Русский
Influence of anemic syndrome correction on the course of coronary heart disease in outpatient practice
DOI: https://dx.doi.org/10.18565/therapy.2022.8.32-40
Budnevsky A.V., Ovsyannikov E.S., Nekhaenko N.E., Ostroushko N.I., Simion A.Yu., Martynov A.I.
1) N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia; 2) Department of Healthcare of the Voronezh Region, Voronezh; 3) A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia
The aim: to study the influence of hemoglobin level correction at the course of coronary heart disease in outpatient practice patients.
Material and methods. 1210 patients (309 males and 901 females) with coronary artery disease aged 50 to 85 years were included in the study. Data analysis was carried out using a computer program developed by us. All participants of the study received standard therapy recommended for coronary heart disease treatment, while the majority of patients with iron deficiency anemia received an additional iron preparation. The average duration of therapy was 160,1±8,4 days.
Results. In the first subgroup of the main group of patients with coronary heart disease in combination with anemia, who received an iron-containing preparation, an increase of serum iron and transferrin saturation with iron, an increase in hemoglobin and hematocrit took place after the therapy. An increase in the level of general blood test indexes was accompanied by a statistically significant improvement in the left ventricular ejection fraction (LV EF) by 27,4% and an increase in exercise tolerance by 112,6% (p <0,05). At the same time, in the second subgroup of the main group of patients with coronary heart disease in combination with anemia who did not receive an iron preparation, as well as in the comparison group (patients with ischemic heart disease, but without anemia), there were no statistically significant changes in the studied parameters. Holter ECG monitoring in the first subgroup of the main group of patients after therapy showed a statistically significant decrease in the frequency of ischemic episodes by 79,2%.
Conclusion. Anemia contributes to a more severe course of coronary heart disease, which is proved by decrease in LV EF, exercise tolerance and a higher incidence of functional class IV of angina pectoris. Correction of anemia leads to a decrease in the frequency of ischemic episodes in patients with coronary artery disease and anemia.
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About the Autors
Andrey V. Budnevsky, Dr. med. habil., professor, head of the Department of faculty therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia, vice-rector for research and innovation, honored inventor of the Russian Federation. Address: 394036, Voronezh, 10 Studencheskaya Str. E-mail: budnev@list.ru. ORCID: https://orcid.org/0000-0002-1171-2746. SPIN-code: 7381-0612
Evgeniy S. Ovsyannikov, Dr. med. habil., professor of the Department of faculty therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia. Address: 394036, Voronezh, 10 Studencheskaya Str. E-mail: ovses@yandex.ru. ORCID: https://orcid.org/0000-0002-8545-6255. SPIN-code: 3923-1003
Natalia E. Nekhaenko, Dr. med. habil., professor, head of the Department of management in healthcare,
N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia, deputy head of the Department of Healthcare of the Voronezh Region. Address: 394036, Voronezh, 10 Studencheskaya Str. E-mail: nehaenko_natalia@mail.ru. ORCID: https://orcid.org/0000-0002-5916-3248
Nadezhda I. Ostroushko, PhD in Medicine, associate professor of the Department of management in healthcare, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia, head of the division for providing medical care to the adult population of the Department of Healthcare of the Voronezh Region. Address: 394036, Voronezh, 10 Studencheskaya Str. E-mail: ostroushko100@yandex.ru.
ORCID: https://orcid.org/0000-0002-2667-4180. SPIN-code: 3903-0501
Aleksey Yu. Simion, applicant of the Department of faculty therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia, advisor of the division of medical care for adults of the Department of Healthcare of the Voronezh Region. Address: 394036, Voronezh, 10 Studencheskaya Str. E-mail: al-simion@yandex.ru. ORCID: https://orcid.org/0000-0002-8259-840X. SPIN-code: 1377-7205
Anatoly I. Martynov, Dr. med. habil., professor, academician of the Russian Academy of Sciences, professor of the Department of hospital therapy No. 1, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia, president of RSMSIM, honored scientist of the Russian Federation, honored doctor of the Russian Federation. Address: 127473, Moscow, 20/1 Delegatskaya Str.
ORCID: https://orcid.org/0000-0003-2839-7292. SPIN-code: 5271-3173
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