Risk factors and outcomes of gastrointestinal bleeding in patients with stable coronary artery disease: data from the observational registry of long-term antithrombotic therapy REGATTA-1

Комаров, А. Л.; Шахматова, О. О.; Korobkova, V; Новикова, Е. С.; Гуськова, Е. В.; Яровая, Е. Б.; Балахонова, Т. В.; Шулешова, А. Г.; Панченко, Е. П.

doi:10.15829/1560-4071-2021-4465

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Although Blatchford associated the cause of death during gastrointestinal bleeding with the spread of Helicobacter pylori, comorbidities, age, gender, hypotension, steroid and non-steroid drugs, the results of his study did not confirm these possibilities at all [14,15].…”

Section: Discussionmentioning

confidence: 91%

Relationship between Social Support, Adherence to Pharmacological Treatment, and Quality of Life among Hemodialysis Patients

Badawy,

A Raslan,

Bauomy, et. al.

2024

IJHMS

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Social support and level of adherence to medications influences the quality of life among hemodialysis patients. The study aimed to investigate the relationship between social support, adherence to pharmacological treatment, and quality of life among hemodialysis patients. A correlational descriptive study was conducted on a convenience sample of 102 hemodialysis patients. Four tools were used to collect the required data: Demographic Data Sheet, Kidney Disease and Quality of Life, Perceived Social Support Scale, and Adherence to Pharmacological Treatment. Results of the study revealed that social support has a positive effect on adherence to pharmacological medications, and quality of life.

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Section: Discussionmentioning

confidence: 91%

Relationship between Social Support, Adherence to Pharmacological Treatment, and Quality of Life among Hemodialysis Patients

Badawy,

A Raslan,

Bauomy, et. al.

2024

IJHMS

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“…Поскольку исследование имело характер регистра, авторский коллектив не вмешивался в проводимую терапию, однако она была подробно проанализирована. Было показано [2,6], что ИПП примерно с равной частотой назначались как пациентам с высоким риском кровотечений по ЕОК 2015, так и просто в связи с фактом проведения ДАТ, что отражает отсутствие единой позиции экспертов по этому вопросу в действующих на момент включения пациентов клинических рекомендациях.…”

Section: Discussionunclassified

“…Включено 623 пациента, медиана возраста 60 [53,68] лет, 78,7% мужчин. За 2,5 [1,[1][2][3][4][5][6][7][8][9][10][11][12][13][14]7] года наблюдения частота больших и клинически значимых ЖКК составила 1,9 случаев/100 человек/год. Достаточной предсказательной ценностью в отношении ЖКК обладали шкалы РЕГАТА -Area Under the Receiver Operating Characteristic Curve (ROC AUC) 0,865, р<0,0001, F1 мера 0,4; ЕОК 2015 -ROC AUC 0,791, p<0,0001, F1 0,243; PRECISE-DAPT -ROC AUC 0,713, p=0,001, F1 0,397 и ABC HBR -ROC AUC 0,743, p<0,01, F1 мера 0,432.…”

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“…Данная шкала характеризуется некоторыми ограничениями: она не учитывает общие факторы риска кровотечений, а целый ряд включенных в нее показателей трудно объективизировать. В НМИЦ кардиологии по результатам РЕГистра Антитромботической ТерАпии (РЕГАТА) была создана одноименная шкала риска кровотечений из верхних отделов ЖКТ у пациентов со стабильной ИБС, учитывающая гастроэнтерологические факторы риска и сердечно-сосудистую коморбидность, влияющую на вероятность геморрагических осложнений [6]. Шкала учитывает такие параметры, как возраст, анамнез язвенной болезни и эрозивного поражения верхних отделов ЖКТ, анамнез ЖКК, хроническая сердечная недостаточность (ХСН), периферический атеросклероз, прием АК, НПВС и стероидов.…”

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Which scale is best to assess the risk of upper gastrointestinal bleeding in patients with stable coronary artery disease in the Russian population?

Shakhmatova,

Komarov,

Ergasheva

et al. 2024

Cardiovasc Ther Prev

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Aim. To evaluate and compare the prognostic value of various scales on the risk of upper gastrointestinal bleeding (GIB) in patients with stable coronary artery disease (CAD) in the Russian population.Material and methods. The study included patients with stable CAD — participants of the REGATTA-1 prospective single-center registry. The number of points was assessed according to the reference score of the 2015 European Society of Cardiology (ESC), PRECISE-DAPT, ABC-HBR and REACH scores, as well as two Russian scores — the REGATTA score and the ORACUL score, originally developed for patients with acute coronary syndrome (ACS).Results. A total of 623 patients were included (median age 60 [53, 68] years; men — 78,7%). Over 2,5 [1,1-14,7]-year follow-up, the incidence of major and clinically significant GIBs was 1,9 cases/100 people/year. There were following score with sufficient predictive value: REGATTA — Area Under the Receiver Operating Characteristic Curve (ROC AUC) 0,865, p<0,0001, F1 measure 0,4; ESC 2015 — ROC AUC 0,791, p<0,0001, F1 measure 0,243; PRECISE-DAPT — ROC AUC 0,713, p=0,001, F1 measure 0,397, and ABC HBR — ROC AUC 0,743, p<0,01, F1 measure 0,432. The REGATTA score is characterized by the greatest predictive significance (p<0,05 for all pairwise comparisons). The original ORACUL scale (ROC AUC 0,507, p=0,9, F1 measure 0,150) and the REACH scale (ROC AUC 0,572, p=0,164, F1 0,177) did not significantly predict the GIB risk. The identified patterns maintained when analyzed with binary values "high risk/no high risk" for each of the scales. Modified ORACUL scale for stable coronary artery disease after recalibration using binary analysis was not inferior to the ESC 2015, PRECISE-DAPT and ABC-HBR scales (ROC AUC — 0,645 (p=0,002)).Conclusion. The universal PRECISE-DAPT and ABC-HBR scales can be used to assess the GIB risk of along with the 2015 ESC score in patients with stable coronary artery disease. The Russian REGATTA score has the best predictive ability, but its limitation is the lack of external validation. Modification and recalibration of the ORACUL scale significantly increases its predictive value in patients with stable coronary artery disease.

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Relationship between the D-dimer and von Willebrand factor levels and the development of gastrointestinal bleeding in patients with stable coronary artery disease: data from the registry of long-term antithrombotic therapy REGATTA-1

Шахматова

Комаров

Korobkova

et al. 2021

Cardiovasc Ther Prev

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Aim. To study the role of von Willebrand factor (VWF) and D-dimer (DD) as predictors of upper gastrointestinal bleeding (GIB) in patients with stable coronary artery disease (CAD).Material and methods. The study included patients with stable CAD who are members of the prospective registry of long-term antithrombotic therapy (REGATTA-1) (ClinicalTrials.gov Identifier: NCT04347200). The primary endpoints were actionable GIBs (Bleeding Academic Research Consortium type 2-5). Cut-off points for DD and VWF were determined by ROC analysis. The predictive significance of an increase in VWF and DD was assessed by the logistic regression.Results. The study included 408 patients (men, 77,5%; mean age, 61,3±10,8 years). The median follow-up period was 2,5 [1,1-14,7] years. DD was determined in all patients, including 36 patients with GIB, while VWF — in 169 patients (28 patients with GIB). An increase in DD >928 ng/ml was an independent predictor of GIB, including taking into account clinical risk factors (odds ratio (OR), 3,26 [95% confidence interval (CI), 1,43-7,42] (p=0,0047), or the previously developed REGATTA scale score (OR, 3,73, 95% CI: 1,65-8,43 (p=0,0015)). VWF >105% was also an independent predictor of GIB (OR, 14,02; 95% CI: 1,41-139,42 (p=0,023)); in the REGATTA scale model — OR 11,3, 95% CI: 1,43-88,83 (p=0,021). The increase in both markers was most unfavorable, since the proportion of those with GIB was 41,4%, while among patients with normal DD and increased VWF — 14,9%, and with low values of both markers — 0%. OR of GIB in patients with an increase in both markers was 4,1 (95% CI: 1,6-10,3 (p=0,003)).Conclusion. In patients with stable CAD, an increase in VWF and DD was associated with an increase in GIB risk regardless of the presence of clinical risk factors.

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Risk factors and outcomes of gastrointestinal bleeding in patients with stable coronary artery disease: data from the observational registry of long-term antithrombotic therapy REGATTA-1

Cited by 6 publications

References 16 publications

Relationship between Social Support, Adherence to Pharmacological Treatment, and Quality of Life among Hemodialysis Patients

Relationship between Social Support, Adherence to Pharmacological Treatment, and Quality of Life among Hemodialysis Patients

Which scale is best to assess the risk of upper gastrointestinal bleeding in patients with stable coronary artery disease in the Russian population?

Relationship between the D-dimer and von Willebrand factor levels and the development of gastrointestinal bleeding in patients with stable coronary artery disease: data from the registry of long-term antithrombotic therapy REGATTA-1

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