Pogosova N V, Sokolova O J, Ausheva A K, Karpova A V, Yufereva Yu M, Salbieva S A, Yusubova A I, Isakova S S, Iosifyan M A, Vygodin V A
National Research Center for Preventive Medicine, Moscow, Russia.
Kardiologiia. 2016 Dec;56(11):18-26. doi: 10.18565/cardio.2016.11.18-26.
The purpose of the study "Invasive Techniques for the treatment of atherosclerosis: the effectiveness of secondary preventive intervention" (IMLA-TRAC) - long-term efficacy of single preventive counseling of patients with coronary heart disease (CHD) in a stationary treatment for percutaneous coronary intervention (PCI).
In a prospective, randomized, controlled trial included 160 patients with coronary artery disease who underwent PCI between the ages of 38 to 87 years (mean age 59,43+/-8,94 years, 81.9% male). Included in the study, patients were randomized in a ratio of 1: 1 into 2 groups - the primary (n=80) and control (n=80). Patients in both groups received standard hospital treatment and hospital doctors recommendations. In addition to these patients of the main group carried out a preventive educational program After being discharged from hospital patients in both groups were followed for 12 months.
The study showed that a single prevention counseling, conducted in patients with coronary heart disease at the stage of hospital treatment over a planned or emergency PCI, does not provide a stable positive dynamics of the main risk factors and has no effect on mortality and combined end point. There is only a small positive dynamics of individual indicators, for example, significantly lower intake of saturated fats, an increase in adherence to treatment, in particular, receive aspirin.
Further studies are needed to determine the most effective models for preventive intervention in patients with coronary artery disease, which can start in a hospital, but should continue on an outpatient or remote formats.
“动脉粥样硬化治疗的侵入性技术:二级预防干预的有效性”(IMLA - TRAC)研究的目的——冠心病(CHD)患者在接受经皮冠状动脉介入治疗(PCI)的住院治疗中进行单次预防性咨询的长期疗效。
在一项前瞻性、随机、对照试验中,纳入了160例年龄在38至87岁之间接受PCI的冠心病患者(平均年龄59.43±8.94岁,男性占81.9%)。纳入研究的患者按1:1比例随机分为两组——主要组(n = 80)和对照组(n = 80)。两组患者均接受标准的住院治疗和医院医生的建议。此外,主要组的患者还开展了预防性教育项目。两组患者出院后均随访12个月。
研究表明,在冠心病患者住院治疗阶段,针对计划或急诊PCI进行的单次预防咨询,并未使主要危险因素呈现稳定的积极变化趋势,对死亡率和复合终点也无影响。仅个别指标有微小的积极变化,例如,饱和脂肪摄入量显著降低,治疗依从性提高,尤其是阿司匹林的服用情况。
需要进一步研究以确定对冠心病患者进行预防干预的最有效模式,这种干预可在医院启动,但应在门诊或远程模式下持续进行。