B''lgarska kardiologiia最新文献_第2页

Economic evaluation and analysis of the budget effect of the measuring of fractional flow reserve in Bulgaria 保加利亚部分流量储备计量预算效应的经济评估与分析

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e100666

G. Slavchev, N. Mileva, A. Dacheva, E. Mekov, S. Dzhambazov, D. Vassilev

{"title":"Economic evaluation and analysis of the budget effect of the measuring of fractional flow reserve in Bulgaria","authors":"G. Slavchev, N. Mileva, A. Dacheva, E. Mekov, S. Dzhambazov, D. Vassilev","doi":"10.3897/bgcardio.29.e100666","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e100666","url":null,"abstract":"Introduction: Fractional fl ow reserve (FFR) implies the ratio of the maximal hyperemic myocardial blood fl ow in the case of a pathologically changed coronary artery to the maximal hyperemic myocardial blood fl ow in the case of a healthy coronary artery. Aims: The aim of the current study is to perform an economic evaluation and budget impact analysis of measuring FFR as a medical activity in Bulgaria. Material and Methods: For the purpose of the current analysis, two models using Microsoft Excel and TreeAge Pro were developed to evaluate the cost-effectiveness of the FFR-guided percutaneous coronary intervention (PCI) compared to the classic angiography-guided PCI in patients with ischemic heart disease (IHD) with one-vessel coronary artery disease (CAD) or multivessel CAD. The analysis will focus on the health perspective and the payer perspective - National Health Insurance Fund (NHIF). Results: The medico-diagnostic activity related to measuring FFR in patients with multi-vessel coronary artery disease is shown to be a cost-effective therapeutic approach in Bulgaria compared to the angiography-guided PCI (ICER = 50 456 BGN/QALY) with a cost-effectiveness threshold of 51 510 BGN/QALY. FFR- guided PCI strategy in one-vessel coronary artery disease patients is a cost-saving approach (-853 BGN) when compared to the angiography-guided PCI (4 150 BGN). Conclusion: Budget impact analysis revealed that the FFR-guided PCI strategy is a cost-saving alternative approach to the angiographyguided PCI. The savings of the NHIF during the fi rst year of reimbursement of FFR would be -1,1 million BGN and could reach -1,6 million BGN in the third year.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46638081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of acute infective endocarditis and septic shock 急性感染性心内膜炎合并感染性休克1例

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e105978

B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, K. Stanev, N. Ivanova, P. Nikolov, M. Tokmakova

引用次数: 0

Characteristics of infective endocarditis according to the mode of acquisition – a single-center, retrospective analysis 感染性心内膜炎的特征:单中心回顾性分析

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e108621

B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, I. Manolov, P. Nikolov, N. Ivanova, D. Iovanovska, I. Kuchmov, M. Tokmakova

{"title":"Characteristics of infective endocarditis according to the mode of acquisition – a single-center, retrospective analysis","authors":"B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, I. Manolov, P. Nikolov, N. Ivanova, D. Iovanovska, I. Kuchmov, M. Tokmakova","doi":"10.3897/bgcardio.29.e108621","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e108621","url":null,"abstract":"According to the mode of acquisition, infective endocarditis (IE) is classifi ed as community-acquired (CAIE), healthcareassociated (HAIE), and injection drug use–related IE (IDUIE). At this stage, there are no data for Bulgaria for these three groups of patients. Objective: We set ourselves the goal of investigating IE according to the mode of acquisition and to make a clinical-instrumental characterization of the groups. Material and methods: The study is single-center, retrospective and includes 270 patients treated at the UMHAT “Sveti Georgi” – Plovdiv for the period 01.2005-12. 2021. Results: Patients with CAIE were 64.8% (175), with HAIE 26.7% (72) and with IDUIE 8.5% (23). Patients with IDUIE are younger compared to the other two groups (33; 8 years) (p = 0.000), with low comorbidity (CCI – 1, IQR – 1; p = 0.000), with most frequent right-sided involvement (p < 0.001) and with the most common causative agent being Staphylococcus aureus (p < 0.01). Patients with HAIE were the oldest (69; 18 years;), with the most comorbidity (CCI – 4; IQR – 3), with no signifi cant difference with CAIE (66; 20 years; and CCI – 3; IQR – 3). The large proportion of portal of entry for them were manipulations/ procedures (62.5%) and hemodialysis (18.1%), with Enterococci being the most common causative agent (19.5%, p = 0.001). In-hospital mortality and early surgical intervention were without signifi cant difference in the three groups. Conclusion: Knowledge of the three groups of IE according to the mode of acquisition – CAIE, HAIE and IDUIE and their characteristics is important for the choice of initial empiric antibiotic treatment and for improvement of prevention.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41963930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiovascular risk in patients with chronic obstructive pulmonary disease and metabolic syndrome 慢性阻塞性肺疾病和代谢综合征患者的心血管风险

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e106477

S. Nikolaeva, A. Angelov

引用次数: 0

Multisystem inflammatory syndrome in adults: new insights into a rare but serious complication of COVID-19 成人多系统炎症综合征:对COVID-19罕见但严重并发症的新认识

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e106652

M. Rushid, Y. Yotov, A. Kisheva

{"title":"Multisystem inflammatory syndrome in adults: new insights into a rare but serious complication of COVID-19","authors":"M. Rushid, Y. Yotov, A. Kisheva","doi":"10.3897/bgcardio.29.e106652","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e106652","url":null,"abstract":"Since 2019, humanity has been relentlessly fi ghting the pandemic caused by the SARS-CoV-2 virus. Respiratory distress syndrome is the main clinical manifestation of COVID-19, which often results in full recovery but can also end fatally. Of interest to modern medicine is a small group of patients in whom the disease persists for months, known as “Long COVID.” This condition predisposes to the development of a rare but life-threatening syndrome, manifested and defi ned as one of the most serious complications of SARS-CoV-2 infection – multisystem Infl ammatory Syndrome in Adults (MIS-A). This syndrome was fi rst described in children and called MIS-C (Multisystem Infl ammatory Syndrome in Children). The affected population consists of patients ≥ 21 years old, regardless of gender. Despite numerous studies, clinical-laboratory and demographic analyses, there are still disagreements regarding the frequency of occurrence, pathogenesis, and diagnostic-therapeutic algorithm for these patients. The purpose of this article is to systematize the congested experience and knowledge, as well as to demonstrate their application in clinical practice.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43902052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute neurological symptoms as a debut of infective endocarditis 急性神经症状作为感染性心内膜炎的首次亮相

B''lgarska kardiologiia Pub Date : 2023-07-19 DOI: 10.3897/bgcardio.29.e105505

B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, I. Manolov, K. Stanev, N. Ivanova, M. Tokmakova

{"title":"Acute neurological symptoms as a debut of infective endocarditis","authors":"B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, I. Manolov, K. Stanev, N. Ivanova, M. Tokmakova","doi":"10.3897/bgcardio.29.e105505","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e105505","url":null,"abstract":"Infective endocarditis (IE) is an infl ammatory disease of the endocardium of the heart affecting heart valves (native or prosthetic) and, in the last few decades, also available intracardiac permanent devices or catheters. Despite technological progress and accumulated experience, this disease continues to be a huge challenge for doctors in terms of diagnosis, treatment and improvement of survival. The clinical picture is atypical and heterogeneous, with different clinical \"masks\" of other diseases – infectious, oncological, hematological, rheumatological, neurological, etc. Embolic complications are often the fi rst manifestation of the disease and are most often cerebral. We present a clinical case of a 29-year-old woman with acute neurological symptoms as a fi rst manifestation of IE. This case refl ects the atypical clinical presentation of the disease, the importance of new imaging modalities for the precise diagnosis of neurological complications, and the decision on the timing of operative intervention when indicated. The question of IE prophylaxis in moderate-risk patients, such as those with mitral valve prolapse and bicuspid aortic valve, remains open.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41409468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immediate outcome after percutaneous coronary revascularization in STEMI for left main coronary artery lesions STEMI患者经皮冠状动脉血运重建术治疗左主干冠状动脉病变后的即时结果

B''lgarska kardiologiia Pub Date : 2023-04-07 DOI: 10.3897/bgcardio.29.e100555

I. Zheleva-Kyuchukova, V. Gelev

{"title":"Immediate outcome after percutaneous coronary revascularization in STEMI for left main coronary artery lesions","authors":"I. Zheleva-Kyuchukova, V. Gelev","doi":"10.3897/bgcardio.29.e100555","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e100555","url":null,"abstract":"Background: Acute coronary syndrome with ST elevation (STEMI) with a lesion in the left main coronary artery (LMCA) occurs infrequently; moreover, patients are at very high risk for mortality. However, limited data are available regarding the prevalence, clinical characteristics, and outcomes of patients presenting with LM-STEMI treated with percutaneous coronary intervention (LM-PCI STEMI). Therefore, we aimed to evaluate patient clinical and procedure factors associated with in-hospital outcomes in LM-STEMI patients undergoing PPCI in a real-life registry. Material and methods: From 439 consecutive patients with LM disease treated with PCI in the prospective single-center Acibadem City Clinic UMHAT Tokuda registry enrolled between March 2013 and October 2022, we identifi ed 35 LM-PCI STEMI patients (8%). We analyzed baseline demographic, coronary lesion characteristics, procedural details and success, and in-hospital mortality. Results: Among 35 LM-STEMI patients, the mean age was 66.0 ± 16 years, and 69% were male – forty percent presented with cardiogenic shock (CS). The risk profi le of the overall study population was relatively high (mean Euro Score (ES) was 19.1 ± 22, while 54.3% were high risk with ES > 6). Radial access had a remarkably high proportion (68.6%), regardlessof coronary anatomic complexity being intermediate to high (mean Syntax Score (SS) was 29.5 ± 8,15, 42,9% had SS ≥ 32). The distal LM bifurcation was most commonly involved (82.9%), yet the provisional strategy (85.7%) was most often employed during emergent PCI. The observed overall in-hospital mortality rate was 25.7% (64.3% in pts presenting with CS vs. 23.5% without CS, p = 0.0166). Conclusion: STEMI from culprit LMCA lesion is associated with signifi cant mortality. Emergent LM PCI in unselected patients, including cardiogenic shock, is an appropriate and feasible treatment option for this high-risk group, with acceptable mortality and in-hospital survival rates.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45602705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myocardial infarction-related ventricular arrhythmias 心肌梗死相关室性心律失常

B''lgarska kardiologiia Pub Date : 2023-04-07 DOI: 10.3897/bgcardio.29.e101578

M. Stoyanov, T. Shalganov

引用次数: 0

Percutaneous coronary interventions in patients over 80 years old age with acute coronary syndrome 80岁以上急性冠状动脉综合征患者的经皮冠状动脉介入治疗

B''lgarska kardiologiia Pub Date : 2023-04-07 DOI: 10.3897/bgcardio.29.e102027

A. Alexandrov, H. Mateev, G. Vladimirov, I. Bayraktarova, I. Petrova, E. Kostova-Dimitrova

{"title":"Percutaneous coronary interventions in patients over 80 years old age with acute coronary syndrome","authors":"A. Alexandrov, H. Mateev, G. Vladimirov, I. Bayraktarova, I. Petrova, E. Kostova-Dimitrova","doi":"10.3897/bgcardio.29.e102027","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e102027","url":null,"abstract":"Age is an important non-modifi able risk factor for cardiovascular disease. Both European and American guidelines recommend offering an invasive reperfusion strategy in elderly patients with ACS, taking into account the patients‘ comorbidities and baseline level of functioning. Materials and methods: All patients over 80 years of age with acute coronary syndrome, treated in the Department of Invasive Cardiology of the National Heart Hospital for the period between January 1, 2016. and December 31, 2018, are retrospectively analyzed. The primary endpoint was defi ned as all-cause mortality during the hospital stay and at follow-up. Predictors of mortality were assessed and independent predictors were identifi ed. Results: During the study period, 179 patients aged 80 years or older were identifi ed as being treated for ACS with PCI. In the study population, in hospital mortality for the index event was 11.8%. At a mean follow-up time of 20.19 ± 11.9 months, mortality rose signifi cantly to 64.6%. When evaluating in-hospital mortality on multivariate analysis, the two independent predictors were Cardiogenic shock (HR 0.005, 95% CI 0.01–0.44; p < 0.001) and acute/exacerbated renal failure (0.986 95% CI 0.984-0.997; p = 0.015). Conclusion: The present study provides important information regarding characteristics and outcomes in very elderly patients undergoing PCI for ACS. In the future, this subset of patients is predicted to grow, meaning that their approach must be evidence-based to ensure safe and effective treatment options.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42699847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Editorial 编辑

B''lgarska kardiologiia Pub Date : 2023-04-07 DOI: 10.3897/bgcardio.29.e104169

E. Trendafilova

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