Secondary Prevention and Associated Drug Therapy

2015 ◽  
pp. 84-93
Author(s):  
K. Donat
Keyword(s):  
Drug Therapy ◽  
Secondary Prevention

Drug Therapy in Primary and Secondary Prevention of Variceal Hemorrhage in Portal Hypertension

2015 ◽  
pp. 137-147
Author(s):  
Jaime Bosch ◽  
Gennaro D�Amico ◽  
Faust Feu ◽  
Angelo Luca ◽  
Juan C. Garc�a-Pag�n ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Drug Therapy ◽  
Secondary Prevention ◽  
Variceal Hemorrhage ◽  
Primary And Secondary Prevention

scholarly journals Assessment of the effectiveness of treatment in patients after acute coronary syndrome

2020 ◽  
Vol 25 (2) ◽  
pp. 9-18
Author(s):  
D. A. Shvets ◽  
S. V. Povetkin ◽  
A. Yu. Karasev ◽  
V. I. Vishnevsky
Keyword(s):  
Acute Coronary Syndrome ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Secondary Prevention ◽  
Generic Drugs ◽  
Myocardial Revascularization ◽  
Cardiovascular Complications ◽  
Drug Prevention ◽  
Coronary Syndrome

Aim. To assess the effectiveness of secondary drug prevention and surgical myocardial revascularization in patients with coronary artery disease (CAD) during long-term follow-up after acute coronary syndrome (ACS).Material and methods. The study involved 400 patients with ACS discharged from the hospital in 2012-2016. The diagnosis was verified according to the European Society of Cardiology (ESC) guidelines. There were no exclusion criteria. We analyzed the data of medical records (complaints, medical history, physical examination, laboratory and instrumental data). Repeated data collection was carried out by distance survey and during a face-to-face examination during 2018. According to the clinical course of CAD, all patients were divided into 2 groups. Group 1 consisted of 151 patients with complicated course of CAD, group 2 — 249 patients with stable CAD. We analyzed drug therapy recommended at hospital discharge and taken at the time of the repeated examination. The drug names and daily dosage used for the secondary prevention of CAD were recorded. Assessment of survival without cardiovascular complications was carried out according to the Kaplan-Mayer analysis.Results. Seven-year mortality was 22,5%. The total number of cardiovascular events was 37,7%. The main reason for the frequent complications was the insufficient secondary prevention of CAD after ACS. We found that the drugs and their dosage did not have a significant effect on survival. Statin use is associated with a paradoxical increase in the number of complications. The increased frequency of use and dosage of statins are a consequence of unfavorable course of CAD and do not have the proper preventive effect. For some groups of drugs, we observed irregular intake over the observation period. The low effectiveness of therapy is not only due to insufficient doses, but also in the frequent use of generic drugs. The significant effect of coronary angiography on the probability of cardiovascular complications compared with stenting is due to high proportion of coronary angiography use without revascularization.Conclusion. The combination of following factors of drug therapy can explain the low effectiveness of secondary CAD prevention: low dose (26,1±2,8 mg for atorvastatin), irregular intake and common use of generic drugs (97,6% for statins), present in different ratios. The contribution of surgical treatment to reducing cardiovascular complications is lower, the more significant residual coronary artery stenosis.

scholarly journals Cardiac rehabilitation today: opportunities and challenges

2019 ◽  
Vol 23 (1) ◽  
pp. 17-26
Author(s):  
Evgenij А. Protasov ◽  
Arseniy A. Velikanov
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Drug Therapy ◽  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Special Problem ◽  
Outpatient Rehabilitation ◽  
Technical Base ◽  
Drug Treatments

Russian health care faces the task of reducing mortality and disability of patients with coronary heart disease. This problem could be solved with outpatient rehabilitation and secondary prevention. Despite of numerous evidences of their effectiveness there is no publicly available system for the management of patients with the addition of non-drug treatments to drug therapy in our country. This is due to the lack of material and technical base, a sufficient number of specialists, underestimation of this method by the physicians and low patients’ motivation. A special problem is the patient behavior itself, which can be described as “irrational”.

P6207Polypill to improve adherence in cardiovascular secondary prevention: a real challenge in real practice

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Merino Argos ◽  
R Dalmau Gonzalez-Gallarza ◽  
A Velez Salas ◽  
A Castro Conde ◽  
L A Martinez Marin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Therapy ◽  
Secondary Prevention ◽  
Cardiovascular Prevention ◽  
Pressure Control ◽  
Poor Adherence ◽  
Fixed Dose ◽  
High Dose ◽  
Statin Intolerance ◽  
Real Practice

Abstract Background Poor adherence is a barrier to optimal secondary cardiovascular prevention. The need for a polymedication, the cost of some drug therapies and the silent evolution of some cardiovascular conditions are often related to poor adherence. A fixed-dose polypill strategy (AAS, ACEi and statin) has emerged as a possibility to improve adherence in cardiovascular prevention and therefore improve outcomes. Nevertheless, the complexity of cardiovascular disease patients' drug therapy regimes and the need for titration of doses in order to reach the goals, makes it difficult to introduce a fix-dose polypill. Methods We performed a prospective study of consecutive patients attending a secondary prevention consultancy. In order to find out whether they were amenable to a polypill regime, we analyzed their drug therapy scheme and the level of control of blood pressure and LDL cholesterol. Results We included 302 patients, and their treatment is shown in table 1. Of the total of patients, we found that only 25 patients (8.3%) were optimal candidates for receiving a fixed-dose polypill. The reasons for not being eligible are summarized in figure 1, highlighting the need for higher statin dose or statin intolerance as the most frequent cause (79.5%), or the need for titration or combination of drugs according to the blood pressure levels. Patients' characteristics and therapy Patients (n=392) Sex (male) 252 (83.4%) Age (mean ± SD) 60.82 (±11,33) Event (STEMI, NSTEMI, angina) 155 (51.3%), 123 (40,7%), 24 (7.9%) ACEi/ARBs 279 (72.5%) ASA 279 (92.4%) Statins (Atorvastatin 80mg, atorvastatin 40mg, rosuvastatin, other statin) 221 (73.2%), 37 (12.3%), 25 (8.3%), 17 (5.6%) Anti-arterial hypertensive combination pill 51 (16.9%) Number of drugs (mean±SD) 6.61 (±2.47) Optimal blood pressure control (<140/90 mmHg) 197 (65.2%) Optimal LDL control (<70 mg/dl) 208 (69.8%) Causes of non-eligibility for polypill Conclusion Despite the fact that polypill could bring the opportunity to improve cardiovascular drug therapy adherence, the complexity of secondary prevention patients and the common need for a high dose statin makes it difficult to implement a polypill scheme in the real practice.

Secondary Prevention of Stroke in the Elderly: Focus on Drug Therapy

Drugs & Aging ◽  
2014 ◽  
Vol 31 (10) ◽  
pp. 721-730 ◽  
Author(s):  
Martinson K. Arnan ◽  
Gregory L. Burke ◽  
Cheryl Bushnell
Keyword(s):  
Drug Therapy ◽  
Secondary Prevention ◽  
The Elderly
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