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1. Clinical and functional characteristics of chronic heart failure in different age groups

Author

O. N. Gerasimenko, Yu. D. Zimina, I. V. Pankova, A. A. Tolmacheva, V. I. Solovyova, M. I. Voevoda, and Yu. A. Nikolaev

Subjects
chronic heart failure, clinical picture, old age, Medicine
Abstract

Chronic heart failure (CHF) is a common complication of many cardiovascular diseases. It is important to study the clinical and functional features of CHF to clarify the further prognosis of this disease due to the unfavorable course and high mortality rate. Diagnosis and treatment of CHF is an issue for doctors of various specialties, in particular when it comes to geriatric patients with multiple concomitant diseases. Various physiological and morphological transformations in the aging population contribute to heart failure. The most common type of HF in older people is HF with preserved ejection fraction. Atypical clinical symptoms of CHF are much more common in elderly people than in young people. The prevalence of HF with age is associated with a longer period of influence of damaging factors on the heart, such as arterial hypertension, metabolic stress or ischemia-related damage. Due to the unfavorable course and high mortality rate, it is important to study the clinical and functional characteristics of CHF to clarify its prognosis. However, the data available on this issue vary significantly; the mechanisms, issues of diagnosis and treatment of patients with heart failure in different age groups have not been sufficiently studied, which determined the purpose of this study ‒ to investigate the features of the clinical and functional characteristics of CHF depending on age. Material and methods. The study included 90 male and female patients with diagnosed CHF stages I-IIB, NYHA functional class I-IV, aged 40–86 years, who underwent echocardiography, general and biochemical blood tests. The patients were divided into two groups: group 1 – patients of working age (women 16–54 years old and men 16–59 years old, n = 20), group 2 – patients older than working age (women 55 years and older, men 60 years and older, n = 70). Results and its discussion. According to the data obtained, the average age of all surveyed was 68.1 ± 9.8 years. The second stage of CHF prevailed in both the first and second groups of the studied categories of participants. Atypical symptoms prevailed, which creates difficulties in its diagnosis and treatment. The frequency of CHF decompensation in patients over working age, as well as the concentration of natriuretic peptide, is higher compared to the group of CHF patients of working age, which is probably due to the presence of comorbid pathology and cognitive deficit. The data obtained can be used to develop an approach to stratify the risk of CHF.

Published
2024
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2. Analysis of influence of background therapy for comorbidities in the period before infection on the risk of the lethal COVID outcome. Data from the international ACTIV SARS-CoV-2 registry («Analysis of chronic non-infectious diseases dynamics after COVID-19 infection in adult patients SARS-CoV-2»)

Author

N V Lareva, A Sh Kerimova, D A Shсukarev, I. V. Fomin, I. A. Karetnikov, K. F. Kasymova, U. K. Kamilova, A. M. Budu, A O Konradi, A. A. Marusina, V. I. Majseenko, Yu D Zimina, E. V. Ponomarenko, E. V. Grigorieva, N. V. Bakulina, I. G. Pochinka, O. V. Kondriakova, N. A. Lyubavina, A. G. Sushilova, K. V. Protasov, E A Konstantinova, Yu. M. Lopatin, I I Shaposhnik, O. V. Karpov, I. A. Soloveva, N. V. Zarechnova, M. V. Bragin, G. T. Aimakhanova, O Yu Badina, O Yu Chizhova, A. P. Rebrov, D. V. Soloveva, E S Kim, V. I. Levankova, S. V. Malchikova, A. S. Galyavich, I. M. Sukhomlinova, M. B. Cholponbaeva, A. V. Klimova, A. R. Vaisberg, M. P. Konoval, V. V. Skachkova, N. N. Vezikova, E. A. Gаlova, N. A. Prokofeva, M Е Levin, L. A. Balykova, M. V. Kazakovtseva, A. S. Makarova, T. I. Chudinovskikh, K R Vagapova, A. K. Subbotin, N Yu Kurchugina, A. T. Tursunova, L. D. Petrov, O. R. Aruslanova, M V Ilina, Yu N Belenkov, I. V. Gubareva, E. S. Melnikov, G. A. Bykova, S Yu Ivanova, Yu V Titojkina, Z. F. Kim, A. V. Aparkina, D Yu Konstantinov, A. M. Maripov, K. V. Trenogina, Ch K. Kulchoroeva, E. A. Yausheva, S. S. Plastinina, N. D. Ulanova, D. D. Varlamova, E. V. Makarova, S. V. Nedogoda, R. V. Gostishev, A. P. Babin, A S Sarybaev, S. A. Avetisian, M. S. Torgunakova, G P Arutyunov, O. V. Fedorishina, L. V. Kurenkova, Sh O. Ospanova, G M Dabylova, E. I. Gorshenina, V V Genkel, N. M. Nikitina, M Kh Karsiev, R. G. Muradyan, M. V. Boldina, S Yu Sherbakov, A. A. Odegova, E. P. Tikhonova, M. I. Kolyadich, D. N. Protsenko, V. V. Gomonova, N. A. Karoli, T. V. Kuprina, N. B. Moiseenko, A O Myshak, K Yu Shishkov, N Yu Grigorieva, K. E. Egorova, A. N. Rakhimov, V. A. Pogrebetskaya, S. N. Tereshchenko, V. V. Vustina, I. U. Bikhteyev, N. A. Magdeyeva, Sh N. Musaelian, A. A. Tulichev, O. V. Khlynova, E. V. Kolmakova, A. I. Demchenko, E. V. Pahomova, I. A. Frolova, D. A. Trofimov, M. Y. Duyshobayev, A I Chesnikova, T. S. Fil, A. S. Kuznetsova, N. A. Kamardina, K. V. Kuzmichev, I. V. Demko, D. A. Klimenko, D. S. Evdokimov, O. E. Vilkova, K. V. Mazalov, A Ch Akunov, A. N. Ermilova, N. A. Rakov, B. B. Ogurlieva, O. V. Fatenkov, O. A. Shevchenko, A A Tolmacheva, E Yu Ashina, E. A. Vinnikova, D Yu Ruzanau, Zh B. Kerimbekova, A. K. Abdrahmanova, Yu S. Kalinina, T. V. Sheshina, I. G. Bakulin, Yu M. Omarova, A. V. Zharkov, I S Fominova, H. G. Hayrapetyan, L. A. Burygina, N. V. Kiseleva, A. M. Karachenova, A. M. Bitieva, D. S. Polyakov, T V Kriukova, F. M. Sokhova, A. G. Arutyunov, D. A. Ayipova, M. M. Petrova, M K Alieva, N. A. Borodulina, F. N. Muradova, I. A. Pudova, N A Kushubakova, A. A. Simonov, V. V. Tsoma, S. Serikbolkyzy, O Yu Barisheva, E. A. Shishkina, O. V. Kovalishena, L. L. Popova, A. V. Evzerikhina, A S Batchayeva, T Yu Kuzmina, K. K. Azarian, D. S. Tokmin, N. A. Omurzakova, D S Кaskaeva, A. E. Zheldybayeva, T. Yu. Kuznetsova, I Yu Fomina, E. A. Verbitskaya, N. A. Rozanova, D. R. Tagayeva, S. M. Tsvinger, E. Yu. Ivanchenko, S A Sayganov, N. A. Trostianetckaia, A. S. Blagonravova, A. Yu. Kraposhina, V. A. Kordukova, E. I. Tarlovskaya, O Yu Dolgikh, I. M. Kouranova, H. G. Avoyan, E. V. Kazymova, T. P. Kolchinskaya, N M Selezneva, A. B. Sugraliev, E. V. Koroleva, and E Yu Gubareva

Subjects
Adult, Male, medicine.medical_specialty, Population, Disease, Comorbidity, Lower risk, Pharmacotherapy, Internal medicine, medicine, Humans, Registries, education, Noncommunicable Diseases, Pandemics, education.field_of_study, COPD, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Clopidogrel, Diabetes Mellitus, Type 2, Female, Cardiology and Cardiovascular Medicine, business, Ticagrelor, medicine.drug
Abstract

Aim To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients’ privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).ResultsThe analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.

Published
2021

3. Clinical features of post-COVID-19 period. Results of the international register 'Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)'. Data from 6-month follow-up

Author

G. P. Arutyunov, E. I. Tarlovskaya, A. G. Arutyunov, Yu. N. Belenkov, A. O. Konradi, Yu. M. Lopatin, A. P. Rebrov, S. N. Tereshchenko, A. I. Chesnikova, H. G. Hayrapetyan, A. P. Babin, I. G. Bakulin, N. V. Bakulina, L. A. Balykova, A. S. Blagonravova, M. V. Boldina, A. R. Vaisberg, A. S. Galyavich, V. V. Gomonova, N. Yu. Grigorieva, I. V. Gubareva, I. V. Demko, A. V. Evzerikhina, A. V. Zharkov, U. K. Kamilova, Z. F. Kim, T. Yu. Kuznetsova, N. V. Lareva, E. V. Makarova, S. V. Malchikova, S. V. Nedogoda, M. M. Petrova, I. G. Pochinka, K. V. Protasov, D. N. Protsenko, D. Yu. Ruzanau, S. A. Sayganov, A. Sh. Sarybaev, N. M. Selezneva, A. B. Sugraliev, I. V. Fomin, O. V. Khlynova, O. Yu. Chizhova, I. I. Shaposhnik, D. A. Shchukarev, A. K. Abdrahmanova, S. A. Avetisian, H. G. Avoyan, K. K. Azarian, G. T. Aimakhanova, D. A. Ayipova, A. Ch. Akunov, M. K. Alieva, A. V. Aparkina, O. R. Aruslanova, E. Yu. Ashina, O. Yu. Badina, O. Yu. Barisheva, T. I. Batluk, A. S. Batchayeva, R. A. Bashkinov, A. M. Bitieva, I. U. Bikhteyev, N. A. Borodulina, M. V. Bragin, A. M. Budu, G. A. Bykova, K. R. Vagapova, D. D. Varlamova, N. N. Vezikova, E. A. Verbitskaya, O. E. Vilkova, E. A. Vinnikova, V. V. Vustina, E. A. Gаlova, V. V. Genkel, E. I. Gorshenina, E. V. Grigorieva, E. Yu. Gubareva, G. M. Dabylova, I. A. Demchenko, O. Yu. Dolgikh, M. Y. Duyshobayev, D. S. Evdokimov, K. E. Egorova, A. N. Ermilova, A. E. Zheldybayeva, N. V. Zarechnova, Yu. D. Zimina, S. Yu. Ivanova, E. Yu. Ivanchenko, M. V. Ilina, M. V. Kazakovtseva, E. V. Kazymova, Yu. S. Kalinina, N. A. Kamardina, A. M. Karachenova, I. A. Karetnikov, N. A. Karoli, M. K. Karsiev, D. S. Кaskaeva, K. F. Kasymova, Zh. B. Kerimbekova, A. Sh. Kerimova, E. S. Kim, N. V. Kiseleva, D. A. Klimenko, A. V. Klimova, O. V. Kovalishena, E. V. Kolmakova, T. P. Kolchinskaya, M. I. Kolyadich, O. V. Kondriakova, M. P. Konoval, D. Yu. Konstantinov, E. A. Konstantinova, V. A. Kordukova, E. V. Koroleva, A. Yu. Kraposhina, T. V. Kriukova, A. S. Kuznetsova, T. Yu. Kuzmina, K. V. Kuzmichev, Ch. K. Kulchoroeva, T. V. Kuprina, I. M. Kouranova, L. V. Kurenkova, N. Yu. Kurchugina, N. A. Kushubakova, V. I. Levankova, N. A. Lyubavina, N. A. Magdeyeva, K. V. Mazalov, V. I. Majseenko, A. S. Makarova, A. M. Maripov, A. A. Marusina, E. S. Melnikov, N. B. Moiseenko, F. N. Muradova, R. G. Muradyan, Sh. N. Musaelian, A. O. Myshak, E. S. Nekaeva, N. M. Nikitina, B. B. Ogurlieva, A. A. Odegova, Yu. M. Omarova, N. A. Omurzakova, Sh. O. Ospanova, E. V. Pahomova, L. D. Petrov, S. S. Plastinina, V. A. Pogrebetskaya, D. V. Polyakov, D. S. Polyakov, E. V. Ponomarenko, L. L. Popova, N. A. Prokofeva, I. A. Pudova, N. A. Rakov, A. N. Rakhimov, N. A. Rozanova, S. Serikbolkyzy, A. A. Simonov, V. V. Skachkova, D. V. Soloveva, I. A. Soloveva, I. M. Sukhomlinova, A. G. Sushilova, D. R. Tagayeva, Yu. V. Titojkina, E. P. Tikhonova, D. S. Tokmin, A. A. Tolmacheva, M. S. Torgunakova, K. V. Trenogina, N. A. Trostianetckaia, D. A. Trofimov, M. A. Trubnikova, A. A. Tulichev, A. T. Tursunova, N. D. Ulanova, O. V. Fatenkov, O. V. Fedorishina, T. S. Fil, I. Yu. Fomina, I. S. Fominova, I. A. Frolova, S. M. Tsvinger, V. V. Tsoma, M. B. Cholponbaeva, T. I. Chudinovskikh, O. A. Shevchenko, T. V. Sheshina, E. A. Shishkina, K. Yu. Shishkov, S. Yu. Sherbakov, and E. A. Yausheva

Subjects
Pediatrics, medicine.medical_specialty, Acute coronary syndrome, diabetes, Coronavirus disease 2019 (COVID-19), business.industry, Mortality rate, Type 2 diabetes, medicine.disease, cardiovascular diseases, Coronary artery disease, covid-19, RC666-701, Heart failure, Diabetes mellitus, postcovid-19 period, medicine, Diseases of the circulatory (Cardiovascular) system, aktiv register, Cardiology and Cardiovascular Medicine, business, Stroke
Abstract

Aim.To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register.Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months.Results.According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure.Conclusion.According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period.

Published
2021

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