Preview

Rational Pharmacotherapy in Cardiology

Advanced search

The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study

https://doi.org/10.20996/1819-6446-2016-12-1-51-55

Full Text:

Abstract

Aim. To evaluate the long-term prognosis of life in patients after cerebral stroke (MI) and to identify the main factors influencing it.

Material and methods. All patients (n=960) who had MI or transient ischemic attack in the period from 01.01.2009 to 31.12.2011, admitted to Lyubertsy district hospital №2, were included into the register of LIS-2. The primary endpoint was total mortality of patients.

Results. The average age of patients was 72±9 years, 2/3 were women. 207 patients (21.7%) died in the hospital, 753 were discharged from the hospital. Median follow-up was 2.8 (2.1, 3.5) years. 31.5% of the patients died during this period. The main cause of death (36%) was re-MI, and 22.4% of patients died from the heart failure. The relative risk (RR) of death was significantly increased with the age of patients (RR=1.1). The probability of death increased in the presence of diabetes mellitus (RR=1.4), alcohol abuse (RR=2.3), any signs of consciousness disorders in the acute phase of MI (RR=1.6), heart failure (RR=1.6), atrial fibrillation (RR=1.4). Patients who were treated with calcium channel blockers before admission to the hospital, had a lower risk of death than those who did not receive these drugs (RR=0.4). Prescription of ACE inhibitors at discharge from the hospital reduced significantly the risk of death in the long-term period (RR=0.7).

Conclusion. High rate of long-term mortality in the LIS-2 register can be largely explained by the poor quality of primary and secondary prevention of cardiovascular events.

About the Authors

S. Yu. Martsevich
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


N. P. Kutishenko
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


A. V. Suvorov
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


A. V. Zagrebelnyy
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


M. L. Ginzburg
Lyubertsy District Hospital №2. Oktyabr’skiy prospect 338, Moscow Region, Lyubertsy, 140006 Russia
Russian Federation


A. D. Deev
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


References

1. Thrift AG, Cadilhac DA, Thayabaranathan T, et al. Global stroke statistics. Int J Stroke 2014;9(1):6-18

2. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014;129(3):e28-292.

3. Spirin NN, Korneeva NN. These hospital stroke in Kostroma. Fundamental'nye Issledovaniya 2012; 4: 123-8. In Russian (Спирин Н.Н., Корнеева Н.Н. Данные госпитального инсульта в Костроме. Фундаментальные Исследования 2012;4:123-8).

4. Malakshinova ZH, Manzhueva TK, Tsyrenov B.Ts. Morbidity and mortality from stroke in Ulan-Ude on the register data for the years 2005-2007. Byulleten' VSNTs SO RAMN 2008; 3 (61): 99-100. In Russian (Малакшинова З.Х., Манжуева Т.К., Цыренов Б.Ц. Заболеваемость и смертность от мозгового инсульта в г. Улан-Удэ по данным регистра за 2005-2007 гг. Бюллетень ВСНЦ СО РАМН 2008;3(61):99-100).

5. Lebedev IA, Anicshenko LI, Akinina SA, et al. Clinical and epidemiological features of stroke in the Khanty-Mansiysk Autonomous Okrug (according to the population register). Vestnik Rossiyskoy Voennomeditsinskoy akademii 2011; 3 (35): 103-7. In Russian (Лебедев И.А., Анищенко Л.И., Акинина С.А., и др. Клинико-эпидемиологические особенности мозгового инсульта в Ханты-Мансийском автономном округе (по данным популяционного регистра). Вестник Российской Военно-медицинской академии 2011;3(35):103-7).

6. Kotova EY, Mashin VV. Epidemiology and major risk factors for stroke in Ulyanovsk (according to the register of stroke). Ul'yanovskiy Mediko-biologicheskiy Zhurnal 2011; 2: 100-7. In Russian (Котова Е.Ю., Машин, В.В. Эпидемиология и основные факторы риска развития инсульта в г. Ульяновске (по данным регистра инсульта). Ульяновский Медико-биологический Журнал 2011;2: 100-7).

7. Starodubtseva OS, Begicheva SV Analysis of the incidence of stroke with the use of information technology. Fundamental'nye Issledovaniya 2012; 8: 424-7. In Russian (Стародубцева О.С., Бегичева С.В. Анализ заболеваемости инсультом с использованием информационных технологий. Фундаментальные Исследования 2012;8:424-7).

8. Didenko MA, Shprakh BB., Martynenko EA The structure, outcomes and risk factors of cerebral stroke according to the hospital register in Irkutsk. Sibirskiy Meditsinskiy Zhurnal 2008; 4: 10-4. In Russian (Биденко, М.А., Шпрах, ВВ., Мартыненко Е.А. Структура, исходы и факторы риска мозговых инсультов по данным госпитального регистра в г. Иркутске. Сибирский Медицинский Журнал 2008; 4: 10-4).

9. Boytsov S.A., Martsevich S.Y., Ginzburg M.L., et al. Lyubertsy study on mortality rate in patients after cerebral stroke or transient ischemic attack (LIS-2). Design and medical treatment estimation. Rational Pharmacotherapy in Cardiology 2013;9(2):114-22. (In Russ.) DOI:10.1234/1819-6446-2013-2-114-122Бойцов С.А., Марцевич С.Ю., Гинзбург М.Л., и др. Люберецкое исследование смертности больных, перенесших мозговой инсульт или транзиторную ишемическую атаку (ЛИС-2). Дизайн и оценка лекарственной терапии. Рациональная Фармакотерапия в Кардиологии 2013;9(2):114-22.

10. Martsevich S.Y., Kutishenko1 N.P., Suvorov A.Y., et al. Characteristics of patients with cerebral stroke or transient ischemic attack, included into the LIS-2 register (Lyubertsy study of mortality in patients after stroke). Rational Pharmacotherapy in Cardiology 2015;11(1):18-24. In Russian (Марцевич С.Ю., Кутишенко Н.П., Суворов А.Ю. и др. Характеристика пациентов с мозговым инсультом или транзиторной ишемической атакой, включенных в регистр ЛИС-2 (Люберецкое исследование смертности больных, перенесших мозговой инсульт). Рациональная Фармакотерапия в Кардиологии 2015;11(1): 18-24).

11. Martsevich SYu, Kutishenko NP, Suvorov A. Yu, et al., On behalf of the working group study "LIS-2." Analysis of anamnestic factors and their role in determining the nearest (hospital) prognosis in patients after stroke or transient ischemic attack. register LIS-2 results. Rossiyskiy Kardiologicheskiy Zhurnal 2015; 6 (122): 14-9. In Russian (Марцевич С. Ю., Кутишенко Н. П., Суворов А. Ю., и др. от имени рабочей группы исследования “ЛИС-2”. Анализ анамнестических факторов и их роль в определении ближайшего (госпитального) прогноза у больных, перенесших мозговой инсульт или транзиторную ишемическую атаку. Результаты регистра ЛИС-2. Российский Кардиологический Журнал 2015; 6 (122): 14-9).

12. Kim D., Lee S.H., Kim B.J., et al. Korean Stroke Registry investigators. Eur Heart J 2013;34:2760-7.

13. Fang M.C., Go A.S., Chang Y., et al. Long-tern survival after ischemic stroke in patients with atrial fibrillation. Neurology 2014; 82: 1033-7.

14. Lakshminarayan K., Berger A.K., Fuller C.C., et al. Trends in 10-year survival of patients with stroke hospitalized between 1980 and 2000: The Minnesota stroke survey. Stroke 2014; 45: 2575-81.

15. Ntaios G., Papavasileiou V., Makaritsis K., et al. Association of ischaemic stroke subtype with longterm cardiovascular events. Eur J Neurol 2014; 21: 1108-14.

16. Suvorov A.Y., Martsevich S.Y., Kutishenko N.P., et al. Evaluation of the conformity of cardiovascular therapy to current clinical guidelines in the improvement of outcomes in patients after stroke (according to the LIS-2 register). Rational Pharmacotherapy in Cardiology 2015;11(3):247-52. In Russian (Суворов А.Ю., Марцевич С.Ю., Кутишенко Н.П., и др., от имени рабочей группы исследования ЛИС-2. Оценка соответствия современным клиническим рекомендациям сердечно-сосудистой терапии, направленной на улучшение исходов после перенесенного инсульта (по данным регистра ЛИС-2). Рациональная Фармакотерапия в Кардиологии 2015; 11: 247-52).

17. Staessen J, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with Isolated systolic hypertension in Europe. Lancet 1997; 350: 757-64.

18. Liu L., Wang J.G., Celis H., Staesen J.A. Implications of Systolic Hypertension in China trial. Clin Exp Hypertens 1999; 21: 499-505.

19. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood pressure lowering regimen among 6105 individuals with previous stroke or transient ischemic attack. Lancet 2001;358:1033-41.


For citation:


Martsevich S.Y., Kutishenko N.P., Suvorov A.V., Zagrebelnyy A.V., Ginzburg M.L., Deev A.D. The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study. Rational Pharmacotherapy in Cardiology. 2016;12(1):51-55. (In Russ.) https://doi.org/10.20996/1819-6446-2016-12-1-51-55

Views: 329


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)