Real-world data on managing patients with coronary artery disease and multifocal atherosclerosis. Results of the 12-month international clinical registry of patients with identified multifocal atherosclerosis in the Russian Federation and Eurasian co

Aim. To study real-world data on managing patients with coronary artery disease (CAD) and multifocal atherosclerosis (MFA) for 12 months by outpatient cardiologists. Material and methods. KAMMA is a real-world registry organized by the Eurasian Association of Therapists. The main branch included men and women over 18 years of age with confirmed atherosclerosis in two or more arterial systems and one or more risk factors for atherosclerosis. The start date for patient recruitment was February 1, 2022 and the end date was November 27, 2022. The design included 3 following visits: 1 — baseline, 2 — after 6 months, 3 — after 12 months. Twentyeight research centers were located in 7 federal districts of the Russian Federation, as well as in the Republics of Kazakhstan, Uzbekistan and Belarus. Results. A patient population (n=2905) was formed, all of whom had verified CAD. The mean age was 66,0 [59,0; 72,0] years (men — 60,3%). Low-density lipoprotein cholesterol decreased by 20,4% over 12 months, while non-high-density lipoprotein cholesterol — by 12,7%. Over 12 months, lipid-lowering therapy did not undergo significant changes. Statin monotherapy was maintained in 83%, of which only 53,7% of patients received high-dose therapy. Combined statin+ezetimibe therapy was used in 12,4%, while statin+ezetimibe+PCSK9 inhibitor — in 4,6%. During the 1-year follow-up, antithrombotic therapy was not enhanced. Low prescription rate of combination therapy with antiplatelet agents (15,7%) and low-dose rivaroxaban and acetylsalicylic acid (7,9%) remained. By the follow-up end, a high incidence of major adverse cardiovascular events (8,8%) was registered in patients included in the KAMMA registry. Conclusion. Despite the fact that patients with MFA have a very high cardiovascular risk, routine management of these patients is characterized by high clinical inertia. During the 1-year follow-up, lipid-lowering and antithrombotic therapy was not properly strengthened, due to which the target levels of key lipid profile parameters were not achieved and a high rate of major adverse cardiovascular events was observed in patients included in the registry.

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Journal
Russian Journal of Cardiology
Published
2025-04-29
DOI
https://doi.org/10.15829/1560-4071-2025-6152
Primary Topic
Cardiac Imaging and Diagnostics
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article
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article

Real-world data on managing patients with coronary artery disease and multifocal atherosclerosis. Results of the 12-month international clinical registry of patients with identified multifocal atherosclerosis in the Russian Federation and Eurasian co

А. И. Чесникова, Ya. B. Khovaeva, A. G. Frolov, S. G. Kechedzhieva et al.
Russian Journal of Cardiology
Cardiac Imaging and Diagnostics
article

Real-world data on managing patients with coronary artery disease and multifocal atherosclerosis. Results of the 12-month international clinical registry of patients with identified multifocal atherosclerosis in the Russian Federation and Eurasian co

А. И. Чесникова, Ya. B. Khovaeva, A. G. Frolov, S. G. Kechedzhieva, Д. С. Евдокимов, V. V. Genkel, А. О. Рубаненко, О. Л. Барбараш, T. P. Trunina, Z. F. Kim, T. V. Shnyukova, O. Yu. Chizhova, Г. В. Шавкута, E. I. Blokhina, Н. А. Кароли, A. G. Arutyunov, V. V. Khatlamadzhiyan, А. S. Galyavich, A. N. Ermilova, G. M. Dabylova, Игорь Геннадьевич Бакулин, О. А. Рубаненко, Т. И. Батлук, Е. А. Смирнова, L. M. Nurieva, A. I. Chernyavina, Е. А. Григоренко, E. V. Grigoryeva, Y. I. Khokhlova, S.V. Nemirova, Yu. V. Shchukin, Н. А. Козиолова, Н А Корягина, А. П. Ребров, F. Yu. Valikulova, D. A. Akhmentaeva, Ш.Б. Жангелова, Н. В. Жданкина, А. С. Кузнецова, Е. В. Горбунова, A. B. Almukhanova, R. A. Bashkinov, С. А. Макаров, D. A. Kapsultanova, G. P. Arutyunov, Наталья Юрьевна Григорьева, M. V. Novikova, Ш.А. Тыналиева, Elizaveta Gordeychuk, И. И. Шапошник, Akhmetzhan Sugraliyev, А. В. Апаркина, М. А. Шамбатов, E. S. Melnikov, U. K. Kamilova, E. I. Tarlovskaya, С. Миронова, D. S. Tokmin, М. М. Петрова, В. А. Сафроненко, V. O. Bochkareva, A. V. Svarovskaya, Н. В. Изможерова, И. Л. Давыдкин, M. A. Trubnikova, M. V. Buianova, E. I. Suchkova, N. P. Mitкоvsкаyа, I. A. Obukhova, И. В. Губарева, D. R. Tagaeva, N. А. Magdeeva, A. D. Vende, N. S. Ilyanok, Rizvangul Namatova, A. T. Kumaritova, A. Yu. Vaskin, Е. А. Карташова, Michael Alieva, E. I. Zheleznyak, Е. В. Пономаренко, A. I. Sycheva, Е. А. Polyanskaya, Л Н Белоусова, G. T. Aimakhanova, N. M. Bekisheva, O. A. Mamadaliev, Nurzhan Musrepov
article en

Abstract

Aim. To study real-world data on managing patients with coronary artery disease (CAD) and multifocal atherosclerosis (MFA) for 12 months by outpatient cardiologists. Material and methods. KAMMA is a real-world registry organized by the Eurasian Association of Therapists. The main branch included men and women over 18 years of age with confirmed atherosclerosis in two or more arterial systems and one or more risk factors for atherosclerosis. The start date for patient recruitment was February 1, 2022 and the end date was November 27, 2022. The design included 3 following visits: 1 — baseline, 2 — after 6 months, 3 — after 12 months. Twentyeight research centers were located in 7 federal districts of the Russian Federation, as well as in the Republics of Kazakhstan, Uzbekistan and Belarus. Results. A patient population (n=2905) was formed, all of whom had verified CAD. The mean age was 66,0 [59,0; 72,0] years (men — 60,3%). Low-density lipoprotein cholesterol decreased by 20,4% over 12 months, while non-high-density lipoprotein cholesterol — by 12,7%. Over 12 months, lipid-lowering therapy did not undergo significant changes. Statin monotherapy was maintained in 83%, of which only 53,7% of patients received high-dose therapy. Combined statin+ezetimibe therapy was used in 12,4%, while statin+ezetimibe+PCSK9 inhibitor — in 4,6%. During the 1-year follow-up, antithrombotic therapy was not enhanced. Low prescription rate of combination therapy with antiplatelet agents (15,7%) and low-dose rivaroxaban and acetylsalicylic acid (7,9%) remained. By the follow-up end, a high incidence of major adverse cardiovascular events (8,8%) was registered in patients included in the KAMMA registry. Conclusion. Despite the fact that patients with MFA have a very high cardiovascular risk, routine management of these patients is characterized by high clinical inertia. During the 1-year follow-up, lipid-lowering and antithrombotic therapy was not properly strengthened, due to which the target levels of key lipid profile parameters were not achieved and a high rate of major adverse cardiovascular events was observed in patients included in the registry.

Russian Journal of CardiologyVol. 30(3)
Privolzhsky Research Medical University (RU), Rostov State Medical University (RU), Kazan State Medical University (RU), Kazakh National Medical University (KZ), Chelyabinsk State Medical Academy (RU), Pirogov Russian National Research Medical University (RU), Perm State Medical Academy (RU), Stavropol Regional Clinical Oncology Center (RU), Krasnoyarsk State Medical University (RU), Ural State Medical University (RU), National Institute of Health Sciences (LK), Saratov State Medical University (RU), Tomsk National Research Medical Center (RU), Samara State Medical University (RU), City Clinical Hospital (RU), City Clinical Hospital No. 2 (RU), Ryazan State Medical University named after Academician I.P. Pavlov (RU), Republican Scientific and Practical Center of Cardiology (BY), North-Western State Medical University named after I.I. Mechnikov (RU), Kemerovo State University (RU), N. I. Lobachevsky State University of Nizhny Novgorod (RU)
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Cardiac Imaging and Diagnostics
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