Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke
Aim. To improve the long-term outcomes of patients with atrial fibrillation (AF) after cardioembolic stroke by creating and testing a comprehensive ambulatory monitoring system.Material and methods. The present study included 139 AF patients after cardioembolic stroke for the period 2016-2019, of wh...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
«FIRMA «SILICEA» LLC
2021-04-01
|
| Series: | Российский кардиологический журнал |
| Subjects: | |
| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4402 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849689755098284032 |
|---|---|
| author | O. I. Efimova T. V. Pavlova L. V. Pyscheva S. M. Khokhlunov |
| author_facet | O. I. Efimova T. V. Pavlova L. V. Pyscheva S. M. Khokhlunov |
| author_sort | O. I. Efimova |
| collection | DOAJ |
| description | Aim. To improve the long-term outcomes of patients with atrial fibrillation (AF) after cardioembolic stroke by creating and testing a comprehensive ambulatory monitoring system.Material and methods. The present study included 139 AF patients after cardioembolic stroke for the period 2016-2019, of which 80 (57,55%) were women and 59 (42,45%) were men. The mean age of the patients was 72,25±6,33years. Before the hospital discharge, all patients signed an informed consent and were randomized into two groups. Patients of the group I (n=72) were followed up during the year in accordance with a specially developed comprehensive ambulatory monitoring system. This system included a rehabilitation program created individually for each patient, monthly visits to a physician-researcher, during which a complex of diagnostic tests was carried out. Also, the changes of complaints, symptoms, and medical adherence were assessed. The latter was corrected. A physician talked with the patient's relatives about the need to comply with the recommended medication regimen, supporting the motivation for treatment. Patients of group II (n=67) were followed up at the primary care level in accordance with the current program, and a control visit to was performed for them once — after 12 months.Results. After one-year follow-up, a significant decrease in all-cause mortality was obtained in the first group in comparison with the second one: 3 (4,17%) and 18 (26,87%) deaths, respectively (p=0,021).In addition, in group II, a relationship was found between the death and absence of anticoagulant therapy (odds ratio, 7,68; 95% confidence interval, 1,59-37,03; p=0,01). The ROC analysis confirmed the relationship between the absence of anticoagulant therapy and death, while the regression quality was good (area under the curve, 0,77, sensitivity — 94,74%, specificity — 59,17%).Conclusion. Comprehensive ambulatory monitoring program for AF patients after cardioembolic stroke has proven high effectiveness, and its widespread practice is an urgent task of modern healthcare. |
| format | Article |
| id | doaj-art-aebe984b41384525b6e2cfe10fc38d90 |
| institution | DOAJ |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| publishDate | 2021-04-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj-art-aebe984b41384525b6e2cfe10fc38d902025-08-20T03:21:31Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-04-01261S10.15829/1560-4071-2021-44023225Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic strokeO. I. Efimova0T. V. Pavlova1L. V. Pyscheva2S. M. Khokhlunov3Samara State Medical University; V.D. Seredavin Samara Regional Clinical HospitalSamara State Medical University; V.P. Polyakov Samara Regional Clinical Cardiology DispensarySamara State Medical UniversitySamara State Medical University; V.P. Polyakov Samara Regional Clinical Cardiology DispensaryAim. To improve the long-term outcomes of patients with atrial fibrillation (AF) after cardioembolic stroke by creating and testing a comprehensive ambulatory monitoring system.Material and methods. The present study included 139 AF patients after cardioembolic stroke for the period 2016-2019, of which 80 (57,55%) were women and 59 (42,45%) were men. The mean age of the patients was 72,25±6,33years. Before the hospital discharge, all patients signed an informed consent and were randomized into two groups. Patients of the group I (n=72) were followed up during the year in accordance with a specially developed comprehensive ambulatory monitoring system. This system included a rehabilitation program created individually for each patient, monthly visits to a physician-researcher, during which a complex of diagnostic tests was carried out. Also, the changes of complaints, symptoms, and medical adherence were assessed. The latter was corrected. A physician talked with the patient's relatives about the need to comply with the recommended medication regimen, supporting the motivation for treatment. Patients of group II (n=67) were followed up at the primary care level in accordance with the current program, and a control visit to was performed for them once — after 12 months.Results. After one-year follow-up, a significant decrease in all-cause mortality was obtained in the first group in comparison with the second one: 3 (4,17%) and 18 (26,87%) deaths, respectively (p=0,021).In addition, in group II, a relationship was found between the death and absence of anticoagulant therapy (odds ratio, 7,68; 95% confidence interval, 1,59-37,03; p=0,01). The ROC analysis confirmed the relationship between the absence of anticoagulant therapy and death, while the regression quality was good (area under the curve, 0,77, sensitivity — 94,74%, specificity — 59,17%).Conclusion. Comprehensive ambulatory monitoring program for AF patients after cardioembolic stroke has proven high effectiveness, and its widespread practice is an urgent task of modern healthcare.https://russjcardiol.elpub.ru/jour/article/view/4402atrial fibrillationcardioembolic strokeambulatory monitoringsecondary prevention |
| spellingShingle | O. I. Efimova T. V. Pavlova L. V. Pyscheva S. M. Khokhlunov Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke Российский кардиологический журнал atrial fibrillation cardioembolic stroke ambulatory monitoring secondary prevention |
| title | Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| title_full | Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| title_fullStr | Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| title_full_unstemmed | Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| title_short | Effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| title_sort | effectiveness of a comprehensive ambulatory monitoring system for patients with atrial fibrillation after cardioembolic stroke |
| topic | atrial fibrillation cardioembolic stroke ambulatory monitoring secondary prevention |
| url | https://russjcardiol.elpub.ru/jour/article/view/4402 |
| work_keys_str_mv | AT oiefimova effectivenessofacomprehensiveambulatorymonitoringsystemforpatientswithatrialfibrillationaftercardioembolicstroke AT tvpavlova effectivenessofacomprehensiveambulatorymonitoringsystemforpatientswithatrialfibrillationaftercardioembolicstroke AT lvpyscheva effectivenessofacomprehensiveambulatorymonitoringsystemforpatientswithatrialfibrillationaftercardioembolicstroke AT smkhokhlunov effectivenessofacomprehensiveambulatorymonitoringsystemforpatientswithatrialfibrillationaftercardioembolicstroke |