Patient management in CHD and high risk of hemorrhage
E.V. Filippov
Ryazan State Medical University
Coronary heart disease (CHD) is one of the deaths leading causes in the Russian Federation. Its treatment in the United States alone is estimated at $ 204.4 billion annually. Considering the patient clinical profile with CHD has changed, it requires new ways in the hemorrhage risk management in patients. Thus, from 1995 to 2014, the number of patients with polymorbidity increased significantly, primarily due to chronic kidney disease, chronic lung diseases, and malignant neoplasms. Besides, the risk factors “set” in patients is changing. In addition to the CVD risk management, the practitioner should pay attention to patients with dyspepsia, gastric ulcer (both complicated and not) and gastrointestinal disease in their history. Studies show that the transferred gastrointestinal bleeding significantly worsens patients’ prognosis for 12 months. The article is devoted to the practical aspects of patient management in CHD and high risk of hemorrhage. Ways to gastrointestinal bleeding frequency reduction, gastroprotection, and examination of such patients are enlightened. The article also describes tools for assessing the hemorrhage risk, as well as the frequency of their use. Safety and efficacy key aspects of acetylsalicylic acid, as the most commonly used antiplatelet agent, are discussed in detail.
Keywords: coronary heart disease, acetylsalicylic acid, hemorrhage, antiplatelets, risk factors, secondary prevention, dual antiplatelet therapy.
For citation: Filippov E.V. Patient management in CHD and high risk of hemorrhage. RMJ. Medical Review. 2019;6:5–10.
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