Abstract
Introduction. Insufficient application of pharmaceuticals with proved efficiency was noted despite
clinical guidelines for secondary ischemic heart disease prevention including percutaneous angioplasty
and/or CABG. Special role in early and postoperative period is assigned to therapeutic
education of patients to pharmacologic and drug-free measures.
Material and methods. The study included 196 patients after cardiac surgery for IHD using multivariable
program were randomized in 2 groups using random numbers: group of intervention
including therapeutic education and intensive outpatient observation and control group.
Results. Program of treatment was noted to improve the treatment compliance to first-line drugs
(statins, angiotesin-converting enzyme inhibitors, beta-blockers, disaggregants) in 12 months of
postoperative period, to achieve target doses which are provided for clinical randomized trials.
Conclusions. Optimization of IHD-patients treatment after surgical intervention includes structured
education, written information about pharmaceutical and non-pharmaceutical measures,
intensive outpatient observation, integration of necessary specialists. This program offers the possibility
to choose the agent with proved efficiency, titrate the agent dosage which is not observed
in traditional approach.
References
Бокерия Л. А. Влияние оптимизированного многофакторного подхода к лечению больных ИБС после прямой реваскуляризации миокарда на качество жизни и потребность в госпитализациях (результаты 3-месячного рандомизированного клинического исследования) / Л. А. Бокерия, М. М. Алшибая, Н. Г. Бенделиани, С. Ф. Никонов // Клин. физиол. кровообр. - 2011. - № 3. - С. 5-16.
Орлов, В. А. Влияние терапевтического обучения больных с выраженной хронической сердечной недостаточностью на качество их жизни и потребность в повторных госпитализациях: результаты 12-месячного рандомизированного исследования / В. А. Орлов, С. Р. Гиляревский, О. А. Боева и др. // Кардиология. - 2002. - № 5. - С. 56-61.
Bramlage, P. The effect of optimal medical therapy on 1-year mortality after acute myocardial infarction / P. Bramlage, C. Messer, N. Bitterlich at al. // Heart. - 2010. - Vol. 96. - P. 604-609.
Denton, T. A. Secondary prevention after coronary bypass: the American Heart Association
Kathryn, A. AHA/ACC Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 / A. Kathryn et al. // Circulation. - 2006. - Vol. 113. - P. 2363-2372.
Williams, J. B. Secondary prevention after coronary artery bypass graft surgery findings of a National randomized controlled trial and Sustained societyled incorporation into practice / J. B. Williams, E. R. DeLong, E. D. Peterson et al. for the Society of Thoracic Surgeons and the National cardiac database // Circulation. - 2011. - Vol. 123. - P. 39-45.
