CORONOR study. Coron Artery Dis. 2017; 28(8):636-41. DOI:10.1097/MCA.0000000000000560
6. Abbadi AB, Lemesle G, Lamblin N, Bauters C. Very long-term outcomes of older adults with stable coronary artery disease (from the CORONOR study). Coron Artery Dis. 2022;33(3):169-75. DOI:10.1097/MCA.0000000000001086
7. Viana-Tejedor A, Loughlin G, Fernández-Avilés F, Bueno H. Temporal trends in the use of reperfusion therapy and outcomes in elderly patients with first ST elevation myocardial infarction. Eur Heart J Acute Cardiovasc Care. 2015;4(5):461-7. DOI:10.1177/2048872614565928
8. Terkelsen CJ, Lassen JF, Nørgaard BL, et al. Mortality rates in patients with ST-elevation vs. non-ST-elevation acute myocardial infarction: observations from an unselected cohort. Eur Heart J. 2005;26(1):18-26. DOI:10.1093/eurheartj/ehi002
9. Lamblin N, Meurice T, Tricot O, et al. First Hospitalization for Heart Failure in Outpatients With Stable Coronary Artery Disease: Determinants, Role of Incident Myocardial Infarction, and Prognosis. J Card Fail. 2018;24(12):815-22. DOI:10.1016/j.cardfail.2018.09.013
10. Blanke P, Naoum C, Ahmadi A, et al. Long-Term Prognostic Utility of Coronary CT Angiography in Stable Patients With Diabetes Mellitus. JACC Cardiovasc Imaging. 2016;9(11):1280-8. DOI:10.1016/j.jcmg.2015.12.027
11. Lima EG, Charytan DM, Hueb W, et al. Long-term outcomes of patients with stable coronary disease and chronic kidney dysfunction: 10-year follow-up of the Medicine, Angioplasty, or Surgery Study II Trial. Nephrol Dial Transplant. 2020;35(8):1369-76. DOI:10.1093/ndt/gfy379
12. Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Stable coronary artery disease. Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020;25(11):4076 (in Russian). DOI:10.15829/1560-4071-2020-4076
13. Knuuti J, Wijns W, Saraste A, et al. ESC Scientific Document Group, 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(3):407-77. DOI:10.1093/eurheartj/ehz425
14. Lindholm D, Lindbäck J, Armstrong PW, et al. Biomarker-Based Risk Model to Predict Cardiovascular Mortality in Patients With Stable Coronary Disease. J Am Coll Cardiol. 2017;70(7):813-26. DOI:10.1016/j.jacc.2017.06.030
15. Samorodskaya IV, Chernyavskaya TK, Kakorina EP, Semenov VYu. Ischemic heart disease: medical certificate of cause of death analysis. Russian Journal of Cardiology. 2022;27(1):4637 (in Russian). DOI:10.15829/1560-4071-2022-4637
16. Sawicki OA, Mueller A, Glushan A, et al. Intensified ambulatory cardiology care: effects on mortality and hospitalisation – a comparative observational study. Sci Rep. 2020;10(1):14695. DOI:10.1038/s41598-020-71770-9
17. Order of the Ministry of Health of the Russian Federation dated March 15, 2022 №168n “On approval of the procedure for dispensary observation of adults”. Russian newspaper. 04.22.2022. Available at: https://rg.ru/documents/2022/04/22/minzdrav-prikaz168-site-dok.html. Accessed: 14.11.2022 (in Russian).
18. Order of the Ministry of Health of the Russian Federation dated September 29, 2022 №639n “On approval of the list of drugs for medical use in order to provide outpatient care for people under dispensary observation who have suffered acute cerebrovascular accident, myocardial infarction, and who have undergone coronary artery bypass grafting, angioplasty of the coronary arteries with stenting and catheter ablation for cardiovascular diseases, within 2 years from the date of diagnosis and (or) surgical intervention”. Russian newspaper. 10.28.2022. Available at: https://rg.ru/documents/2022/10/28/minzdrav-prikaz639-site-dok.html. Accessed: 14.11.2022 (in Russian).
19. Luiza VL, Chaves LA, Silva RM, et al. Pharmaceutical policies: effects of cap and co-payment on rational use of medicines. Cochrane Database Syst Rev. 2015;2015(5):CD007017. DOI:10.1002/14651858.CD007017.pub2
20. Mills EJ, O'Regan C, Eyawo O, et al. Intensive statin therapy compared with moderate dosing for prevention of cardiovascular events: a meta-analysis of >40 000 patients. Eur Heart J. 2011;32(11):1409-15. DOI:10.1093/eurheartj/ehr035
21. Espinoza C, Mukherjee D. Dual Antiplatelet Therapy in Patients with High Cardiovascular Risk. Heart Int. 2021;15(1):26-36. DOI:10.17925/HI.2021.15.1.26
22. The procedure for providing medical care to patients with cardiovascular diseases. Russian newspaper. 04.24.2013. Available at: https://rg.ru/documents/2013/04/25/serdechniki-dok.html. Accessed: 14.11.2022 (in Russian).
23. Osokina AK, Potekhina AV, Filatova AYu, et al. Possibility of lipid profile control in patients under coronary stenting using remote monitoring on the results of observation for 6 months. Vestnik of Russian Society of Specialists on Medical Social Expertise and Rehabilitation Industry. 2020;3:56-64 (in Russian). DOI:10.17238/issn1999-2351.2020.3.56-64
24. Alsadat N, Hyun K, Boroumand F, et al. Achieving lipid targets within 12 months of an acute coronary syndrome: an observational analysis. Med J Aust. 2022;216(9):463-8. DOI:10.5694/mja2.51442
25. Hachamovitch R, Hayes SW, Friedman JD, et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107(23):2900-7. DOI:10.1161/01.CIR.0000072790.23090.41
26. Elbez Y, Cheong AP, Fassa AA, et al. Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization. Eur Heart J Qual Care Clin Outcomes. 2016;2(1):23-32. DOI:10.1093/ehjqcco/qcv017
27. Boden WE, O'Rourke RA, Maron DJ, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007;356:1503-16. DOI:10.1056/NEJMoa070829
28. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020;382:1395-407. DOI:10.1056/NEJMoa1915922

Авторы

С.А. Бойцов1,2, С.И. Проваторов*1

1 ФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России, Москва, Россия;
2 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
*semaver@yandex.ru

________________________________________________

Sergey A. Boytsov1,2, Sergei I. Provatorov*1

1 Chazov National Medical Research Center of Cardiology, Moscow, Russia;
2 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
*semaver@yandex.ru

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