Тематичний Архів | Category Archives: Practical advices

Working group: L.G. Voronkov, K.M. Amosova, G.V. Dziak, O.J. Zharinov, V.M. Kovalenko, O.V. Korkushko, E.G. Nesukay, O.S. Sychov, Yu.S. Rudyk, O.M. Parkhomenko Guideline of the Ukrainian Association of Cardiology for the Diagnosis and Treatment of Chronic Heart Failure (2017)

Guideline on the diagnosis and treatment of chronic heart failure is an original consensus-document of the leading experts of Ukraine on chronic heart failure. Its preparation took into account the previous national consensus-document (2012), as well as principal positions of the new ESC guidelines on the diagnosis and treatment of heart failure (2016). Compared to the previous corresponding document, the 2017 national guidelines provided more detailed information about technologies of chronic heart failure management – from monitoring of efficiency and safety of therapeutic approaches to the practical issues concerning lifestyle modification and self-control of patients with chronic heart failure. Compared to previous guidelines, more attention is paid to high-technological device methods of treatment, becoming more widespread in Europe and having great potential in Ukrainian practice. A special chapter summarizes clinical approaches to decrease risk of heart failure in patients with cardiovascular diseases. The guideline is an official document of the Ukrainian Association of Cardiology, directed at improving diagnosis and treatment of chronic heart failure in our country and might be used by cardiologists, internists, family physicians, as well as teachers of high medical school.

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H. Heidbuchel, P. Verhamme, M. Alings, M. Antz, H.-C. Diener, W. Hacke, J. Oldgren, P. Sinnaeve, A.J. Camm, P. Kirchhof. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Part 2.

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References:
Europace Advance Access published August 31, 2015
Europace
doi:10.1093/europace/euv309
http://europace.oxfordjournals.org/content/europace/early/2015/08/29/europace.euv309.full.pdf

H. Heidbuchel, P. Verhamme, M. Alings, M. Antz, H.-C. Diener, W. Hacke, J. Oldgren, P. Sinnaeve, A.J. Camm, P. Kirchhof. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Part 1.

The current manuscript is an update of the original Practical Guide, published in June 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atrial fibrillation (AF). Both physicians and patients have to learn how to use these drugs effectively and safely in clinical practice. Many unresolved questions on how to optimally use these drugs in specific clinical situations remain. The European Heart Rhythm Association set out to coordinate a unified way of informing physicians on the use of the different NOACs. A writing group defined what needs to be considered as ‘non-valvular AF’ and listed 15 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The topics are (i) practical start-up and follow-up scheme for patients on NOACs; (ii) how to measure the anticoagulant effect of NOACs; (iii) drug–drug interactions and pharmacokinetics of NOACs; (iv) switching between anticoagulant regimens; (v) ensuring adherence of NOAC intake; (vi) how to deal with dosing errors; (vii) patients with chronic kidney disease; (viii) what to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a risk of bleeding?; (xi) management of bleeding complications; (x) patients undergoing a planned surgical intervention or ablation; (xi) patients undergoing an urgent surgical intervention; (xii) patients with AF and coronary artery disease; (xiii) cardioversion in aNOAC-treated patient; (xiv) patients presenting with acute stroke while onNOACs; and (xv)NOACs vs. VKAs in AF patients with a malignancy.

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References:
Europace Advance Access published August 31, 2015
Europace
doi:10.1093/europace/euv309
http://europace.oxfordjournals.org/content/europace/early/2015/08/29/europace.euv309.full.pdf

V.М. Коvalenkо, E.G. Nesukay (moderators), G.V. Knyshov, M.T. Vatutin, L.G. Voronkov, M.G. Illiash, D.V. Riabenko, V.I. Tseluiko. The diagnosis and treatment of the infectious endocarditis. The guidelines of the Working Group on Myocardial, Pericardial and Endocardial and Valve Diseases of the Ukrainian Association of Cardiology.

The infectious endocarditis (IE) is associated with high death rate and frequent development of heavy complications, despite improvement of the diagnosis and treatment. During recent years the changes of epidemiology characteristics of IE took place. The factors which were earlier not considered important receive a special value in the etiology of IE as a result of the larger risk of bacteriemia, i.e. degenerative changes, valve prostheses, abuse of intravenous usage of medications and drugs, growth of the number of invasive procedures. In this regard there are more cases of associated with medical interventions and less role of streptococcus as an etiological factor. The Working Group on Myocardial, Pericardial and Endocardial and Valve Diseases of the Ukrainian Association of Cardiology revised classification of IE, taking into account recommendations of ESC, 2009. Greater possibilities of visualization of heart, especially by MRI are highlighted in the guidelines. The idea of multidisciplinary approach received subsequent development in the renewed guidelines. The diagnosis and treatment of patients the with IE in the specialized centers by expert groups («the team of endocarditis») is recommended.

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