DOI: https://doi.org/10.22263/2312-4156.2023.6.25
V.I. Kozlovsky, O.M. Kovtun
The method of identifying the increased risk groups for the development of strokes, myocardial infarctions and lethal outcomes during 5 years in patients with arterial hypertension of the 2nd degree combined with chronic obstructive pulmonary disease
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2023;22(6):25-34.
Abstract.
Objectives. To develop a method for identifying an increased risk group of the total negative events (NE): strokes, myocardial infarctions and deaths in patients with arterial hypertension (AH) of the 2nd degree in combination with chronic obstructive pulmonary disease (COPD) for 5 years, considering the aggregation of leukocyte-platelet suspension (LPS) and erythrocytes deformability (ED).
Material and methods. Patients with AH and COPD of the 1st, main, and the 2nd, control groups, groups of high NE risk – the 3rd (n=18) and the 4th (n=29) ones received standard antihypertensive therapy. The 4th group received in addition clopidogrel at the dose of 75 mg per day.
Results. Factors correlating with the number of NE for a 5-year period in the main group of patients were determined, including ED (r=0.62), spontaneous platelet aggregation (r=0.65). Taking into account these factors, using logit-regression analysis, a method grouping a high risk of NE within 5 years among patients with AH and COPD was created. Its sensitivity (84.6%) and specificity (88.4%) were determined using the control group. The number of myocardial infarctions and strokes (p=0.046), deaths (p=0.014), and the total number of NE (p<0.001) over a 5-year follow-up period was significantly lower in the 4th group, receiving clopidogrel, than in the 3rd group. Conclusions. The method for identifying an increased total NE risk group for the 5-year long period among patients with the 2nd degree AH and COPD has been developed. It has been shown that the use of clopidogrel with traditional antihypertensive treatment provides a significant reduction in the NE number.
Keywords: arterial hypertension, chronic obstructive pulmonary disease, risk assessment of strokes, myocardial infarctions and deaths, clopidogrel.
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Information about authors:
V.I. Kozlovsky – Doctor of Medical Sciences, professor, head of the Chair of Faculty Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Vladimir I. Kozlovsky;
O.M. Kovtun – lecturer of the Chair of Faculty Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.
