M.I. Lutay, A.F. Lysenko Assessment of medical therapy of coronary heart disease in Ukraine: PULSAR trial results

In 2009 Ukrainian trial PULSAR (ePidemiological evalUation of heart rate control and treatment in stable coronary artery diSease AmbulatoRy patients) was provided. 165 ambulatory cardiologists in big cities of 16 regions took part in this study. It included 1875 patients with stable angina. Trial’s objective was to study clinical features of patients with different forms of chronic coronary heart disease (CAD) and to evaluate drugs prescriptions in ambulatory practice. The diagnosis of CAD in most participants was proved by chest pain with confirmation by positive ECG exercise test (78.4 %), rest ECG abnormalities (54.7 %), coronary angiography (30.6 %). Drugs which influence disease prognosis (aspirin, statins, beta-blockers, angiotensin converting enzyme inhibitors) were prescribed nearly as often as in the European survey covering last five years. But the efficacy of therapy was rather insufficient. Despite therapy, cholesterol levels and blood pressure were higher then “target” in most of patients (>70 %). More than half of participants had severe angina (category III CCS). In 43.5 % of patients, including those taking beta-blockers, heart rate was more than 80 per minute. Such results suggest more active monitoring of the mentioned symptoms. According to PULSAR results, to improve quality of stable angina management, adequate doses of medications should be prescribed and patient compliance increased.

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