Estimation of the efficacy of therapy at the outpatientpolyclinic stage of observation in patients who have suffered from acute myocardial infarction (according to the PROFILE-IM register data)

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Abstract

Providing the quality and efficacy of drug therapy for patients during the 1st year after myocardial infarction (MI) leads to reduced risk of cardiovascular complications (CVC) and increased quality of life (QOL) for them.

The aim: to estimate the quality of therapy in patients after MI in terms of achieving target performance indicators during the 1st year.

Material and methods. PROFILE-MI prospective register included patients discharged from the hospital after MI event. Observation period was 1 year, visits were made every 2 months, the criterion for the efficacy of therapy was achieving target blood pressure (BP < 130/80 mm Hg), heart rate (HR 60–70 beats per minute at rest), and lipid spectrum parameters (low-density lipoprotein cholesterol, LDL < 1.8 mmol/l). A visual analogue scale was used to assess the life quality (QOL).

Results. The study involved 160 individuals: 106 male (66.2%) and 54 female patients (33.8%), aged 74.2 ± 11.2 years [33; 87]. Maximum daily doses of the main groups of drugs were not achieved in the treatment of these patients. At the 1st visit, only 46.9% of participants had target BP values, after a year of observation – in 34.7% (p = 0.001). Target HR values at the 1st visit were fixed in 31.9% of patients, after a year of observation – in 53.7%, (p < 0.001). Target total cholesterol values at the 1st visit were fixed in 11.8% of patients, after a year – in 41.4% (p < 0.001). The frequency of LDL determination did not exceed 30%. The average daily dose of statins was 20 mg for all drugs in this group. Life quality (QOL) indexes did not exceed 7 points on average (according to a 10-point scale).

Conclusion. According to the PROFILE-IM registry data, in real clinical practice, when treating patients after MI, the potential for therapy aimed at reducing CVC and increasing QOL is not fully realized. Patients were prescribed medium or low doses of drugs, which led to unsatisfactory indexes of achieving blood pressure, heart rate and lipid spectrum parameters, as well as to low level of QOL.

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About the authors

Elena P. Kalaydzhyan

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Author for correspondence.
Email: yarlenok@yandex.ru
ORCID iD: 0000-0003-1337-6499

MD, PhD (Medicine), researcher at the Laboratory of pharmacoepidemiological studies of the Department of preventive pharmacotherapy

Russian Federation, 101990, Moscow, 10/3 Petroverigsky Lane

Natalya P. Kutishenko

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Email: nkutishenko@gnicpm.ru
ORCID iD: 0000-0001-6395-2584

MD, Dr. Sci. (Medicine), head of the Laboratory of pharmacoepidemiological studies of the Department of preventive pharmacotherapy

Russian Federation, 101990, Moscow, 10/3 Petroverigsky Lane

Yulia V. Lukina

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Email: yuvlu@mail.ru
ORCID iD: 0000-0001-8252-3099

MD, Dr. Sci. (Medicine), leading researcher at the Laboratory of pharmacoepidemiological studies of the Department of preventive pharmacotherapy

Russian Federation, 101990, Moscow, 10/3 Petroverigsky Lane

David P. Sichinava

City Polyclinic No. 9 of the Department of Healthcare of Moscow

Email: dato-s86@yandex.ru
ORCID iD: 0000-0002-7399-5315

MD, PhD (Medicine), deputy chief physician for clinical and expert work

 

Russian Federation, 109451, Moscow, 4/2 Perervinsky Boulevard

Sergey Yu. Martsevich

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Email: sergeymartsevich@mail.ru
ORCID iD: 0000-0002-7717-4362

MD, Dr. Sci. (Medicine), professor, head of the Department of preventive pharmacotherapy

 

Russian Federation, 101990, Moscow, 10/3 Petroverigsky Lane

Oksana M. Drapkina

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Email: ODrapkina@gnicpm.ru
ORCID iD: 0000-0002-4453-8430

MD, Dr. Sci. (Medicine), professor, academician of RAS, director

Russian Federation, 101990, Moscow, 10/3 Petroverigsky Lane

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2. Fig. 1. The proportion of observed patients who achieved the target values of blood pressure, heart rate and total cholesterol

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3. Fig. 2. Average daily doses of angiotensin converting enzyme inhibitors/angiotensin II receptor blockers and calcium antagonists in observed patients with arterial hypertension

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4. Fig. 3. Average daily doses of beta-blockers in the observed patients with unreached heart rate parameters

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5. Fig. 4. Average daily doses of statins in the observed patients with missed targets of the lipid spectrum

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6. Fig. 5. The frequency of prescribing blood tests for total cholesterol and low-density lipoproteins by the doctor to the observed patients (n = 160)

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