THE PROBLEM OF COMORBIDITY IN THE CLINICAL PRACTICE OF A CARDIOLOGIST
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i2.13129Keywords:
cardiac pathology, comorbid pathology, unified approachAbstract
SUMMARY. Comorbidity is one of the major challenges for healthcare systems worldwide today. Modern management protocols for cardiac patients include some concomitant conditions (diabetes, renal failure, etc.), but recommendations for comprehensive recovery of patients with cardiac pathology and comorbid conditions are currently very limited.
The aim – to analyze the current experience of treatment of patients with cardiac profile with comorbid pathology and to outline the possibilities of improving the effectiveness of treatment of this category of patients.
Main part. The literature review provides evidence of the impact of certain forms of comorbid pathology on the underlying cardiac disease, as well as existing methods of treatment, rehabilitation and reduction of cardiovascular risks in patients with cardiac disease and comorbidity.
Conclusions. Management of a comorbid cardiac patient requires a comprehensive unified approach with risk assessment and forecasting the outcome of a combination of means of influencing all aspects of the pathogenesis of a clinical problem.
References
Hughes, L.D., McMurdo, M.E., & Guthrie, B. (2013). Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age Ageing, 42, 1, 62-69.
Taylor, A.W. (2010). Multimorbidity – not just an older person’s issue. Results from an Australian biomedical study. BMC Public Health, 10, 718.
Di Angelantonio, Е. (2015). Association of cardiometabolic multimorbidity with mortality. JAMA, 314, 1, 52-60.
Fortin, M. (2005). Prevalence of multimorbidity among adults seen in family practice. Ann. Fam. Med, 3, 223-228.
Sachdev, M. (2004). The prognostic importance of comorbidity for mortality in patients with stable coronary artery disease. J. Am. Coll. Cardiol., 43, 4, 576-582.
Zhang, M. (2009). Comorbidity and repeat admission to hospital for adverse drug reactions in older adults: retrospective cohort study. BMJ, 338, a2752.
McManus, D.D. (2012). Multiple cardiovascular comorbidities and acute myocardial infarction: temporal trends (1990–2007) and impact on death rates at 30 days and 1 year. Clin. Epidemiol., 4, 115-123.
Tisminetzky, M. (2016). Multiple chronic conditions and psychosocial limitations in patients hospitalized with an acute coronary syndrome. Am. J. Med., 129, 6, 608-614.
Canivell, S. (2018). Prognosis of cardiovascular and noncardiovascular multimorbidity after acute coronary syndrome. PLoS One, 13, 4, e0195174.
Farmer, C., Fenu, E., O’Flynn, N., & Guthrie, B. (2016). Clinical assessment and management of multimorbidity: summary of NICE guidance. BMJ, 354, i4843.
Sanchis, J. (2017). Prognostic value of geriatric conditions beyond age after acute coronary syndrome. Mayo Clin. Proc., 92, 6, 934-939.
Zozulia, I.S., & Muravska, O.M. (2013). Osoblyvosti elektrokardiohrafichnykh porushen pry ishemichnomu insulti, zumovlenomu infarktom miokarda [Features of electrocardiographic abnormalities in ischemic stroke caused by myocardial infarction]. Ostryie i neotlozhnyie sostoiania v praktike vracha – Acute and Urgent Conditions in the Practice of a Doctor, 1, 39-41 [in Ukrainian].
Shirafkan, A., Mehrad, M., Gholamrezanezhad, A., & Shirafkan, A. (2009). Conduction disturbances in acute myocardial infarction: a clinical study and brief review of the literature. Hellenic J. Cardiol., 50, 3, 179-184.
Vozniuk, V.V., Melnychuk, N.O., & Karpenko, P.O. (2010). Alimentarna reabilitatsia khvorykh pislia perenesenoho infarktu moikarda ta ishemichnoho insultu [Alimentary rehabilitation of patients after myocardial infarction and ischemic stroke]. Pidvyshchennya yakosti medychnoyi dopomohy: naukovi zasady ta praktychni rezultaty : materialy Vseukr. nauk.-prakt. konf., 22 zhovtnya 2010 r. – Improving the quality of medical care: scientific principles and practical results: materials of All-Ukrainian science and practice conference, October 22, 2010. Kyiv [in Ukrainian].
Muravska, O.M. (2010). Osoblyvosti lokalizatsiyi vohnyshchevykh zmin holovnoho mozku ta sertsya pry ishemichnomu insulti na tli hostroho infarktu miokarda [Features of the localization of focal changes in the brain and heart in ischemic stroke on the background of acute myocardial infarction]. Patolohiya – Pathology, 7, 2, 27-28 [in Ukrainian].
Semenene, Yu., Krishchunas, A., & Medziavichius, P. (2013). Opredeleniye obiema reabilitatsii pri tserebralnom insulte i infarkte miokarda po Mezhdunarodnoy klassifikatsii funktsionirovaniya, ogranicheniy zhiznedeyatelnosti i zdorovya [Determining the scope of rehabilitation for cerebral stroke and myocardial infarction according to the International Classification of Functioning, Disabilities and Health]. Terapevticheskiy arkhiv – Therapeutic Archive, 85, 4, 66-70 [in Russian].
Kokubo, Y. (2009). Relationship between blood pressure category and incidence of stroke and myocardial infarction in an urban Japanese population with and without chronic kidney disease: the Suita Study. Stroke, 40, 8, 2674-2679.
Oldridge, N.B., Guyatt, G.H., Fischer, M.E., & Rimm, A.A. (1988). Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA, 260, 7, 945-950.
Inglis, S.C. (2013). Peripheral artery disease and outcomes after myocardial infarction: an individual-patient meta-analysis of 28,771 patients in CAPRICORN, EPEHESUS, OPTIMAAL and VALIANT. Int. J. Cardiol., 168, 2, 1094-1101.
Piepoli, M.F. (2016). 2016 European guidelines on cardiovascular disease prevention in clinical practice. The sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European association for cardiovascular prevention & rehabilitation (EACPR). Eur. J. Prev. Cardiol., 23, NP1-NP96.
Ibanez, B. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 39, 2, 119-177.
Aboyans, V. (2018). 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. European Heart Journal, 39, 9, 763-816.
Frazier, L. (2009). Inflammatory proteine levels and depression screening after coronary stenting predict major adverse coronary events. Biol. Res. Nurs., 11, 2,163-173.
Ross, R. (1999). Atherosclerosis – an inflammatory disease. N. Engl. J. Med., 340, 2, 115-126.
Libby, P., Ridker, P.M., & Hansson, G.K. (2009). Inflammation in atherosclerosis: from pathophysiology to practice. J. Am. Coll. Cardiol., 54, 23, 2129-2138.
Roversi, S. (2014). Coronary artery disease concomitant with chronic obstructive pulmonary disease. Eur. J. Clin. Invest., 44, 1, 93-102.
Kaplan, M.H., & Feinstein, A.R. (1973). Acritique of methods in reported studies of long-term vascular complications in patients with diabetes mellitus. Diabetes, 22, 3, 160-174.
Rothnie, K.J., Yan, R., Smeeth, L., & Quint, J.K. (2015). Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis. BMJ Open, 5, 9, e007824.
The top 10 causes of death / World Health Organization. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.
Takeki, Hata (2010). Critical role of Thl7 cells in inflammation and neovascularization after ischaemia. J. Med. Cardiovasc. Res., 90, 2, 364-372.
Andell, P. (2014). Impact of chronic obstructive pulmonary disease on morbidity and mortality after myocardial infarction. Open Heart., 1, e000002.
Feary, J.R. (2010). Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care. Thorax, 65, 11, 956-962.
Ades, P.A. (2009). High-calorie-expenditure exercise: a new approach to cardiac rehabilitation for overweight coronary patients. Circulation, 119, 2671-2678.
Kemps, H. (2019). Exercise training for patients with type 2 diabetes and cardiovascular disease: What to pursue and how to do it. A Position Paper of the European Association of Preventive Cardiology (EAPC). Eur. J. Prev. Cardiol, 26, 7, 709-727.
Krankel, N. (2019). Exercise training to reduce cardiovascular risk in patients with metabolic syndrome and type 2 diabetes mellitus: How does it work? Eur. J. Prev. Cardiol, 26, 7, 701-708.
Zinman, B., Ruderman, N., & Campaigne, B.N. (2003). Physical activity/exercise and diabetes mellitus. Diabetes Care, 26 (1), S73-S77.
Takeki, Hata (2010). Critical role of Thl7 cells in inflammation and neovascularization after ischaemia. J. Med. Cardiovasc. Res., 90 2, 364-372.
(1998). DCCT Research Group Reliability and validity of a diabetes quality of life measure for the diabetes control and complications trial (DCCT). Diabetes Care, 11, 725-732.
Townsend, N. (2016). Cardiovascular disease in Europe: epidemiological update 2016. European Heart Journal, 37, 42, 3232-3245.
Chugh, S.S. (2010). Early identification of risk factors for sudden cardiac death. Nat. Rev. Cardiol, 7, 6, 318-326.
Dunlay, S.M., & Chamberlain, A.M. (2016). Multimorbidity in Older Patients with Cardiovascular Disease. Curr. Cardiovasc. Risk Rep., 10, 3.
Miller, M.D. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res., 41, 3, 237-248.
Van Weel, C., & Schellevis, F.G. (2006). Comorbidity and guidelines: conflicting interests. Lancet, 367, 550-551.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Achievements of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
