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Registry of patients with stable angina receiving antianginal therapy: What is the physicians’ CHOICE in the Russian Federation?

Karpov Yu. A.
Federal State Budgetary Institution, “Russian Cardiology Science and Production Center” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: coronary heart disease, register, angina, treatment, trimetazidine, preductal

DOI: 10.18087/rhj.2016.1.2178

Background. The major treatment goal of therapy for angina is not only improvement of prognosis but also decreasing ischemic episodes (angina attacks) or enhancing quality of life. However, despite a considerable progress in treatment angina attacks still persist in many IHD patients. Aim. The aim of the CHOICE program was obtaining reliable information about therapy and clinical status of patients with IHD as well as evaluation of medical approaches to changing the therapy if a previous antianginal treatment failed. Materials and methods. The program included epidemiological and observational parts. Total duration was two months. At the first visit, the epidemiological part of program was performed (history, RFs, clinical and instrumental examination, quality of life surveys, etc.) and the physician made a decision about transferring the patient to the observational part (changing therapy). Results of the instrumental examination and exercise tolerance were recorded. At the second visit, the effectiveness of administered treatment was evaluated. The epidemiological part of program included 3 598 patients, and the observational part included 2 273 patients with FC I–IV stable angina. The major clinical manifestation noted by patients was pain during exercise (92.8 %). Analyses showed that 91.6 % of patients received antithrombotic treatment, 3 % – anticoagulants, 77.1 % – statins, 60 % – ACE inhibitors, 25.6 % – angiotensin receptor blockers (ARB), 78.3 % – β-blockers, 28.2 % – calcium antagonists, 6.5 % – ivabradine, 54.8 % – short-acting nitrates, 36 % – long-acting nitrates, 26.4 % – trimetazidine (16.9 % of them received Preductal MR), and 43.4 % – diuretics. We observed decreases in proportions of patients receiving short-acting (from 57.8 % to 37.4 %) and long-acting nitrates (from 37 % to 24.5 %) and other trimetazidines (from 9.2 % to 1.2 %). The frequency of angina attacks per week decreased from 5.9±5.5 to 2.2±3.0 (р<0.00001), and the number of nitroglycerine doses per week decreased from 4.9±5.2 to 1.5±2.5 (р<0.00001). The treatment was associated with significant improvement of patients’ compliance (from 35.3 % to 50.6 %). Conclusion. Adjustment of the administered therapy considerably improved the situation, particularly the quality of life by reducing the number of angina attacks and other parameters characterizing the course of IHD. These data evidence that not all options of current antianginal therapy are sufficiently used for management of patients with IHD in real-life clinical practice.
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Karpov Yu. A. Registry of patients with stable angina receiving antianginal therapy:
What is the physicians’ CHOICE in the Russian Federation? Russian Heart Journal. 2016;15 (1):9–15

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