Vol 18, No 1 (2016)

Cover Page

Full Issue


There is a new era for anticoagulant therapy in Central and Eastern Europe. Today, Pradaxa® is the single new oral anticoagulant to have a specific reversal agent Praxbind®

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После регистрации препарата Праксбайнд® (идаруцизумаб*) рядом регулирующих органов в мире у врачей и пациентов в Европе, в том числе в странах Центральной и Восточной Европы, в антикоагулянтной терапии начался следующий этап.
Consilium Medicum. 2016;18(1):8-9
pages 8-9 views

Rational choice of combination antihypertensive therapy

Morozova T.E., Gontarenko S.V.


The review presents data concerning the optimization of pharmacotherapy of hypertension to reduce the risk of cardiovascular diseases and their complications fixed combinations of antihypertensive drugs, on the basis of application perindopril and indapamide.
Consilium Medicum. 2016;18(1):10-15
pages 10-15 views

Risk of hypertension development in patientswith oncological diseases under anticancer treatment

Chazova I.E., Oshchepkova E.V., Kirillova M.Y., Stenina M.B.


In recent years, a new direction in medicine has been formed, combining the efforts of cardiologists and oncologists - cardio-oncology, whose objectives are to develop and optimize the algorithms of collaborative management of cancer patients, to minimize cardiotoxic effects of antineoplastic treatment that would improve prognosis and prolong their life. It is known that chemotherapeutic drugs have cardio - and vasotoxication effects, contributing to the development and aggravation of existing cardiovascular disease. Arterial hypertension (AH) is one of the complications of antineoplastic therapy of malignant oncological diseases and most often occurs in the prescription of inhibitors of the receptor of epidermal growth factor. The true prevalence of "new-onset" hypertension in these patients can hardly be defined, and it varies considerably depending on the type, dose, time-period of chemotherapy. Examination and treatment of patients with oncological diseases, who developed AH due to chemotherapy, are conducted according to recommendations; however, there are peculiarities in prescription of different antihypertensive drugs.
Consilium Medicum. 2016;18(1):16-20
pages 16-20 views

Age aspects of -adrenergic blocking agents dosing in arterial hypertension treatment using Bisoprolol application as an example

Savenkov M.P., Ivanov S.N., Shtandel L.N., Savenkova A.M., Postnikova Z.V.


We analyzed the correlation between the starting dose and the corrected one within 2 weeks of outpatient or inpatient treatment of Bisoprolol (b-AB) in 48 elderly (mean age 56±7.9 years old) and 65 senile (mean age 87±6.4 years old) patients with arterial hypertension associated with chronic cardiovascular and bronchopulmonary diseases in remission in clinical practice due to the presence of the wide range of b-adrenergic blocking agents (b-AB) dosing in the treatment of cardiovascular diseases. Bisoprolol was prescribed as the second or third additional agent in combination with angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, calcium channel blocker and diuretic to low to target blood pressure and to slow the heart rate. We revealed that effective and tolerated dose of Bisoprolol was 1.25-2.5 mg in more than 1/2 of elderly patients and more than 80% of senile patients. We identified the clinical situations where low doses of Bisoprolol should be prescribed in elderly patients, and the recommendations on managing the therapy with the focus on monitoring diuretic profile to prevent possible urodynamic disorders. We made the conclusion showing the need of lowest dosage of Bisoprolol (2.5 mg) application in clinical practice.
Consilium Medicum. 2016;18(1):21-24
pages 21-24 views

Actual aspects of rational pharmacotherapy in cardiology.Pros and cons fixed and arbitrary combinations of antihypertensive drugs

Trukhan D.I., Pozdnyakov Y.M.


The article discusses the relevant aspects of rational pharmacotherapy in cardiology. As an example, lists the steps of selecting from the standpoint of rational pharmacotherapy diuretic for treatment of arterial hypertension. Reviewed the pros and cons of 2 strategies of combination therapy: application of an arbitrary (non-fixed) combinations of 2 drugs and fixed combinations in a single tablet.
Consilium Medicum. 2016;18(1):25-31
pages 25-31 views

Characteristics of diuretic therapy in chronic heart failure

Evdokimova A.G., Kovalenko E.V., Lozhkina M.V., Evdokimov V.V., Voronina G.V.


The article discusses the importance of diuretic therapy in patients with chronic heart failure, using evidence-based results, monitoring the efficacy and safety. Special attention is paid to the loop diuretics, especially torsemide, recommended for long-term use not only as diuretic therapy, but also as a novel neurohumoral modulator from the standpoint of organoprotective property.
Consilium Medicum. 2016;18(1):32-37
pages 32-37 views

Chronic ischemic heart disease: treatment news

Karpov Y.A.


The main aim of chronic ischemic heart disease (IHD) treatment is to reduce the risk of complications - especially a myocardial infarction, and mortality (to increase life expectancy) in providing a good quality of life. New treatment options for IHD have been worked out recently: the increase of duration of dual antiplatelet therapy and intensive lowering of low-density lipoprotein cholesterol levels as a part of combined therapy, new schemes of antianginal therapy and some others. The characteristics of invasive treatment, including the correlation between endovascular treatment and coronary artery bypass graft surgery, have been outlined. Modern multi-component strategy using for management of patients with chronic IHD allows us to improve not only the quality of life, but also to increase life expectancy, without cardiovascular complications.
Consilium Medicum. 2016;18(1):38-44
pages 38-44 views

Pill in the pocket": the pros and cons

Syrov A.V.


Issues of interruption of paroxysmal atrial fibrillation (AF). Discussed in detail the tactics of "pill in the pocket", including the clinical case. Despite convincing data from clinical trials and practice, the method of "pill in pocket" with the use of propafenone is rarely used. A protocol on management of paroxysmal AF to be used in an outpatient setting.
Consilium Medicum. 2016;18(1):45-48
pages 45-48 views

Can the generic drugs application increase the treatment compliance in patients?

Grigoreva N.Y., Kuznetsov A.N., Maiorova M.V., Yarkova N.A.


The article deals with the characteristics of the original and generic drugs. We showed the benefits of original drugs application in comparison with generics, according to the results of different Russian and our own studies.
Consilium Medicum. 2016;18(1):50-53
pages 50-53 views

Key features of candesartan application in clinical practice

Evdokimova A.G., Lozhkina M.V., Kovalenko E.V.


The article deals with the literature review concerning the candesartan cilexetil application in patients with arterial hypertension, chronic heart failure, chronic kidney disease, diabetes mellitus and other conditions. Particular attention is paid to the special aspects of the pharmacokinetics and pharmacodynamics of the drug, organoprotective properties, metabolic neutrality and safety application.
Consilium Medicum. 2016;18(1):54-59
pages 54-59 views

Management of patients with infectious endocarditis at the present stage

Belov B.S., Tarasova G.M.


The problem of infective endocarditis (IE) continues to maintain its importance because of the high mortality rate and severe complications. Modern IE is a polyetiological disease, the emergence and development of which may be due to pathogens, components of an extremely extensive list, enlarged almost every year. Given the marked clinical polymorphism, special attention is paid to early diagnosis of the disease, including the use of new medical technologies, and the timely use of antimicrobial therapy. In terms of the increasing amount of information of great practical importance is the timely informing of doctors about modern principles of treatment of patients with IE. In the present review, the main approaches to the diagnosis, treatment and prevention of IE taking into account the latest recommendations of experts of the European Society of Cardiology-2015.
Consilium Medicum. 2016;18(1):60-66
pages 60-66 views

Angiotensin-converting enzyme inhibitors - the risk of dementia and possibilities of improving cognitive functions:the unique characteristics of perindopril

Ostroumova O.D., Galeeva N.Y., Bondarets O.V., Guseva T.F., Kopchenov I.I.


The article considers the possibility of 5 major classes of antihypertensive drugs to reduce the risk of dementia and to impact on cognitive functions. It is noted that angiotensin-converting enzyme inhibitors do not have a class effect associated with cerebral protection. We show in detail the results of perindopril usage for the prevention of dementia and improvement of cognitive functions. We discuss the mechanisms of cerebral protection in case of applying perindopril.
Consilium Medicum. 2016;18(1):67-72
pages 67-72 views

The possibility of the angiotensin-converting enzyme (fosinopril) application in patients with comorbid cardiorespiratory diseases

Karoli N.A., Rebrov A.P.


This review notes the possibility of renin-angiotensin-aldosterone system (RAAS) blocking as a special therapeutic strategy in case of chronic obstructive pulmonary disease (COPD) and, in particular, the role of angiotensin-converting enzyme (ACE) inhibitors in the treatment of comorbid cardiovascular pathology associated with COPD. We know that the increased renin-angiotensin system activity can contribute to the pathogenesis and progression of COPD. The data show that ACE inhibitors application is associated with the reduction in mortality in elderly patients with COPD, hospitalized due to worsening. We have results showing beneficial skeletal muscles and cardiovascular morbidity effects of ACE inhibitors in patients with COPD.The review shows that ACE inhibitors, particularly fosinopril, remain their clinical relevance in treating patients with cardiorespiratory pathology. Fosinopril action is multiplex and is determined not only by the effect on blood pressure, left ventricular systolic and diastolic dysfunction (the cause of chronic heart failure), but also by the normalization of the RAAS functioning and organoprotective effect. Fosinopril is a drug with favorable metabolic profile and low incidence of adverse events.
Consilium Medicum. 2016;18(1):73-78
pages 73-78 views

Experience of ivabradine application in patients with comorbid pathology

Kochetkova I.V., Chernykh T.M.


The aim of the study is to assess the antiarrhythmic action of ivabradine in patients with comorbid pathology, and associated with the combination of effort angina and chronic obstructive pulmonary disease following coronary artery bypass graft surgery.Materials and methods: we examined 120 men with stable effort angina functional classes II-III 3 years after coronary artery bypass graft surgery using the hardware-software complexes “ETON” and “Holter-DMS”. The article describes the following results: the application of ivabradine can reduce ventricular extrasystoles.Conclusion: we recommend using ivabradine in patients with ischemic heart disease combined with chronic obstructive pulmonary disease after coronary artery bypass graft surgery because of significant antianginal effect of this drug: such as reducing the number of angina attacks, improving the quality of life of patients, increasing heart rate variability.
Consilium Medicum. 2016;18(1):80-82
pages 80-82 views

Obstructive sleep apnea syndrome and cardiovascular events

Litvin A.Y., Mikhailova O.O., Elfimova E.M., Chazova I.E.


The epidemiological and randomized clinical studies show that obstructive sleep apnea syndrome (OSA) is a common, risk factor of cardiovascular disease which can be treated. There are numerous studies, confirming the negative impact of OSA on cardiovascular morbidity and mortality. The present review focuses on new results arguing for the strong link between OSA and chronic ischemic heart disease, acute coronary syndrome, and stroke, as well. The article deals with the studies, evaluating the impact of CPAP therapy (CPAP - continuous positive airway pressure) on reduction of cardiovascular mortality and incidence of cardiovascular events among cardiac patients with OSA. OSA treatment using CPAP therapy is associated with the reduction of fatal and non-fatal cardiovascular events. At the same time, there are no clear evidence-based recommendations concerning the application of CPAP therapy in asymptomatic OSA patients worked out.
Consilium Medicum. 2016;18(1):83-87
pages 83-87 views

Macronodular bilateral adrenal hyperplasia: the pathogenesis and genetic aspects

Yukina M.Y., Nuralieva N.F., Beltsevich D.G., Troshina E.A., Platonova N.M.


Macronodular bilateral adrenal hyperplasia (MBAH) in major cases is genetically-determined disease, which is manifested by symptoms of hypercortisolism. The MBAH is a diagnostic challenge due to the lack of usual clinical features, the questionable laboratory data, the great amount of tests, the different cutoff points and the lack of specificity of radiological characteristics.According to the latest data, a central role in hormonal hypersecretion and cellular proliferation in MBAH play aberrant membrane receptors of adrenal cortex, ectopic adrenocorticotropic hormone production, defects in adenylate cyclase and Wnt signaling systems, disorders of steroidogenesis. However, the exact molecular mechanisms, responsible for the development of MBAH, are unknown. The identification of pathogenetic mechanisms of development MBAH will allow to develop new methods of timely diagnostics and comprehensive treatment of the disease.
Consilium Medicum. 2016;18(1):88-93
pages 88-93 views

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