Terapevt Arkh
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The activity of the renin-angiotensin-aldosterone system is one of the main pathogenetic mechanisms underlying cardiovascular diseases at all stages of the cardiovascular continuum. This article discusses the role of telmisartan and azilsartan as the most powerful sartans in modern cardiology. ⋯ However, the effect of azilsartan on hard endpoints has not been studied while the efficacy of telmisartan on hard endpoints has been evaluated in plenty clinical trials including 3 large randomized clinical trials with several thousand patients. The article also presents calculations showing the better cost-effectiveness of telmisartan compared to azilsartan.
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To evaluate and compare the accuracy of volemic status determination by remote dielectric sensing with computed tomography (CT) in patients with acute decompensated heart failure. ⋯ Correlation analysis revealed an average direct significant correlation (r=+0,5; p=0.001) between the CCT and ReDS data. Hypervolemia indexes according to the CCT revealed statistically significant decrease in the dynamics, which was also reflected in the ReDS index decrease. Lung fluid content according to ReDS averaged 38.2±4.6% on admission, and 34.5±3.9% on discharge (p=0.005). According to CT scan of the CCT, MLD at admission was 23.03±3.9%, at discharge 19.6±3.3% (p=0.003). The positive dynamics of the study methods was also reflected in the positive dynamics of NT-proBNP, which decreased by 46%. In the analysis of ReDS data before and after exercise, there was an increase in ReDS value after the performed 6MWT and it was 35.09±3.9% compared with the initial value of 34.5±3.9%. A strong direct significant correlation (r=+0.7; p=0.0001) was found between the ReDS before and after 6MWT at discharge.
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To evaluate the changes in blood pressure (BP), the severity of pain syndrome and non-steroidal anti-inflammatory drugs (NSAIDs) use patterns in patients hospitalized for elective arthroplasty of large joints of the lower extremities during the postoperative period. ⋯ In the population of patients with elective arthroplasty of large joints of the lower extremities, a significant incidence of hypertension and a high prevalence of NSAIDs use are noted. During the postoperative period, a significant trend towards a decrease in the severity of pain was found, as well as the relationship of pain and NSAIDs with a decrease in BP.
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The role of albuminuria as a marker of the atherosclerosis burden and a predictor of prognosis in patients with polyvascular disease (PD) has been little studied. ⋯ Albuminuria is highly prevalent in patients with PD. It is a marker of atherosclerosis burden. CKD, diagnosed taking into account the level of albuminuria, can be used in a comprehensive assessment of cardiovascular risk in this category of patients.