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Journal: Art of Medicine (Vol.4, No. 1)

Publication Date:

Authors : ;

Page : 180-193

Keywords : prognostic scales; cardiovascular risk;

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This article presents the most popular and well-recommended scales and calculators used in practical medicine. A large amount of information can create obstacles in the aggregate data to obtain a reliable assessment of the patient's condition and make decisions about diagnosis, subsequent treatment tactics, evaluation of their effectiveness and further prognosis. A positive feature of the scales is the ease of use, which allows them to be used in clinics, family clinics and hospitals. The presented scales allow to carry out a sys-tematic evaluation of coronary risk, to predict long-term risks of cardiovascular events, fatal outcomes and as-sessment of the duration of antiplatelet therapy in patients with Acute Coronary Syndrome, to determine the risk of thromboembolic complications in patients with fibrillation with hysteresis and patients with fibrillation bypass. Also, the risk factors used in the scales are often nonspecific and may affect the prognosis of other diseases. For example, age, smoking, blood pressure, kidney pathology, heart failure class, anemia, lipid levels are considered on many scales. There fore, scales designed for one disease may be useful for other pathologies. In this article (part 1) we provide an overview of the main scales that are recommended for use in cardiol-ogy practice. There are many internationally recognized and proven registries and scales for risk of Coronary Heart Disease and Acute Coronary Syndrome. According to the recommendations of the American Heart Associa-tion (ACC/AHA) and the European Society of Cardiolo-gy (ESC), the following registries and scales are most commonly used in practical cardiology: HEART Score, PURSUIT, TIMI, GRACE, CRUSADE (for patients with ACS without ST segment elevation), TIMI II (for patients with ACS and ST segment elevation); CADILLAC, SYNTAX, DAPT, PRECISE-DAPT, GUSTO, PAMI (when referring patients with percutaneous coronary intervention); CHA2DS2VASc, HAS-BLED, TIMI-AF, SAMe-TT2R2 (assessment of total risk of complications in patients with atrial fibrillation and to choose the opti-mal anticoagulation therapy); Charlson Index, Cumula-tive Illness Rating Scale, Index of Coexisting Disease (used to predict the risks of cardiovascular disease in conditions of comorbidity), and others. Thus, the use of prognostic scales in practice helps clinicians to assess the potential risks of adverse events for groups of patients with similar conditions, and to make more effective diagnostic and treatment deci-sions based on each patient's position. Scales for determining overall cardiovascular risk, including the SCORE (Systematic Coronary Risk Evaluation) scale, the Fremingham Scale for calculating a 10-year risk of developing cardiovascular events in individuals with no clinical manifestations of cardiovascular pathology, are also the most common; The Reynolds Risk Scale estimates a 10-year cumulative risk of cardiovascular events (IM, ischemic stroke, coronary artery revascularization, and cardiovascular mortality).

Last modified: 2020-04-08 05:06:39