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 countries (KAMMA)
G. P. Arutyunov,
E. I. Tarlovskaya,
A. G. Arutyunov,
T. I. Batluk,
N. A. Koziolova,
A. I. Chesnikova,
A. Y. Vaskin,
D. S. Tokmin,
I. G. Bakulin,
O. L. Barbarash,
N. Y. Grigoryeva,
I. V. Gubareva,
N. V. Izmozherova,
U. R. Kamilova,
S. G. Kechedzhieva,
Z. F. Kim,
N. A. Koriagina,
S. V. Mironova,
N. P. Mitkovskaya,
S. V. Nemirova,
L. M. Nurieva,
M. M. Petrova,
E. A. Polyanskaya,
A. P. Rebrov,
A. V. Svarovskaya,
E. A. Smirnova,
A. B. Sugraliev,
Y. B. Khovaeva,
G. V. Shavkuta,
I. I. Shaposhnik,
G. T. Aimakhanova,
M. Y. Alieva,
A. B. Almukhanova,
A. V. Aparkina,
D. A. Akhmentaeva,
R. A. Bashkinov,
N. M. Bekisheva,
L. N. Belousova,
E. I. Blokhina,
V. O. Bochkareva,
M. V. Buianova,
F. Y. Valikulova,
A. D. Vende,
A. S. Galyavich,
V. V. Genkel,
E. V. Gorbunova,
E. D. Gordeychuk,
E. A. Grigorenko,
E. V. Grigoryeva,
G. M. Dabylova,
I. L. Davydkin,
D. S. Evdokimov,
A. N. Ermilova,
S. B. Zhangelova,
N. V. Zhdankina,
E. I. Zheleznyak,
N. S. Ilyanok,
D. A. Kapsultanova,
N. A. Karoli,
E. A. Kartashova,
A. S. Kuznetsova,
A. T. Kumaritova,
N. A. Magdeeva,
S. A. Makarov,
O. A. Mamadaliev,
E. S. Melnikov,
N. J. Musrepov,
R. Ya. Namatova,
M. V. Novikova,
I. A. Obukhova,
E. V. Ponomarenko,
A. O. Rubanenko,
O. A. Rubanenko,
V. A. Safronenko,
E. I. Suchkova,
A. I. Sycheva,
D. R. Tagaeva,
M. A. Trubnikova,
T. P. Trunina,
S. A. Tynalieva,
A. G. Frolov,
V. V. Khatlamadzhiyan,
Y. I. Khokhlova,
A. I. Chernyavina,
O. Y. Chizhova,
M. A. Shambatov,
T. V. Shnyukova,
Y. V. Shchukin https://doi.org/10.15829/1560-4071-2025-6152
EDN: MBFXKR
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.
About the Authors
G. P. Arutyunov
Association "Eurasian Association of Internal Medicine"; Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
E. I. Tarlovskaya
Association "Eurasian Association of Internal Medicine";
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Moscow
Nizhny Novgorod
A. G. Arutyunov
Association "Eurasian Association of Internal Medicine";
S. Avdalbekyan National Institute of Health
Russian Federation
Competing Interests:
Russian Federation
Moscow
Yerevan
Competing Interests:
нет
T. I. Batluk
Association "Eurasian Association of Internal Medicine"
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
N. A. Koziolova
E. A. Wagner Perm State Medical University
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
A. I. Chesnikova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
A. Y. Vaskin
Association "Eurasian Association of Internal Medicine"
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
D. S. Tokmin
"Alphastat" analytic agency
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
I. G. Bakulin
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
O. L. Barbarash
Scientific Research Institute for Complex issues of cardiovascular disease
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
нет
N. Y. Grigoryeva
Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
I. V. Gubareva
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
нет
N. V. Izmozherova
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yekaterinburg
Competing Interests:
нет
U. R. Kamilova
Republican Specialized Scientific and Practical Medical
Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
нет
S. G. Kechedzhieva
Stavropol State Medical University
Russian Federation
Competing Interests:
Russian Federation
Stavropol
Competing Interests:
нет
Z. F. Kim
Kazan State Medical University;
Sadykov City Clinical Hospital № 7
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
нет
N. A. Koriagina
E. A. Wagner Perm State Medical University;
LLC Women's Health Clinic
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
S. V. Mironova
Perm Regional Hospital for Veterans War
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
N. P. Mitkovskaya
Republican Scientific and Practical Center "Cardiology"
Belarus
Competing Interests:
Belarus
Minsk
Competing Interests:
нет
S. V. Nemirova
Privolzhsky Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
L. M. Nurieva
Sadykov City Clinical Hospital № 7
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
нет
M. M. Petrova
V. F. Voino-Yasenetsky Krasnoyarsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
нет
E. A. Polyanskaya
E. A. Wagner Perm State Medical University
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
A. P. Rebrov
V. I. Razumovskiy Saratov State Medical University;
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
нет
A. V. Svarovskaya
Cardiology Research Institute;
Tomsk National Research Medical Center
Russian Federation
Competing Interests:
Russian Federation
Tomsk
Competing Interests:
нет
E. A. Smirnova
Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
нет
A. B. Sugraliev
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
Y. B. Khovaeva
F. C. Gral City Clinical Hospital № 2
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
G. V. Shavkuta
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
I. I. Shaposhnik
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
нет
G. T. Aimakhanova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
M. Y. Alieva
Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
нет
A. B. Almukhanova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
A. V. Aparkina
V. I. Razumovskiy Saratov State Medical University;
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
нет
D. A. Akhmentaeva
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
R. A. Bashkinov
Association "Eurasian Association of Internal Medicine";
I. I. Mechnicov North-Western State Medical University;
Clinical Rheumatology Hospital № 25
Russian Federation
Competing Interests:
Russian Federation
Moscow
St. Petersburg
Competing Interests:
нет
N. M. Bekisheva
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
L. N. Belousova
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
E. I. Blokhina
Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
V. O. Bochkareva
V. F. Voino-Yasenetsky Krasnoyarsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
нет
M. V. Buianova
Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
F. Y. Valikulova
Privolzhsky Research Medical University;
City Polyclinic № 31 of Sovetsky District
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
A. D. Vende
Cardiology Research Institute;
Tomsk National Research Medical Center
Russian Federation
Competing Interests:
Russian Federation
Tomsk
Competing Interests:
нет
A. S. Galyavich
Kazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Kazan
Competing Interests:
нет
V. V. Genkel
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
нет
E. V. Gorbunova
Scientific Research Institute for Complex issues of cardiovascular disease;
L. S. Barbarash Kuzbass Clinical Cardiology Dispensary
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
нет
E. D. Gordeychuk
Association "Eurasian Association of Internal Medicine;
Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
E. A. Grigorenko
Republican Scientific and Practical Center "Cardiology"
Belarus
Competing Interests:
Belarus
Minsk
Competing Interests:
нет
E. V. Grigoryeva
V. I. Razumovskiy Saratov State Medical University;
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
нет
G. M. Dabylova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
I. L. Davydkin
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
нет
D. S. Evdokimov
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
A. N. Ermilova
Association "Eurasian Association of Internal Medicine;
Fomin's clinic Michurinsky;
Fomin's clinic Dolgorukovskaya
Russian Federation
Competing Interests:
Russian Federation
Moscow
Competing Interests:
нет
S. B. Zhangelova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
N. V. Zhdankina
Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
E. I. Zheleznyak
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
N. S. Ilyanok
Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
нет
D. A. Kapsultanova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
N. A. Karoli
V. I. Razumovskiy Saratov State Medical University;
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
нет
E. A. Kartashova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
A. S. Kuznetsova
South-Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chelyabinsk
Competing Interests:
нет
A. T. Kumaritova
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
N. A. Magdeeva
V. I. Razumovskiy Saratov State Medical University;
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Saratov
Competing Interests:
нет
S. A. Makarov
Scientific Research Institute for Complex issues of cardiovascular disease
Russian Federation
Competing Interests:
Russian Federation
Kemerovo
Competing Interests:
нет
O. A. Mamadaliev
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
E. S. Melnikov
Association "Eurasian Association of Internal Medicine";
I. I. Mechnicov North-Western State Medical University;
Clinical Rheumatology Hospital № 25
Russian Federation
Competing Interests:
Russian Federation
Moscow
St. Petersburg
Competing Interests:
нет
N. J. Musrepov
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
R. Ya. Namatova
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
M. V. Novikova
Stavropol Regional Cardiology Dispensary
Russian Federation
Competing Interests:
Russian Federation
Stavropol
Competing Interests:
нет
I. A. Obukhova
V. F. Voino-Yasenetsky Krasnoyarsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Krasnoyarsk
Competing Interests:
нет
E. V. Ponomarenko
LLC "Health Formula"
Russian Federation
Competing Interests:
Russian Federation
Krasnodar
Competing Interests:
нет
A. O. Rubanenko
Samara State Medical University
Russian Federation
Russian Federation
Samara
O. A. Rubanenko
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Samara
Competing Interests:
нет
V. A. Safronenko
Rostov State Medical University
Russian Federation
Russian Federation
Rostov-on-Don
E. I. Suchkova
Pavlov Ryazan State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
нет
A. I. Sycheva
F. C. Gral City Clinical Hospital № 2
Competing Interests:
Perm
Competing Interests:
нет
D. R. Tagaeva
Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation
Uzbekistan
Competing Interests:
Uzbekistan
Tashkent
Competing Interests:
нет
M. A. Trubnikova
Association "Eurasian Association of Internal Medicine";
LLC "Dr. Fomin's clinic"
Russian Federation
Competing Interests:
Russian Federation
Moscow
Sochi
Competing Interests:
нет
T. P. Trunina
Pavlov Ryazan State Medical University;
City Clinical Hospital № 11
Russian Federation
Competing Interests:
Russian Federation
Ryazan
Competing Interests:
нет
S. A. Tynalieva
Asfendiyarov Kazakh National Medical University
Kazakhstan
Competing Interests:
Kazakhstan
Almaty
Competing Interests:
нет
A. G. Frolov
Lobachevsky National Research Nizhny Novgorod State University
Russian Federation
Competing Interests:
Russian Federation
Nizhny Novgorod
Competing Interests:
нет
V. V. Khatlamadzhiyan
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
Y. I. Khokhlova
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
A. I. Chernyavina
Perm Regional Hospital for Veterans War
Russian Federation
Competing Interests:
Russian Federation
Perm
Competing Interests:
нет
O. Y. Chizhova
I. I. Mechnicov North-Western State Medical University
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
нет
M. A. Shambatov
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yekaterinburg
Competing Interests:
нет
T. V. Shnyukova
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Rostov-on-Don
Competing Interests:
нет
Y. V. Shchukin
Samara State Medical University
Russian Federation
Russian Federation
Samara
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Supplementary files
- During the 1-year follow-up, lipid-lowering therapy of patients with coronary artery disease and multifocal atherosclerosis was not properly strengthened, due to which the target levels of key lipid profile parameters were not achieved in the vast majority of patients (low-density lipoprotein cholesterol in 78%, non-high-density lipoprotein cholesterol in 81%).
- During the 1-year follow-up, antithrombotic therapy was not intensified' the low prescription rate of combination therapy with antiplatelet agents (15,7%) and low doses of rivaroxaban and acetylsalicylic acid (7,9%) remained.
- By the end of the 12-month follow-up period, a high rate of major adverse cardiovascular events (8,8%) was registered in patients included in the KAMMA registry.
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