E. V. Krasnoperova

National Medical Research Center of Cardiology

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O. B. Dorogun

National Medical Research Center of Cardiology

ДВ

Д. В. Певзнер

National Medical Research Center of Cardiology

АЛ

А. Л. Комаров

National Medical Research Center of Cardiology

N. S. Kostritsa

National Medical Research Center of Cardiology

МГ

М Г Шматков

Federal State Budgetary Institution "Federal Center For Cardiovascular Surgery" Ministry of Health of The Russian Federation

МЕ

М Е Евдокимов

Federal State Budgetary Institution "Federal Center For Cardiovascular Surgery" Ministry of Health of The Russian Federation

V. I. Ganyukov

Kemerovo State University

L. M. Galaeva

National Medical Research Center of Cardiology

ИБ

И. Б. Меркулова

National Medical Research Center of Cardiology

ЛГ

Л. Г. Шестакова

Republican Scientific and Practical Center of Cardiology

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National Medical Research Center of Cardiology

Federal State Budgetary Institution "Federal Center For Cardiovascular Surgery" Ministry of Health of The Russian Federation

Russian Academy of Sciences

Institute of Experimental Cardiology

Kemerovo State University

Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences

Kemerovo Cardiology Center

Institute for Atherosclerosis Research

Ministry of Health of the Russian Federation

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Temporary mechanical circulatory support with the iVAC 2L transaortic device in high-risk percutaneous coronary intervention — a multicenter experience

Russian Journal of Cardiology (2024)

É. A. Avetisyan O. B. Dorogun E. V. Krasnoperova Р. С. Тарасов V. I. Ganyukov

Aim . To analyze the multicenter international experience of high-risk protected percutaneous coronary intervention (PCI) procedures using the transaortic temporary pulsatile mechanical circulatory support (MCS) device iVAC 2L (PulseCath B. V., Amsterdam, the Netherlands). Material and methods . The pilot prospective-retrospective international multi-center observational study included patients with multivessel and/or complex coronary lesions, indications for coronary revascularization and refusal of the heart team from coronary artery bypass grafting and unprotected PCI due to a high risk of complications. PCI was performed with a temporary MCS using the iVAC 2L device in five clinics in Russia and Belarus. Results . From February 2023 to February 2024, 24 patients were included in the study. The median age was 69,0 years (interquartile range (IQR): 63,5-71,8); 87,5% were men. Twenty patients (83,3%) underwent elective PCI and four patients (16,7%) due to acute coronary syndrome (ACS) as follows: three with non-ST-segment elevation myocardial infarction and one with ST-segment elevation myocardial infarction (STEMI). The patient with STEMI underwent PCI against the background of acute heart failure (AHF). The median MCS time was 66,0 min (IQR: 43,0-98,0). Technical success of PCI was achieved in 100% of patients. The median initial and residual SYNTAX scores were 35,0 (IQR: 25,6-41,4) and 8,0 (IQR: 5,0-17,5), respectively. The median left ventricular ejection fraction before PCI and 7 days after was 44,0% (IQR: 31,0-54,0) and 48,0% (IQR: 36,5-53,5), respectively. In two cases (8,3%), major bleeding from the access site of the MCS device was observed. There were 2 fatal outcomes as follows: during elective PCI due to progression of acute left ventricular failure and in the late period due to septic shock after emergency PCI. Conclusion . PCI with MCP by the iVAC 2L device is an applicable and relatively safe tactic of coronary revascularization in patients with a high risk of complications, including in the conditions of ACS and AHF.

10.15829/1560-4071-2025-5856

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Factors determining adherence to anticoagulant therapy in patients with atrial fibrillation

Russian Journal of Cardiology (2023)

Д. В. Певзнер N. S. Kostritsa L. M. Galaeva И. Б. Меркулова O. B. Dorogun

Aim . To identify risk factors for low adherence and develop a scale for its prediction. To evaluate the association of the predictive score with actual low adherence according to the 8-item Morisky Medication Adherence Scale, self-drug withdrawal, and adverse outcomes in patients with atrial fibrillation (AF). Material and methods . The study included patients with AF and a high risk of thromboembolic events according to the CHA2DS2-VASc scale, who were hospitalized from January 2011 to December 2017. Potential risk factors for non-adherence, selected from the literature, were tested in a multivariate regression analysis followed by the development of an adherence prediction scale. The association of predicted low adherence with actual adherence was assessed. Results . The study included 199 patients. The analysis identified following predictors of low adherence: low income, history of bleeding, prior stroke, 4 positive responses to the adherence questionnaire, warfarin. Based on these predictors, a scale for predicting adherence was developed, while a threshold value of 3 points was identified (sensitivity, 90,2%, specificity, 98,4%). A significant association of low predicted adherence on the developed scale with actual adherence and adverse outcomes was demonstrated. Conclusion . We have developed a scale for predicting adherence to anticoagulant therapy, and also determined its threshold value. In case of a high risk of low adherence, clinicians should try to increase adherence in order to prevent complications.

Medication Adherence

Stroke

Anticoagulant Therapy

10.15829/1560-4071-2023-5418

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