Problems of diagnosis and treatment of chronic ischaemic heart disease combined with chronic obstructive pulmonary disease according to retrospective analysis

Authors

  • V.A. Potabashnii Dnipro State Medical University, Department of Therapy, Cardiology and Family medicine of FPE 30-ty richchia Peremohy sq., 2, Kryvyi Rih, Dnipropetrovsk region, 50056, Ukraine, Ukraine https://orcid.org/0000-0002-0786-8158
  • O.V. Kniazieva Dnipro State Medical University, Department of Therapy, Cardiology and Family medicine of FPE 30-ty richchia Peremohy sq., 2, Kryvyi Rih, Dnipropetrovsk region, 50056, Ukraine , Ukraine https://orcid.org/0000-0002-4272-6745
  • O.Ya. Markova Dnipro State Medical University, Department of Therapy, Cardiology and Family medicine of FPE 30-ty richchia Peremohy sq., 2, Kryvyi Rih, Dnipropetrovsk region, 50056, Ukraine , Ukraine https://orcid.org/0000-0001-7061-4241

DOI:

https://doi.org/10.26641/2307-0404.2021.2.234517

Keywords:

ischemic heart disease, chronic obstructive pulmonary disease, comorbidity, adherence to treatment, Morisky Scale

Abstract

Ischaemic Heart Disease (IHD) and Chronic Obstructive Pulmonary Disease (COPD) are common diseases that rank highest in the Global Burden of Disease Study (2019). IHD and COPD are often combined, making diagnosis and treatment of patients difficult in actual clinical practice. The aim of the study was to identify problems in the diagnosis and treatment of patients with a combination of chronic IHD and COPD, based on a retrospective analysis of medical records. Patient’s adherence to treatment was also assessed with the Morisky Scale (MMAS-8). The analysis of 108 inpatient charts with a combination of chronic IHD and COPD was carried out. The quality of diagnosis and treatment of IHD was evaluated in accordance with the order of the Ministry of Health of Ukraine N152 dated March 02 2016, considering the recommendations of the European Society of Cardiology (2019). It was found that smoking history was in 23.1% of patients, a body mass index (BMI) was calculated in 51,9%, and a carotid ultrasound examination was carried out in 7.4% of cases. The total cholesterol level was determined in 59.2% of patients, while the level of low-density lipoprotein cholesterol (LDL-C) was determined in only 43.5%. Transthoracic echocardiography (TTE) was performed in 62.9 % of patients, but stress-echocardiography and exercise ECG were not performed. Daily ECG monitoring was performed in 60.2% of cases. The levels of brain natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP) were not detrmined to precise etiology of dyspnea. It was also found that beta-blockers (29.6% of patients), ivabradine (11.1% of patients) and statins (65.7% of patients) are seldom administered to patients with IHD and COPD. The targeted doses of these drugs are not reached. Fixed combinations of long-term bronchodilalarors were insufficiently used in therapy of COPD. However, patients' adherence to basic IHD and COPD therapy is weak. 45.4 % of patients were non-adherent to treatment, 43.5% were medium-adherent, and only 11.1% of patients were adherent to treatment.

References

[Adapted evidence-based clinical guideline “Chronic obstructive pulmonary disease”]. Kyiv: National Aca¬demy of Medical Sciences. 2020. p. 70. Ukrainian. Available from: http://www.ifp.kiev.ua/ftp1/metoddoc/nasta¬nova_hozl_2020.pdf

Antomonov MYu. [Mathematical processing and analysis of biomedical data]. MITC "Medinform". 2018;2:579. Russian.

Voinarovska HP, Asanov EO [Ischemic heart disease and chronic obstructive pulmonary disease: the topical problem of comorbidity in internal medicine]. ScienceRise: Medical Science. 2020;3(36):20-24. Ukrainian.

doi: https://doi.org/10.15587/2519-4798.2020.203968

Kovalenko VM. [Problem of comorbidity in cardiology]. Ukr. med. chasopys. [Internet]. 2019;5(1):133. Ukrainian. Available from: https://www.umj.com.ua/article/162879/yuvilej-najmasshtabnishoyi-podiyi-u-vitchiznyanij-kardiologiyi

Lukina YuV, Kutishenko NP, Martsevich SYu, Drapkina OM. [Questionnaires and scores for assessing medication adherence – advantages and disadvantages of the diagnostic method in research and actual clinical practice]. Cardiovascular Therapy and Prevention. 2020;19(3):232-9. Russian. doi: https://doi.org/10.15829/1728-8800-2020-25624

Pertseva TA, Konopkina LI, Basina BO. [Efficacy and safety of prolonged action cholinolytic at the stages of long-term medical rehabilitation of patients with COPD]. Medicni perspektivi. 2012;17(1):59-65. Ukrainian.

Pertseva TA, Konopkina LI, Koval DS, Guba YuV. [The processes of inflammation and fibrosis in patients with chronic obstructive pulmonary disease]. Medicni perspektivi. 2020;25(4):59-65. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2020.4.221229

[Order of the Ministry of Health of Ukraine dated March 2, 2016 N 152 “On Approval anv Implementation of Medical-Technological Documents for the Stan¬dardization of Medical Assistance in Stable Ischemic Heart Disease”]. Kyiv; 2016. Ukrainian. Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/¬2016_152_ykpmd_ihs.pdf

[Cardiovascular diseases – the main cause of death of Ukrainians. Conclusions from the study of the global burden of disease in 2019]. Public Health Center of the Ministry of Health of Ukraine. [Internet]. 2021 Jan 4. Ukrainian. Available from: https://phc.org.ua/news/ser¬cevo-sudinni-zakhvoryuvannya-golovna-prichina-smerti-ukrainciv-visnovki-z-doslidzhennya

Leslie KH, McCowan C, Pell JP. Adherence to cardiovascular medication: a review of systematic re¬views. Journal of Public Health. 2019;41(1):e84–e94. doi: https://doi.org/10.1093/pubmed/fdy088

Rabe KF, Hurst JR, Suissa S. Cardiovascular di¬sease and COPD: dangerous liaisons? Eur Respir Rev. 2018;27:1-32. doi: https://doi.org/10.1183/16000617.0057-2018

Roversi S, Fabbri LM, Sin DD, Hawkins NM, Augusti A. Chronic Obstructive Pulmonary Disease and Cardiac Diseases: An Urgent Need for Integrated Care. Am J Respir Crit Care Med. 2016;194,11:1319-36. doi: https://doi.org/10.1164/rccm.201604-0690SO

Portillo K, Abad-Capa J, Ruiz-Manzano J. Chronic Obstructive Pulmonary Disease and Left Ventricle. Arch Bronconeumol. 2015;51(5):227-34. doi: https://doi.org/10.1016/j.arbres.2014.03.012

Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204-22.

doi: https://doi.org/10.1016/S0140-6736(20)30925-9

Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (2020 Report). Available from: https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf

Hillas G, Perlicos F, Tsiligiani I, Tzanakis N. Managing comorbidities in COPD. Int J Chron Obstruct Pulmon Dis. 2015;7:95-109. doi: https://doi.org/10.2147/COPD.S54473

Pareja-Martínez E, Esquivel-Prados E, Martínez-Martínez F, García-Corpas JP Questionnaires on adhe¬rence to antihypertensive treatment: a systematic review of published questionnaires and their psychometric properties. Int J Clin Pharm. 2020;42(2):335-65. doi: https://doi.org/10.1007/s11096-020-00981-x

2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2020;41:407-77. doi: https://doi.org/10.1093/eurheartj/ehz425

Published

2021-06-18

How to Cite

1.
Potabashnii V, Kniazieva O, Markova O. Problems of diagnosis and treatment of chronic ischaemic heart disease combined with chronic obstructive pulmonary disease according to retrospective analysis. Med. perspekt. [Internet]. 2021Jun.18 [cited 2024Apr.15];26(2):72-9. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/234517

Issue

Section

CLINICAL MEDICINE