Browsing by Author "Trušinskis, Kārlis"

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    Evidence from routine clinical practice : EMPRISE provides a new perspective on CVOTs
    (2019-08-31) Schernthaner, Guntram; Karasik, Avraham; Abraitienė, Agne; Ametov, Alexander S.; Gaàl, Zsolt; Gumprecht, Janusz; Janež, Andrej; Kaser, Susanne; Lalić, Katarina; Mankovsky, Boris N.; Moshkovich, Evgeny; Past, Marju; Prázný, Martin; Radulian, Gabriela; Smirčić Duvnjak, Lea; Tkáč, Ivan; Trušinskis, Kārlis; Rīga Stradiņš University
    EMPA-REG OUTCOME is recognised by international guidelines as a landmark study that showed a significant cardioprotective benefit with empagliflozin in patients with type 2 diabetes (T2D) and cardiovascular disease. To assess the impact of empagliflozin in routine clinical practice, the ongoing EMPRISE study is collecting real-world evidence to compare effectiveness, safety and health economic outcomes between empagliflozin and DPP-4 inhibitors. A planned interim analysis of EMPRISE was recently published, confirming a substantial reduction in hospitalisation for heart failure with empagliflozin across a diverse patient population. In this commentary article, we discuss the new data in the context of current evidence and clinical guidelines, as clinicians experienced in managing cardiovascular risk in patients with T2D. We also look forward to what future insights EMPRISE may offer, as evidence is accumulated over the next years to complement the important findings of EMPA-REG OUTCOME.
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    Nieru artērijas denervācijas ietekme uz ehokardiografijas parametriem pacientiem ar rezistentu arteriālo hipertensiju
    (Rīga Stradiņš University, 2024) Hiļkevičs, Jevgenijs; Trušinskis, Kārlis; Faculty of Residency; Rezidentūras studiju fakultāte
    This work investigates the effect of renal artery denervation (RAD) on various echocardiographic parameters in patients diagnosed with resistant arterial hypertension (RAH). The aim of the study is to evaluate the effectiveness of RDN in improving cardiac structure and function by analysing echocardiographic data before and after the procedure. Introduction: Resistant arterial hypertension (RAH) is a significant global healthcare problem due to its widespread prevalence and severe complications. It is a leading risk factor for cardiovascular disease, chronic kidney disease and cognitive disorders. The introduction points out that the prevalence of RAH is increasing and that effective treatment strategies beyond conventional pharmacotherapy are required. Methods: Seventeen patients with resistant hypertension undergoing RDN participated in the study. Participants included both men and women with a mean age of 59.7 years. Echocardiographic measurements were performed before the RDN procedure and three months after the procedure. Paired t-tests were used to determine the statistical significance of changes in echocardiographic parameters. The main echocardiographic parameters that were analysed were: Diastolic diameter (EDD),End systolic diameter (ESD),Ventricular septal thickness (IVSD),Posterior wall thickness (PWD),Left ventricular mass index (LWMI),Ejection fraction (EF),Deceleration time (DT),E/A ratio,E mean (E),E/E' ratio. RESULTS: The findings showed statistically significant improvements in several parameters including: LWMI (p=0.0263): This indicates a reduction in left ventricular hypertrophy. DT (p = 0.0135): This indicates an improvement in diastolic function. Other parameters such as IVSD (p-0.062) and E/E' (0.0646) showed positive trends but did not reach the usual level of statistical significance (p < 0.05). Discussion: The discussion compares the results with similar studies and highlights the potential clinical role of RDN in improving cardiac function and structure in patients with RAH. It discusses limitations such as small sample size and variability in patient response, and suggests directions for future research. Conclusions: Renal artery denervation is a promising intervention to improve cardiac echocardiographic parameters in patients with resistant hypertension. The study provides evidence supporting the efficacy of RDN in reducing left ventricular mass and improving diastolic function, highlighting the need for larger and longer-term studies to confirm these results. The thesis cites an extensive list of studies and guidelines related to hypertension, echocardiography and renal denervation, providing a solid basis for the study conducted.
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    Opportunities of Amlodipine as a Potential Candidate in the Evaluation of Drug Compliance during Antihypertensive Therapy
    (2023-02-10) Kustovs, Dmitrijs; Urtāne, Inga; Sevostjanovs, Eduards; Moreino, Eva; Trušinskis, Kārlis; Department of Pharmaceutical Chemistry; Department of Internal Diseases
    Background and Objectives: Blood pressure measurement is essential evidence to establish that the chosen medicine and dosage are appropriate, and also indirectly indicates whether the medicine is being used at all. Therefore, current research compares adherence to the target blood pressure at home and in the hospital between different age groups, using similar combinations of the drugs prescribed by the doctor within ongoing antihypertensive therapy. Moreover, it is very important to develop a method for the determination of amlodipine and its metabolite, which would suitable for clinical applications, when the result is needed as quick as possible. Materials and Methods: This prospective study included patients aged ≥18 years who were diagnosed with hypertension. Subjects were divided into two age groups according to European Society of Cardiology (ESC) hypertension guidelines; older patients (≥65 years) and adult patients (
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