1
|
Antoniou P, Dafli E, Giannakoulas G, Igimbayeva G, Visternichan O, Kyselov S, Lykhasenko I, Lashkul D, Nadareishvili I, Tabagari S, Bamidis PD. Education of Patients With Atrial Fibrillation and Evaluation of the Efficacy of a Mobile Virtual Patient Environment: Protocol for a Multicenter Pseudorandomized Controlled Trial. JMIR Res Protoc 2024; 13:e45946. [PMID: 38261376 PMCID: PMC10848131 DOI: 10.2196/45946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a leading cause of mortality and morbidity. Patient knowledge about AF and its management is paramount but often limited. Patients need to be appropriately informed about treatment options, medicinal adherence, and potential consequences of nonadherence, while also understanding treatment goals and expectations from it. Mobile health apps have experienced an explosion both in their availability and acceptance as "soft interventions" for patient engagement and education; however, the prolific nature of such solutions revealed a gap in the evidence base regarding their efficacy and impact. Virtual patients (VPs), interactive computer simulations, have been used as learning activities in modern health care education. VPs demonstrably improved cognitive and behavioral skills; hence, they have been effectively implemented across undergraduate and postgraduate curricula. However, their application in patient education has been rather limited so far. OBJECTIVE This work aims to implement and evaluate the efficacy of a mobile-deployed VP regimen for the education and engagement of patients with AF on crucial topics regarding their condition. A mobile VP app is being developed with the goal of each VP being a simple scenario with a set goal and very specific messages and will be subsequently attempted and evaluated. METHODS A mobile VP player app is being developed so as to be used for the design of 3 educational scenarios for AF management. A pseudorandomized controlled trial for the efficacy of VPs is planned to be executed at 3 sites in Greece, Ukraine, and Kazakhstan for patients with AF. The Welch t test will be used to demonstrate the performance of patients' evaluation of the VP experience. RESULTS Our study is at the development stage. A preliminary study regarding the system's development and feasibility was initiated in December 2022. The results of our study are expected to be available in 2024 or when the needed sample size is achieved. CONCLUSIONS This study aims to evaluate and demonstrate the first significant evidence for the value of VP resources in outreach and training endeavors for empowering and patients with AF and fostering healthy habits among them. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45946.
Collapse
Affiliation(s)
- Panagiotis Antoniou
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Dafli
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Giannakoulas
- 1st Cardiology Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Olga Visternichan
- Internal Medicine Department, Karaganda Medical University, Karaganda, Kazakhstan
| | - Serhii Kyselov
- Department of Internal Diseases No.1 and Simulation Medicine, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
| | - Ivetta Lykhasenko
- Department of Propedeutics of Internal Diseases, Radiation Diagnostics and Radiation, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
| | - Dmytro Lashkul
- Department of Internal Diseases No.1 and Simulation Medicine, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
| | - Ilia Nadareishvili
- AIETI Medical School, David Tvildiani Medical University, Tbilisi, Georgia
| | - Sergo Tabagari
- AIETI Medical School, David Tvildiani Medical University, Tbilisi, Georgia
| | - Panagiotis D Bamidis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
2
|
Taizhanova D, Toleuova A, Babenko D, Turmuhambetova A, Bodaubay R, Visternichan O, Kalimbetova A, Ahmaltdinova L, Kurmanova A. Genetic markers of the risk of coronary heart disease and coronary artery thrombosis developing in the Kazakh population. Caspian J Intern Med 2023; 14:249-256. [PMID: 37223289 PMCID: PMC10201125 DOI: 10.22088/cjim.14.2.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 02/22/2022] [Accepted: 03/08/2023] [Indexed: 05/25/2023]
Abstract
Background Surgical methods such as coronary artery bypass grafting and percutaneous coronary interventions (PCI) are widely used along with traditional conservative therapy in the treatment of coronary artery disease. The disease outcome directly depends on timely diagnosis and treatment. A significant role in predicting the effectiveness of treatment is given to personification of treatment and management of the patient. In this case, the determining component is its individual genetic status. Methods The study groups included persons of Kazakh nationality which identify themselves, their biological parents, and biological grandparents on the maternal and paternal side as Kazakh. Research groups included 108 people at the age from 45 to 65 years of both sexes. Blood samples genotyping was carried out by PCR using highly specific TaqMan samples. Thermo Fisher cloud application was used for genotypes determining on the base of an automatic algorithm. Results The article presents the results of the evaluation of gene polymorphisms associated with coronary artery restenosis in a population of Kazakh nationality. 3 SNPs were determined when searching for an association with stenting due to coronary artery thrombosis: rs7543130 (p=0.009324), rs6785930 (p=0.016858), rs7819412 (p=0.061325). Conclusion Four polymorphisms associated with the risk of developing coronary heart disease were revealed during the study of polymorphisms among the people of the Kazakh population. Three SNPs were determined when searching for an association with stenting due to coronary artery thrombosis. It should be noted that the Bonferonni correction for multiple comparisons did not reveal significant polymorphisms associated with coronary artery disease, which requires further research with more quantity of samples.
Collapse
Affiliation(s)
- Dana Taizhanova
- NJSC "Medical University of Karaganda", Karaganda, Kazakhstan
| | - Aliya Toleuova
- NJSC "Medical University of Karaganda", Karaganda, Kazakhstan
| | - Dmitry Babenko
- NJSC "Medical University of Karaganda", Karaganda, Kazakhstan
| | | | - Roza Bodaubay
- NJSC "Medical University of Karaganda", Karaganda, Kazakhstan
| | | | | | | | - Aigul Kurmanova
- NJSC "Medical University of Karaganda", Karaganda, Kazakhstan
| |
Collapse
|
3
|
Taizhanova D, Kalimbetova A, Bodaubay R, Toleuova A, Toiynbekova R, Beysenbekova Z, Visternichan O, Tauesheva Z, Kadyrova I, Babenko D, Akhmaltdinova L, Kolesnichenko S, Kolesnikova Y, Avdienko OV, Akilzhanova A, Gerotziafas GT. Genetic Predictors of the Development of Complications after Coronary Stenting. J Pers Med 2022; 13:jpm13010014. [PMID: 36675675 PMCID: PMC9863814 DOI: 10.3390/jpm13010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Due to the fact that there are scientific discussions about the significance of gene polymorphisms in the risk of developing cardiovascular complications after a percutaneous coronary intervention, it is of interest to evaluate the genetic predictors of the development of cardiovascular events. This study is a molecular genetic study. Association with the genes of biomarkers for inflammation and immune response increases the risk of cardiovascular events: rs1234313 (TNFSF4): (A/G, OR-4.57 (2.35-8.87), p ≤ 0.0001), (A/G-A/A, OR-3.14 (1.75-5.63), p ≤ 0.0001), and (A/G, OR = 4.01 (2.19-7.36), p ≤ 0.0001); rs3184504 (SH2D3); ATXN2: (C/T, OR-2.53 (1.28-5.01), T/T, OR-2.99 (1.13-7.92), p = 0.017)), (C/T-T/T, OR-2.61 (1.35-5.07), p = 0.000), and (OR-1.89 (1.15-3.09), p = 0.009)). According to the lipid metabolism biomarker genes, rs2943634: (A/C OR-2.57 (1.18-5.62), p = 0.013); according to the endothelial biomarker genes, rs2713604: (DNAJB8-AS1; GATA2): (C/T, OR-4.27 (2.35-7.76), p ≤ 0.0001), (C/T-C/C, OR-4.13 (2.31-7.40), p ≤ 0.0001), (OR-4.05 (2.24-7.30), p ≤ 0.0001), and (C/T, OR-3.46 (1.99-6.00), p ≤ 0.0001). The regression analysis found that in the presence of the rs2943634 gene polymorphism, the risk of late cardiovascular events increases by 4.007 times with 95% CI (1.502:10.692), p = 0.006. The genes of biomarkers for the risk of cardiovascular events are rs1234313(TNFSF4), rs3184504 (SH2D3; ATXN2), rs2943634, and rs2713604 (DNAJB8-AS1; GATA2). The only predictor of the development of new cardiovascular events was rs2943634, which belongs to the group of lipid metabolism biomarkers.
Collapse
Affiliation(s)
- Dana Taizhanova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Akerke Kalimbetova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
- Correspondence:
| | - Roza Bodaubay
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Aliya Toleuova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Rakhima Toiynbekova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Zhazira Beysenbekova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Olga Visternichan
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Zauresh Tauesheva
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Irina Kadyrova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Dmitriy Babenko
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Lyudmila Akhmaltdinova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Svetlana Kolesnichenko
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Yevgeniya Kolesnikova
- Department of Internal Medicine Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Olga V. Avdienko
- Shared Resource Laboratory, Scientific and Research Center, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Ainur Akilzhanova
- National Laboratory Astana, Laboratory of Genomic and Personalized Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Grigorios T. Gerotziafas
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale, INSERM U938 and Faculté de Médecine Pierre et Marie Curie (UPMC), Sorbonne Universities, 75006 Paris, France
| |
Collapse
|
4
|
Taizhanova D, Bodaubay R, Toleuova A, Kalimbetova A, Babenko D, Turmukhambetova A, Akhmaltdinova L, Visternichan O. Genetic Polymorphisms Association in Restenosis of Coronary Arteries. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.4505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: There is a reason to believe that the polymorphism of genes encoding some enzymes and receptors plays a role in increasing of restenosis development risk. It is common knowledge that ethnicity affects the frequency of heterozygous genotypes occurrence. There is the evidence that polymorphism of the FGB gene (rs1800790) and THBD gene was determined in the ethnic group of Kazakhs with restenosis of the coronary arteries, which can be considered as genetic predictors of restenosis development. Today, the questions of the role of the genetic component in the development of coronary heart disease (CHD) remain open.
AIM: Evaluation of gene polymorphism in patients with restenosis of coronary arteries after stent installation.
MATERIALS AND METHODS: The group consisted of Kazakh population of the age category from 45 to 65 years of both sexes: Group I (50 persons) patients with a diagnosis of CHD, with a fixed stent and the development of restenosis during the year; Group 2 (58 persons) – with a fixed stent and no restenosis during the year. The association of genetic polymorphisms was evaluated in accordance with the case–control design based on the generalized linear model assuming a log-additive inheritance model.
RESULTS: Thus, when comparing two groups using five patterns of inheritance, the following SNP were revealed: Codominant inheritance pattern – rs1045642 (p = 0.0427), dominant inheritance pattern – rs12041331 (p = 0.036088), rs13431554 (p = 0.025461), and rs1045642 (p = 0.012774), and overdominant inheritance pattern – rs12041331 (p = 0.051736), rs5918 (p = 0.057652), and rs13431554 (р = 0.036006). Thus, three SNPs associated with stenting were identified: rs7543130 (p = 0.009324), rs6785930 (p = 0.016858), and rs7819412 (p = 0.061325) and two SNPs associated with the development of restenosis after stent placement: rs1061781 (p = 0.063184) and rs342293 (p = 0.061636).
CONCLUSION: The polymorphisms associated with the risk of developing restenosis after stenting were determined: Codominant inheritance pattern – one polymorphism (rs1045642, p = 0.0427); dominant inheritance pattern – three polymorphisms (rs12041331, p = 0.036088; rs13431554, p = 0.025461; rs1045642, p = 0.012774), and overdominant inheritance pattern – one polymorphism (rs13431554, p = 0.036006). Based on the hybrid machine learning approach (RuleFit), four rules were obtained for assessing the empirical risk of restenosis developing after stenting – from 20% to 40%.
Collapse
|
5
|
Visternichan O, Jalali SF, Taizhanova D, Muravlyova L, Igimbayeva G. Dynamic changes in purine catabolism in patients with acute coronary syndrome that underwent percutaneous coronary intervention. Caspian J Intern Med 2019; 10:86-91. [PMID: 30858946 PMCID: PMC6386334 DOI: 10.22088/cjim.10.1.86] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiovascular diseases are global problems. They are causes of death in about 43% of people worldwide and may become the most widespread reason of death by 2020. The prognosis is directly dependent to immediate diagnosis and on time treatment. Introduction of new biochemical markers as the early diagnosis of complications after coronary revascularization is very important in this period. Herein, we assayed the changes of purine catabolites in patients with acute coronary syndrome (ACS) before and after percutaneous coronary intervention (PCI) in comparison with control group. METHODS Thirty five ACS patients (20 males and 15 females) were included (57±17 years old) in the study. The determination of intermediates of purine catabolism as guanine, hypoxanthine (GCS), adenine, xanthine (Kc) and uric acid (MK) were assayed before and 3 days after PCI. Conditionally, 35 healthy-matched persons were included in the control group. Purine catabolites were determined in plasma through the method of Oreshnikov E.V (2008). RESULTS In ACS patients, prior to PCI, there was a tendency to increase the concentration of guanine (P=0.001), hypoxanthine (P=0.002) adenine (P=0.0003), xanthine (P=0.000003) and uric acid (P=-0.000001) relative to the upper limits of normal ranges. And on the third day after PCI, there was the second tendency to increase the levels of guanine (P=0.000001), hypoxanthine (P=0.000001) adenine (P=0.0000001), xanthine (P=0.000001) and uric acid (P=0.0000001) relative to upper limits of normal ranges. CONCLUSION Increment of plasma purine catabolites can be a marker of inflammation and instability of coronary artery plaques and may be used as a restenosis marker in patients with history of PCI.
Collapse
Affiliation(s)
| | - Seyed Farzad Jalali
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | | | | |
Collapse
|
6
|
Zhunussov Y, Taizhanova D, Abdullabekova R, Bitz U, Visternichan O. OPTIMUM APPLICATION OF MODERN ANTITHROMBOTIC DRUGS AMONG PATIENTS WITH THE ACUTE CORONARY SYNDROME WITH THE RISK OF STRICTURE FORMATION OF CORONARY ARTERIES. Georgian Med News 2016:40-45. [PMID: 27001784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of the research is to give the effectiveness and safety of ticagrelor in combination with acetylsalicylic acid as preoperative treatment of primary stenting in patients with ACS. We have investigated 42 patients with ACS, 3 of which were diagnosed with cardiogenic shock, age from 38 to 82 years (63 ± 6.5 years). The ACS diagnosis was verified using the results of the ECG, a troponin test and x-ray contrast coronary angiography. The purpose of preoperative antiplatelet treatment prior to primary PCI ticagrelor was administered in the dose of 180 mg and aspirin at a dose of 200 mg. Emergency coronary angiography and primary PCI was performed 15-90 minutes from the time of diagnosis. TIMI III flow in the infarct-related coronary arteries was achieved in all patients. None of the patients the phenomenon of "No-Reflow" has not developed. The appointment of the antiplatelet drug ticagrelor before primary PCI contributes to the achievement of full blood flow restoration in the infarct-related coronary artery, and also reduces the risk of intraoperative and postoperative complications.
Collapse
Affiliation(s)
- Y Zhunussov
- Karaganda State Medical University, Kazakhstan; Helios Klinikum, Bad Saarow, Germany
| | - D Taizhanova
- Karaganda State Medical University, Kazakhstan; Helios Klinikum, Bad Saarow, Germany
| | - R Abdullabekova
- Karaganda State Medical University, Kazakhstan; Helios Klinikum, Bad Saarow, Germany
| | - U Bitz
- Karaganda State Medical University, Kazakhstan; Helios Klinikum, Bad Saarow, Germany
| | - O Visternichan
- Karaganda State Medical University, Kazakhstan; Helios Klinikum, Bad Saarow, Germany
| |
Collapse
|
7
|
Taizhanova D, Visternichan O, Zhunusov E. C0293: Risk Factors of Restenosis After Coronary Revascularisation. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|