Author(s):
Olga V. Pashanova, Dmitriy A. Ermakov, Alla V. Philippova, Yuliya A. Tikhonova, Nikolay N. Pronkin
Email(s):
ov_pashanova@rambler.ru
DOI:
10.5958/0974-360X.2021.00021.4 
Address:
Olga V. Pashanova1*, Dmitriy A. Ermakov2, Alla V. Philippova3, Yuliya A. Tikhonova4, Nikolay N. Pronkin5
1Department of Economics and Organization of Pharmacy, I.M. Sechenov First State Medical University, Moscow, Russian Federation.
2Department of Pharmacy, I.M. Sechenov First State Medical University, Moscow, Russian Federation.
3Department of Biology and General Genetics, I.M. Sechenov First State Medical University, Moscow, Russian Federation.
4Department of Organization and Economics of Pharmacy, I.M. Sechenov First State Medical University, Moscow, Russian Federation.
5Department of Medical Computer Science and Statistics, I.M. Sechenov First State Medical University, Moscow, Russian Federation.
*Corresponding Author
Published In:
Volume - 14,
Issue - 1,
Year - 2021
ABSTRACT:
The objective of the study was to evaluate the efficacy of medical treatment in patients diagnosed with acute cerebrovascular accident (ACVA) included in the REGION inventory. The research was carried out in 2019 in 4 municipal primary health-care facilities in Moscow (Russia) and included the processing of past medical histories in two groups of totally 750 patients. Group I involved 400 patients treated against ACVA before 2017, and Group II comprised 350 patients treated from 2017 to 2019 inclusive. Patients of both groups were compared across the frequency of medications prescription before admission to the clinic with ACVA diagnosis, during outpatient treatment up to six months, and after discharge. Comparative analysis was performed based on telephone surveys and applying the Morisky Green medications adherence assessment scale. Before admission to the clinic, patients from the second group compared to those from the first one was 2.9 times more frequently prescribed with statins (p = 0.01), within six months of treatment outpatients received those 4.3 times more often (p = 0.001) and anticoagulants – 6.2 times (p = 0.0001). After discharge, patients were assigned to therapy with statins 2.5 times more frequent in the second group of the patient population (p = 0.01). Significant variables in therapeutic efficacy between patients in Group I and II have been established. Starting from 2017, the quality of ACVA medical care has significantly improved compared to that in 2009 – 2017.
Cite this article:
Olga V. Pashanova, Dmitriy A. Ermakov, Alla V. Philippova, Yuliya A. Tikhonova, Nikolay N. Pronkin. Analysis methods for medications improving Cerebral circulation. Research J. Pharm. and Tech. 2021; 14(1):115-121. doi: 10.5958/0974-360X.2021.00021.4
Cite(Electronic):
Olga V. Pashanova, Dmitriy A. Ermakov, Alla V. Philippova, Yuliya A. Tikhonova, Nikolay N. Pronkin. Analysis methods for medications improving Cerebral circulation. Research J. Pharm. and Tech. 2021; 14(1):115-121. doi: 10.5958/0974-360X.2021.00021.4 Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2021-14-1-21
REFERENCES:
1. Madoukh B, Battisha A, Ukwu H, Al-Sadawi M, Shaikh S. Acute Systolic Heart Failure as the only Risk Factor for Cardioembolic Cerebrovascular Accident in the Setting of Nonischemic Cardiomyopathy and Normal Sinus Rhythm: A Case Report with Literature Review. American Journal of Medical Case Reports. 2020; 8(1): 22-25.
2. Zeitler EP, Eapen ZJ. Anticoagulation in Heart Failure: a Review. Journal of Atrial Fibrillation 2015; 8(1): 1250.
3. Sivri N, Yetkin E, Tekin GO, Yalta K, Waltenberger J. Anticoagulation in patients with left ventricular systolic dysfunction and sinus rhythm: when? Clinical and Applied Thrombosis/Hemostasis, 2014; 20(7): 729-734.
4. Schumacher K, Kornej J, Shantsila E, Lip G. Heart Failure and Stroke. Current heart failure reports. 2018; 15(5): 287-296.
5. Siliste RN, Antohi EL, Pepoyan S, Nakou E, Vardas P. Anticoagulation in heart failure without atrial fibrillation: gaps and dilemmas in current clinical practice. European Journal of Heart Failure. 2018; 20(6): 978-988.
6. Beggs SA, Rorth R, Gardner RS, McMurray JJ. Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis. Heart. 2019; 105(17): 1325-1334.
7. Berger JS, Peterson E, Laliberte F, Germain G, Lejeune D, Schein J, Weir MR. Risk of Ischemic Stroke in Patients Newly Diagnosed With Heart Failure: Focus on Patients Without Atrial Fibrillation. Journal of Cardiac Failure. 2019; 25(6): 436-447.
8. Abdul-Rahim AH, Perez AC, Fulton RL, Jhund PS, Latini R, Tognoni G, et al. (2015). Risk of Stroke in Chronic Heart Failure Patients Without Atrial Fibrillation: Analysis of the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) Trials. Circulation. 2015; 131(17): 1486-1494.
9. Hai JJ, Chan PH, Chan YH, Fong CH, Huang D, Li WH, Siu CW. (2016). Prediction of Thromboembolic Events in Heart Failure Patients in Sinus Rhythm: The Hong Kong Heart Failure Registry. PLoS One. 2016; 11(12): e0169095.
10. Melgaard L, Gorst-Rasmussen A, Lane DA, Rasmussen LH, Larsen TB, Lip GY. Assessment of the CHA2DS2-VASc Score in Predicting Ischemic Stroke, Thromboembolism, and Death in Patients with Heart Failure and without Atrial Fibrillation. Jama. 2015; 314(10): 1030-1038.
11. Avellana P, Segovia J, Ferrero A, Vazquez R, Brugada J, Borras X, Cinca J. Anticoagulation therapy in patients with heart failure due to systolic dysfunction and sinus rhythm: analysis of REDINSCOR registry. Revista Española de Cardiología. 2012; 65(8): 705-712.
12. Kang SH, Kim J, Park JJ, Oh IY, Yoon CH, Kim HJ, Choi DJ. Risk of stroke in congestive heart failure with and without atrial fibrillation. International Journal of Cardiology. 2017; 248: 182-187.
13. Vaduganathan M, Patel RB, Yancy CW. Stroke prevention in heart failure and sinus rhythm: where do we go from here? European Journal of Heart Failure. 2016; 18(10), p. 1267-1269.
14. Prajapati MJ, Vora AR. A study of lipid profile in cerebrovascular accidents. International Journal of Scientific Research. 2020; 9(1): 2277 – 8179.
15. Ferreira JP, Girerd N, Gregson J, Latar I, Sharma A, Pfeffer MA. Stroke Risk in Patients with Reduced Ejection Fraction After Myocardial Infarction Without Atrial Fibrillation. Journal of the American College of Cardiology. 2018; 71(7): 727-735.
16. Kim W, Kim EJ. Heart Failure as a Risk Factor for Stroke. Journal of Stroke. 2018; 20(1): 33-45.
17. Ministry of Health. Compendium of statistical materials on cerebral circulation diseases. Statistical handbook. Мoscow.2017.
18. Levshakova AV, Domashenko MA. Acute cerebrovascular disorder: diagnostic and management aspects (lection). Radiology – practice. 2014; 1: 48–57.
19. Morozov IYu, Nasnikova IYu, Shmyrev IYu, Shmyrev VI. Perfusion computed tomography in diagnostics of acute cerebral circulation accidents. Kremlin Medical Clinical Bulletin. 2011; 1: 14–18.
20. Hung WW. CHA 2 DS 2-VASc Score Modestly Predicts Ischemic Stroke, Thromboembolic Events, and Death in Patients with Heart Failure Without Atrial Fibrillation. Journal of Clinical Outcomes Management. 2015; 22(11).
21. WHO. Stroke, Cerebrovascular accident. Available from: https://www.who.int/topics/cerebrovascular_accident/en/
22. Greenberg B, Neaton JD, Anker SD, Byra WM, Cleland JGF, Deng H, Zannad F. Association of Rivaroxaban with Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm: A Post Hoc Analysis of the COMMANDER HF Trial. JAMA Cardiology. 2019; 4(6): 515-523.
23. Haeusler KG, Endres M, Doehner W. Relevance of heart failure in prevention, treatment and prognosis of ischemic stroke. Neurology International Open. 2017; 1(02): E61-E64
24. Smith WS, Johnston SC, Hemphill JC, Cerebrovascular diseases In Harrison’s principles of internal medicine, Edited by Kasper DL, Fauci AS, Hauser SL, Lango DL, Jameson JL and Loscalzo J. New York, McGraw Hill; 2018; 20th ed: pp. 3068
25. Mozaffarian D, Benjamin EJ, AS G. Heart disease and stroke Statistics - 2016 update: a report from the American heart association. Circulation. 2016; 133: 38–60.
26. Powers WJ, Rabinstein AA, Ackerson T. guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American heart Association/American stroke association. Stroke. 2018; 49: e46–110.
27. Saric M, Armour AC, Arnaout MS. Guidelines for the use of echocardiography in the evaluation of a cardiac source of embolism. Journal of the American Society of Echocardiography. 2016; 29: 1–42.
28. Schwartz BG, Chris Alexander MD, MD Paul A. Grayburn, MD. Utility of routine transesophageal echocardiography in patients with stroke or transient ischemic attack utility of routine transesophageal echocardiography in patients with stroke or transient ischemic attack. In Baylor University Medical Center Proceedings. Taylor & Francis. 2018; 31(4): pp. 401-403).
29. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2017; 70: 252–289.
30. Pallesen L-P., Ragaller M, Kepplinger J, et al. Diagnostic impact of transesophageal echocardiography in patients with acute cerebral ischemia. Echocardiography. 2016; 33: 555–661.
31. Katsanos AH, Bhole R, Frogoudaki A, et al. The value of transesophageal echocardiography for embolic strokes of undetermined source. Neurology. 2016; 87: 988–995.
32. Marino B, Jaiswal A, Goldbarg S, Bernardini GL, Kerwin T. Impact of transesophageal echocardiography on clinical management of patients over age 50 with cryptogenic stroke and normal transthoracic echocardiogram. J Hospital Medicine. 2016; 11: 95–98.
33. Wachter R, Groschel K, Gelbrich G, Hamann GF, Kermer P, Liman J, Messerschmid A. Holter-electrocardiogrammonitoring in patients with acute ischaemic stroke (FindAFRANDOMISED): an open-label randomised controlled trial. The Lancet Neurology. 2017;16: 282–290.
34. Sanna T, Diener H-C, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA, Lindborg K. Cryptogenic stroke and underlying atrial fibrillation. New England Journal of Medicine. 2014; 370: 2478–2486.
35. Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J, Sharma M. Atrial fibrillation in patients with cryptogenic stroke. New England Journal of Medicine. 2014; 370: 2467–2477.
36. Wang Y, Wang Y, Zhao X, Liu L, Wang D, Wang C, Jia J. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. New England Journal of Medicine. 2013; 369: 11–19.
37. Gouya G, Arrich J, Wolzt M, Huber K, Verheugt FW, Gurbel PA, Siller-Matula JM. Antiplatelet treatment for prevention of cerebrovascular events in patients with vascular diseases: a systematic review and meta-analysis. Stroke. 2014; 45: 492–503.
38. Kohrmann M, Schellinger PD, Tsivgoulis G, Steiner T. Patent foramen ovale: story closed? Journal of Stroke. 2019; 21: 23–30.
39. Kalaeva E, Kalaev V, Efimova K, Chernitskiy A, Safonov V. Protein metabolic changes and nucleolus organizer regions activity in the lymphocytes of neonatal calves during the development of respiratory diseases. Veterinary World 2019; 12(10): 1657-1667.