Metrika članka

  • citati u SCindeksu: 0
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[=>]
  • posete u poslednjih 30 dana:8
  • preuzimanja u poslednjih 30 dana:1
članak: 1 od 3  
Back povratak na rezultate
Srpski arhiv za celokupno lekarstvo
2016, vol. 144, br. 11-12, str. 590-596
jezik rada: engleski
vrsta rada: originalan članak
doi:10.2298/SARH1612590I


Uticaj medikamentne terapije usklađene prema aktuelnim terapijskim vodičima na težinu stabilne koronarne bolesti kod bolesnika u Srbiji
aMedicinski fakultet, Beograd + Kliničko-bolnički centar 'Zemun', Služba kardiologije, Beograd
bUniverzitet u Beogradu, Medicinski fakultet, Institut za kardiovaskularne bolesti 'Dedinje'
cUniverzitet u Nišu, Medicinski fakultet, Institut za prevenciju, lečenje i rehabilitaciju reumatičkih i kardioloških bolesti 'Niška Banja' - Niška Banja
dMedicinski fakultet, Beograd + Zavod za javno zdravlje 'Vračar', Beograd
eMedicinski fakultet, Beograd + Klinika za rehabilitaciju 'Dr Miroslav Zotović', Beograd
fMedicinski fakultet, Beograd + Klinički centar Srbije, Klinika za kardiologiju, Beograd
gMedicinski fakultet, Niš + Institut 'Niška Banja', Niška Banja
hMedicinski fakultet, Novi Sad + Institut za kardiovaskularne bolesti, Klinika za kardiologiju, Sremska Kamenica
iFakultet medicinskih nauka, Kragujevac + Klinički centar 'Kragujevac', Kragujevac
jOpšta bolnica, Leskovac

e-adresa: neskovic@hotmail.com

Sažetak

Uvod Osobe koje boluju od stabilne koronarne bolesti nedovoljno se pridržavaju preporuka o promeni životnih navika i redovnom uzimanju terapije. Cilj rada Cilj studije je ispitati uticaj medikamentne terapije usklađene prema aktuelnim preporukama na težinu angine pektoris kod pacijenata sa stabilnom koronarnom bolešću u Srbiji. Metode rada U studiju je uključeno 3.490 pacijenata u 15 kardioloških klinika sa simptomima stabilne angine i/ ili promenama na elektrokardiogramu (EKG), preležanim infarktom miokarda (IM), pozitivnim testom fizičkog opterećenja, angiografski dokazanom značajnom koronarnom bolešću ili prethodnom revaskularizacijom miokarda. Svi bolesnici su sveobuhvatno pregledani na prvoj poseti i nakon dva meseca. Cilj istraživanja je smanjenje anginoznih tegoba, definisano kao bilo kakvo smanjenje klase definisane Kanadskim kardiološkim društvom (CCS), broja anginoznih napada nedeljno i/ili smanjenje broja uzetih tableta kratkodelujućih nitrata. Rezultati Većina bolesnika je uključena na osnovu promena na EKG-u (48,4%). Na prvom pregledu prosečan broj klasa lekova prepisanih pacijentu porastao je sa 4,16 ± 1,29 na 4,63 ± 1,57 (p < 0,001). Na kontrolnom pregledu bolesnici su imali značajno manje vrednosti krvnog pritiska (141 ± 19 / 85 ± 11 vs. 130 ± 12 / 80 ± 8 mmHg; p < 0,001) i većina je pripadala CCS klasi I (63,3%). Prosečan broj anginoznih napada nedeljno smanjen je sa 2,82 ± 2,50 na prvoj poseti na 1,72 ± 1,66 na drugoj poseti. Takođe je smanjena nedeljna upotreba kratkodelujućih nitrata radi kupiranja anginoznih napada, sa 2,69 ± 2,53 na 1,74 ± 1,47 tablete (p < 0,001 za sve). Zaključak Usklađivanje medikamentne terapije prema aktuelnim preporukama dovodi do značajnog smanjenja anginoznih tegoba kod bolesnika sa prisutnim faktorima rizika u Srbiji.

Ključne reči

stabilna koronarna bolest; preporuke; medikamentna terapija; trimetazidin

Reference

*** (2000) Effect of 48-h intravenous trimetazidine on short- and long-term outcomes of patients with acute myocardial infarction, with and without thrombolytic therapy. A double-blind, placebo-controlled, randomized trial. European Heart Journal, 21(18): 1537-1546
Arnim, T.von (1995) Medical treatment to reduce total ischemic burden: Total ischemic burden bisoprolol study (TIBBS), a multicenter trial comparing bisoprolol and nifedipine. Journal of the American College of Cardiology, 25(1): 231-238
Belsey, J., Savelieva, I., Mugelli, A., Camm, A.J. (2015) Relative efficacy of antianginal drugs used as add-on therapy in patients with stable angina: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 22(7): 837-848
Chazov, E. I., Lepakchin, V. K., Zharova, E. A., Fitilev, S. B., Levin, A. M., Rumiantzeva, E. G., Fitileva, T. B. (2005) Trimetazidine in Angina Combination Therapy-The TACT Study: Trimetazidine versus Conventional Treatment in Patients with Stable Angina Pectoris in a Randomized, Placebo-Controlled, Multicenter Study. American Journal of Therapeutics, 12(1): 35-42
Chrysant, S.G., Glasser, S.P., Bittar, N., Shahidi, F.E., Danisa, K., Ibrahim, R., Watts, L.E., Garutti, R.J., Ferraresi, R., Casareto, R. (1993) Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris. American journal of cardiology, 72(17): 1249-56
Ciapponi, A., Pizarro, R., Harrison, J. (2005) Trimetazidine for stable angina. Cochrane Database of Systematic Reviews, 19(4):CD003614
Dagenais, G.R., Armstrong, P.W., Theroux, P. (2002) Naylor CD; CCS Ad Hoc Committee for Revising the CCS Grading of Stable Angina. Revising the Canadian Cardiovascular Society grading of stable angina pectoris after a quarter of a century of use. Can J Cardiol, 18(9); 941-4
Danchin, N., Ferrieres, J., Guenoun, M., Cattan, S., Rushton-Smith, S.K., Greenlaw, N., Ferrari, R., Steg, P.G. (2014) Management of outpatients in France with stable coronary artery disease. Findings from the prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY) registry. Archives of Cardiovascular Diseases, 107(8-9): 452-461
Detry, J.M., Sellier, P., Pennaforte, S., Cokkinos, D., Dargie, H., Mathes, P. (1994) Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group. Br J Clin Pharmacol, 37(3): 279-88
Institute of Public Health of Serbia Dr Milan Jovanovic Batut (2011) Incidence and mortality of acute coronary syndrome in Serbia. u: Serbian Acute Coronary Syndrome Registry: Report No. 6, Belgrade: Institute of Public Health of Serbia Dr Milan Jovanovic Batut
Klein, W.W., Jackson, G., Tavazzi, L. (2002) Efficacy of monotherapy compared with combined antianginal drugs in the treatment of chronic stable angina pectoris: a meta-analysis. Coronary Artery Disease, 13(8): 427-436
Kolh, P., Windecker, S., Alfonso, F., Collet, J.P., Cremer, J., Falk, V., i dr. (2014) 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). Eur J Cardiothorac Surg., 46(4); 517-92
Kotseva, K., Wood, D., de Bacquer, D., de Backer, G., Ryden, L., Jennings, C., i dr. (2016) On behalf of the EUROASPIRE Investigators. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol, 23(6); 636-48
Manchanda, S.C., Krishnaswami, S. (1997) Combination treatment with trimetazidine and diltiazem in stable angina pectoris. Heart, 78(4): 353-7
Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cifkova, R., de Backer, G., Dominiczak, A., Galderisi, M., Grobbee, D.E., Jaarsma, T., Kirchhof, P. (2013) 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European heart journal, 34(28): 2159-219
Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A. (2013) 2013 ESC guidelines on the management of stable coronary artery disease. European Heart Journal, 34(38): 2949-3003
Peng, S., Zhao, M., Wan, J., Fang, Q., Fang, D., Li, K. (2014) The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials. International journal of cardiology, 177(3): 780-5
Ribeiro, L.W., Ribeiro, J.P., Stein, R., Leitão, C., Polanczyk, C.A. (2007) Trimetazidine added to combined hemodynamic antianginal therapy in patients with type 2 diabetes: a randomized crossover trial. American heart journal, 154(1): 78.e1-7
Savonitto, S., Ardissino, D., Egstrup, K., i dr. (1996) Combination therapy with metoprolol Nifedipine versus monotherapy in a patients with stable angina pectoris. J Am Coll Cardiol, 27:311
Steg, P., Grollier, G., Gallay, P., Morice, M., Karrillon, G.J., Benamer, H., Kempf, C., Laperche, T., Arnaud, P., Sellier, P., Bourguignon, C., Harpey, C. (2001) A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction. International Journal of Cardiology, 77(2-3): 263-273
Szwed, H., Sadowski, Z., Elikowski, W., Koronkiewicz, A., Mamcarz, A., Orszulak, W., Skibinska, E., Szymczak, K., Swiatek, J., Winter, M. (2001) Combination treatment in stable effort angina using trimetazidine and metoprolol: Results of a randomized, double-blind, multicentre study (TRIMPOL II). TRIMetazidine in POLand. Eur Heart J, 22(24): 2267-74
Vitale, C., Wajngaten, M., Sposato, B., Gebara, O., Rossini, P., Fini, M., Volterrani, M., Rosano, G.M.C. (2004) Trimetazidine improves left ventricular function and quality of life in elderly patients with coronary artery disease. European heart journal, 25(20): 1814-21