CHALLENGES IN TREATING HEMODIALYSIS-DEPENDENT PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. A СLINICAL CASE
https://doi.org/10.17802/2306-1278-2019-8-2-135-142
Abstract
The clinical case reports a personalized expert approach to the management of a patient with myocardial infarction receiving programmed hemodialysis. The challenges facing by cardiologists with antiplatelet therapy, statin therapy, betablockers and renin-angiotensin-aldosterone system blockers as basic therapy have been discussed. The experience of performing coronary angiography with a limited dosage of the contrast agent followed by the stenting in the patient intolerant to unfractionated heparin is presented The complexity of post-puncture hemostasis before dialysis is highlighted. A particular attention has been paid to the existing difficulties in selecting rational loading doses of antiplatelet agents for these patients due to poor evidences on the elimination of clopidogrel metabolites from the blood flow.
About the Authors
D. Yu. Sedykh
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” ; State Budgetary Healthcare Institution of the Kemerovo Region “Kemerovo Regional Clinical Cardiology Dispensary n.a. Academician L.S. Barbarash”
Russian Federation
Russian Federation
MD, PhD, researcher at Laboratory of Pathophysiology of Multivessel Coronary Artery Disease and Polyvascular Disease; cardiologist,
6, Sosnoviy Blvd, Kemerovo, 650002; 6, Sosnoviy Blvd, Kemerovo, 650002
L. Yu. Chesnokova
State Budgetary Healthcare Institution of the Kemerovo Region “Kemerovo Regional Clinical Cardiology Dispensary n.a. Academician L.S. Barbarash”
Russian Federation
Russian Federation
MD, PhD, Head of the Department of Myocardial Infarction, cardiologist,
6, Sosnoviy Blvd, Kemerovo, 650002
V. V. Kashtalap
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” ; Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
MD, PhD, Head of the Laboratory of Pathophysiology of Multivessel Coronary Artery Disease and Polyvascular Disease; Associate Professor at the Department of Cardiology and Cardiovascular Surgery,
6, Sosnoviy Blvd, Kemerovo, 650002; 22a, Voroshilova St., Kemerovo, 650029
S. V. Kirilenko
Kemerovo branch of the Medical Private Institution of Additional Professional Education “Nefrosovet”
Russian Federation
Russian Federation
MD, Head of the Department of Nephrology and Hemodialysis,
22a, Building 1, Oktyabrsky Prospect, Kemerovo, 650066
O. L. Barbarash
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” ; Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
PhD, Corresponding Member of the Russian Academy of Sciences, Director; Professor of the Department of Cardiology and Cardiovascular Surgery,
6, Sosnoviy Blvd, Kemerovo, 650002; 22a, Voroshilova St., Kemerovo, 650029
References
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Review
For citations:
Sedykh D.Yu., Chesnokova L.Yu., Kashtalap V.V., Kirilenko S.V., Barbarash O.L. CHALLENGES IN TREATING HEMODIALYSIS-DEPENDENT PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. A СLINICAL CASE. Complex Issues of Cardiovascular Diseases. 2019;8(2):135-142. (In Russ.) https://doi.org/10.17802/2306-1278-2019-8-2-135-142
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