International Medical Journal, Vol. 22., Iss. 1, 2016, P. 5−10.
EUROPEAN CLINICAL PRACTICE GUIDELINES FOR CARDIOLOGY 2015
Kuban State Medical University, Ministry of Health of RF, Krasnodar, Russian Federation
The review presents the main provisions of 5 clinical practice guidelines of the European Society of Cardiology published in 2015. The focus is on the changes introduced in the new version of the guidelines. For example, in acute coronary syndromes in patients without persistent ST−segment elevation main changes relate to the diagnosis, heart rate monitoring, risk stratification and treatment strategies. New criteria for risk stratification in these patients, which allow choosing treatment and timing of invasive intervention, were defined. It is recommended to switch from the use of femoral approach at coronary angiography and percutaneous coronary intervention to radial approach. Patients with ventricular arrhythmias are recommended apparatus therapies including implantable and wearable cardioverter defibrillators, subcutaneous defibrillators to prevent sudden cardiac death. Diagnostic criteria and recommendations for treatment of hereditary primary arrhythmic syndromes were updated. The recommendations for diagnosis and treatment of pericardium diseases contain etiologic classification, according to which they are divided into infectious and non−infectious. The main causes of pericardial diseases are viruses and bacteria (most commonly Mycobacterium tuberculosis). In−patient treatment of acute and recurrent pericarditis in high−risk patients should be administered. The recommendations on diagnosis and treatment of pulmonary hypertension propose clinical classification, which includes the new state, the newly identified gene mutations and several other changes. The guidelines for treatment of infective endocarditis emphasize the key role of general prevention, not only antibiotic one. Early surgical intervention for treatment of this disease is approved. The new European guidelines summarize all contemporary scientific data on these topics and are a valuable educational resource for practitioners.
Key words: clinical practice guidelines, acute coronary syndrome, sudden cardiac death, pericarditis, pulmonary hypertension, infectious endocarditis.