Регистр Пациентов С Фибрилляцией Предсердий В Курской Области (Рекур-Фп): Дизайн И Стратегия Исследования

Polshakova, I. L.; Поветкин, С. В.

doi:10.21626/vestnik/2017-4/03

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…В исследование РЕКУР-ФП было включено 896 пациентов (435 мужчин и 461 женщина) с ФП старше 18 лет, обратившихся в медицинские организации г. Курска (n=684) и семи районов Курской области (n=212) с сентября 2015 г. по август 2016 г. Дизайн исследования и его первые результаты были описаны ранее [5,6].…”

Section: материал и методыunclassified

Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

Polshakova

Поветкин

2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To conduct a comparative analysis of the significance of the influence of various factors and their combinations on the survival of patients with atrial fibrillation (AF) in the REKUR-AF study.Material and methods. The database includes 896 patients with AF over 18 years old who applied to medical organizations in the city of Kursk and seven districts of the Kursk region from September 2015 to August 2016. Achievement by the patients of the “end point” (death from any cause) was assessed using a telephone contact for a period of 9.0±0.55 months from the end of the database formation. Data were obtained on 532 patients, of which 60 patients reached the end point. To study the differences in survival in subgroups of patients with different characteristics, two groups of categorized factors were analyzed – clinical (sex, age, form of AF, etc.) and pharmacological (use of different classes of drugs). The necessary information was obtained from outpatient cards analyzed when patients were included in the study.Results. The survival rate of patients with AF was significantly (p<0.05-0.001) influenced by the following factors and their categories: age (<60 years – 92.5%, 60-65 years – 92.9%, over 75 years – 80.1%); AF form (paroxysmal – 95.1%, persistent – 93.2%, permanent – 84.4%); stable angina (SA) (presence – 86.5%, absence – 90.7%); chronic heart failure functional class (CHF FC) (I-II – 95.9%, III – 91.5%, IV – 69.6%); glomerular filtration rate (GFR) (>50 ml/min – 89.6%, 30-50 ml/min – 85.8%, <30 ml/min – 72.7%); diabetes mellitus (DM) (presence – 81.9%, absence – 90.4%), hospitalization for the year preceding inclusion in the study (presence – 85.5%, absence – 97.3%), the use of oral anticoagulants (OAC) (presence – 96.7%, absence – 87.1%). In subgroups of patients with the above mentioned categories (especially the most severe) of the studied factors, significant (p<0.05-0.01) differences in the proportion of surviving patients depending on the appointment of OAC were revealed: age >75 years – 78.2% and 100%; permanent form of AF – 81.9% and 96.1%, the presence of SA – 85.0% and 94.7%; CHF FC IV – 67.0% and 91.7%; GFR<30 ml/min – 62.5% and 100%; presence of DM – 80.7% and 88.2%.%; the presence of hospitalizations in the last year – 82.9% and 97.2%; >5 points on the CHA2DS2VASc scale – 67.0% and 91.7%, heart rate >90/min – 68.8% and 100% of patients with the absence and presence of the OAC therapy, respectively. Cox regression analy sis revealed clinical predictors contributing to an increase in the risk of death: age over 75 years, permanent form of AF, CHF FC III-IV, the presence of DM, the presence of previous hospitalizations. The absence of the OAC taking was accompanied by an increase in the risk of death by 3.66 times.Conclusion. The results of the REKUR-AF study allowed to establish the most significant factors affecting the survival of patients with AF: age, form of AF, CHF FC, presence of DM, hospitalization in the last year preceding the inclusion of patients in the study, OAK taking. The prescription of OAC is a priority predictor that improves survival in patients with AF.

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Section: материал и методыunclassified

Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

Polshakova

Поветкин

2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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“The obesity paradox” in patients with atrial fibrillation according to the results of the REKUR-AF study

Polshakova¹,

Поветкин²,

Gaponov³

2021

RRP

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Introduction: to evaluate the effect of excess body weight (EBW) and obesity on the survival of patients with atrial fibrillation (AF) in the REKUR-AF study. Materials and methods: A subanalysis of patients with AF included in the REKUR-AF (382 people) study was performed. Survival rates were analyzed in three patient groups: patients with normal body mass index (BMI), EBW and obesity. Then the nature and significance of the influence of the studied factor on the prognosis in patients with AF were assessed. Results and discussion: Patients with AF and normal BMI were significantly older than those with obesity and EBW (p<0.001 and p=0.021, respectively). Among obese patients, hypertension was significantly (p=0.0015) more common (93.9%) compared to the group of patients with a normal BMI level (80.5%). The frequency of type 2 diabetes in obese patients prevailed over the same indicator in the groups of people with normal BMI and EBW (p=0.007 and p=0.020, respectively). The analysis of the survival rate of patients with AF depending on the BMI level showed that this factor had a significant impact (p=0.013) on the prognosis. The group of individuals with a normal BMI level had a significantly lower survival rate than the cohort of patients with EBW (p=0.011) and OB (p=0.025). The final model for Cox regression analysis (χ2=53.06, p<0.001) included the following factors: age, form of AF, BMI, presence/absence of type 2 diabetes, presence/absence of previous hospitalizations, presence/absence of hypertension, and presence/absence of oral anticoagulant (OAC) intake. Conclusion: The obtained results do not make it possible to unambiguously interpret obesity as a predictor of a positive outcome in this category of individuals.

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Регистр Пациентов С Фибрилляцией Предсердий В Курской Области (Рекур-Фп): Дизайн И Стратегия Исследования

Cited by 2 publications

References 2 publications

Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

Comparative Analysis of Factors Affecting the Prognosis of Patients with Atrial Fibrillation According to the Results of the REKUR-AF Study

“The obesity paradox” in patients with atrial fibrillation according to the results of the REKUR-AF study

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