International Medical Journal, Vol. 23., Iss. 1, 2017, P. 5−9.
EUROPEAN CLINICAL PRACTICE GUIDELINES FOR CARDIOLOGY 2016
Kuban State Medical University (Ministry of Health of Russian Federation), Krasnodar, Russian Federation
In 2016, the European Society of Cardiology presented five new texts of recommendations. The group of experts under the leadership of P. Ponikowski prepared recommendations on diagnosis and treatment of acute and chronic heart failure. The measures aimed at correcting heart failure risk factors in order to prevent its occurrence and extend the life of the patient were proposed. For the first time, the treatment algorithm includes Sacubitril/Valsartan (LCZ696). The new document says that three−chamber pacemaker implantation for resynchronization therapy in chronic heart failure with left ventricular ejection fraction less than 35 % is contraindicated in patients with a QRS duration less than 130 ms. The recommendations for atrial fibrillation treatment are an entirely new text, which emphasizes the importance of intensive screening to identify it in people over the age of 65, especially in those who survived stroke or transient ischemic attack, by recording electrocardiogram. A complex approach to treatment including urgent deceleration of ventricular rate or sinus rhythm restoration; correction of provoking factors; stroke prevention, etc. was suggested. The new text of the recommendations on prevention of cardiovascular disease in addition to the measures at the individual level, emphasizes the importance of population prevention: smoking cessation, healthy nutrition, physical activity, limiting alcohol consumption, and environmental improvement. For the first time, the text is supplemented by the measures of cardiac rehabilitation in patients after acute coronary syndromes. The main therapeutic measures at dyslipidemia include lifestyle changes and pharmacotherapy. It recommended to administer satins up to the maximum dose to achieve target LDL levels. An interesting innovation is optionality of fasting blood sampling to determine cholesterol levels. For the first time, a consensus document on cardiovascular toxicity of cancer treatment was prepared. The objective of cardiooncology is prevention, detection and treatment of cardiovascular complications resulting from cancer therapy. Cardiotoxicity in cancer patients is recommended to correct for the type of complication, the supposed cause, competing risk of death of cardiovascular disease and cancer, quality of life. The next Congress of the European Society of Cardiology is planned to be held in Barcelona (Spain) in August 2017.
Key words: clinical practice guidelines, heart failure, atrial fibrillation, cardiovascular prevention, dysli−pidemia, cardiooncology.