A. Faynyk, M. Faynyk
Danylo Halytsky Lviv National Medical University
Introduction. According to the President of the European Congress of Cardiologists (European Society of Cardiology, ESC) Professor Panos Vardasa, despite the progress of medicine, the diseases of cardiovascular system is now the number one killer of the population of Europe. Clinical trials based on the clinical practice and guidelines were presented at the annual European Congress of Cardiologists in Amsterdam.
Aim. To conduct a description and discussion of current successes and evidence of the results of the European Congress of Cardiologists in Amsterdam (30.08-04.09.2013).
Materials and methods. Information is provided on the results of the European Congress of Cardiologists in Amsterdam (30.08 – 04.09.2013). The description of clinical trials and updated recommendations on the diagnosis, treatment and prevention of the diseases of the cardiovascular system, including arterial hypertension and cardiovascular disease in patients with diabetes mellitus and pre-diabetes.
Results. Among a number of important issues presented during the Congress there were published the results of such studies: HOKUSAI-VTE – using of anticoagulant edoxaban per os for the treatment of venous thromboembolism showed the equal efficacy but better tolerability and safety as compared with warfarin for the primary purpose of low molecular heparin; TASTE – aspiration of blood clots and clots that cause heart attack before opening the artery balloon does not improve the survival compared to using only a balloon dilation or stenting without aspiration; ECHOCRT – the results confirmed the underlying principles that cardiac resynchronization treatment should not be performed for the patients with a narrow QRS complex; DECAAF – the results showed that in patients with atrial fibrillation magnetic resonance imaging prior to ablation allows to determine the extent of damage of the heart tissue. PRAMI – the primary endpoint was the combined death from the cardiac causes, nonfatal myocardial infarction or refractory angina in patients with STEMI and concomitant hemodynamically significant stenosis of the coronary arteries. In addition stenting of the infarct-dependent coronary arteries in all patients with acute elevation of ST-segment, additional preventive coronary artery stenting in the experimental group with hemodynamically significant stenosis showed the significant preference (p <0.001) of such treatment.
The Congress also published the first findings on the elimination of the negative impact of lifestyle in the secondary prevention of cardiovascular diseases.
At the Congress in Amsterdam there were also presented new recommendations – Recommendations of the European Society of Cardiologists and the European Society of Hypertension on the diagnosis, treatment and prevention of arterial hypertension and Recommendations for the prevention, diagnosis and treatment of cardiovascular disease in patients with diabetes and pre-diabetes.
Conclusions. Presented description of the clinical trials and new guidelines for the diagnosis based on their findings, treatment and prevention of the cardiovascular diseases, especially arterial hypertension and cardiovascular diseases in patients with diabetes mellitus and pre-diabetes were provided that must be taken into account in the usual practice of a doctor.
- Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U. Cardiovascular prevention guidelines in daily practice: a comparison of Euroaspire I, II, and III surveys in eight European countries. Lancet. 2009;373(9667):929-940. https://doi.org/10.1016/S0140-6736(09)60330-5
- Marrouche NF, Wilber D, Hindricks G, Jais P, Akoum N, Marchlinski F et al. Association of atrial tissue fibrosis identified by delayed-enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA. 2014;311(5):498-506. https://doi.org/10.1001/jama.2014.3
- ESH/ESC Guidelines for the management of arterial hypertension. J Hypertension. 2013;31:1281-1357.
- Nakano E, Ishizu T, Seo Y, Sato A, Hoshi T, Aonuma K et al. Impacts of Aggressive Treatment With Statin on Cardiovascular Events Among Patients Whose LDL-Cholesterol Concentration Within Normal Range: Results From ICAS Registry. J Am Coll Cardiol. 2013;61(10):1240-1270. https://doi.org/10.1016/S0735-1097(13)61197-3
- Wald DS, Morris JK, Wald NJ, Chase AJ, Edwards RJ, Hughes LO et al. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med. 2013;369(12):1115-1123. https://doi.org/10.1056/NEJMoa1305520
- Ruschitzka F, Abraham WT, Singh JP, Bax JJ, Borer JS, Brugada J et al. Cardiac-resynchronization therapy in heart failure with a narrow QRS complex. N Engl J Med. 2013;369(15):1395-1405. https://doi.org/10.1056/NEJMoa1306687
- Büller HR, Décousus H, Grosso MA, Mercuri M, Middeldorp S, Prins MH et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369(15):1406-1415. https://doi.org/10.1056/NEJMoa1306638
- Fröbert O, Lagerqvist B, Olivecrona GK, Omerovic E, Gudnason T, Maeng M et al. Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013;369(17):1587-1597. https://doi.org/10.1056/NEJMoa1308789
- Wood DA. Euroaspire IV reveals success and challenges in secondary prevention of CVD across Europe. ESC Congress Amsterdam, 03 Sep. 2013.