Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector10889910.17816/0869-2106-2021-27-6-571-587ReviewsНаучные обзорыReview ArticleCardiac rehabilitation and secondary prevention after acute myocardial infarction: a modern view on the problemКардиореабилитация и вторичная профилактика после перенесенного острого инфаркта миокарда: современный взгляд на проблемуhttps://orcid.org/0000-0001-9611-5096SayutinaElena V.СаютинаЕлена Витальевна
Russian Federation

MD, Cand. Sci. (Med.), assistant lecturer

к.м.н., ассистент

sayutina_e_v@staff.sechenov.ruhttps://orcid.org/0000-0003-0485-6802OsadchukMikhail A.ОсадчукМихаил Алексеевич
Russian Federation

MD, Dr. Sci. (Med.), рrofessor

д.м.н., профессор

osadchuk.mikhail@yandex.ruhttps://orcid.org/0000-0001-5429-9528RomanovBoris K.РомановБорис Константинович
Russian Federation

MD, Dr. Sci. (Med.), assistant professor

д.м.н., доцент

bkr@yandex.ruhttps://orcid.org/0000-0002-6542-2277TuaevaElena M.ТуаеваЕлена Михайловна
Russian Federation

MD, Cand. Sci. (Med.), assistant lecturer

к.м.н., ассистент

lenatuaeva@yandex.ruhttps://orcid.org/0000-0003-4689-2844ButorovaLudmila I.БутороваЛюдмила Ивановна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

ludmilabutorova@mail.ruhttps://orcid.org/0000-0002-1500-4974DibirovaGyulnara O.ДибироваГюльнара Омарбековна
Russian Federation

MD, Cand. Sci. (Med.), assistant professor

к.м.н., доцент

g.dibirova@mail.ruhttps://orcid.org/0000-0002-3467-886XKireevaNatalya V.КирееваНаталья Викторовна
Russian Federation

MD, Cand. Sci. (Med.), assistant professor

к.м.н., доцент

kireeva_nat@inbox.ruhttps://orcid.org/0000-0003-1702-7923KorzhenkovNikolay P.КорженковНиколай Петрович
Russian Federation

MD, Cand. Sci. (Med.), assistant lecturer

к.м.н., ассистент

korzhenkof@mail.ruI.M. Sechenov First Moscow State Medical UniversityПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)Pirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаS.M. Kirov Military Medical Academy (Branch)Военно-медицинская академия имени С.М. Кирова (филиал)190720222765715872106202222062022Copyright ©; 2022, Sayutina E.V., Osadchuk M.A., Romanov B.K., Tuaeva E.M., Butorova L.I., Dibirova G.O., Kireeva N.V., Korzhenkov N.P.Copyright ©; 2022, Саютина Е.В., Осадчук М.А., Романов Б.К., Туаева Е.М., Буторова Л.И., Дибирова Г.О., Киреева Н.В., Корженков Н.П.2022Sayutina E.V., Osadchuk M.A., Romanov B.K., Tuaeva E.M., Butorova L.I., Dibirova G.O., Kireeva N.V., Korzhenkov N.P.Саютина Е.В., Осадчук М.А., Романов Б.К., Туаева Е.М., Буторова Л.И., Дибирова Г.О., Киреева Н.В., Корженков Н.П.https://creativecommons.org/licenses/by-nc-nd/4.0/https://medjrf.com/0869-2106/article/view/108899

Cardiovascular diseases remain a heavy socioeconomic burden in the modern world, claiming up to four million lives annually, including one million of the Russian population. Most often, cardiovascular mortality is associated with chronic coronary heart disease and its complications. Despite the progress in the treatment of acute coronary syndrome in the acute disease phase, the problem of recurrent coronary events and associated adequate rehabilitation remains unresolved. Modern Russian and European recommendations for cardiovascular rehabilitation present the main directions of secondary prevention of myocardial infarction, which summarize the global and Russian evidence-based medicine data on the problem and are based on the principles of phasing, continuity, succession, and multidisciplinary approach to the patient management. This review focuses on the problems and shortcomings of secondary prevention and cardiac rehabilitation at the patient, doctor, and healthcare system levels. In addition, contemporary approaches to their elimination are described. The necessity and importance of individual training and informing patients and the formation of their sustainable commitment to a healthy lifestyle and therapeutic and preventive measures prescribed by modern guidelines on this issue are emphasized.

Сердечно-сосудистые заболевания остаются тяжелым социально-экономическим бременем в современном мире, унося ежегодно до 4 млн жизней, 1 млн из которых приходится на российскую популяцию. Наиболее часто сердечно-сосудистая смертность связана с хронической ишемической болезнью сердца и ее осложнениями. Несмотря на достигнутые успехи в лечении острого коронарного синдрома в острую фазу заболевания, проблема повторных коронарных событий и связанной с этим адекватной реабилитацией остается нерешенной до конца. В современных отечественных и европейских рекомендациях по кардиоваскулярной реабилитации представлены основные направления вторичной профилактики инфаркта миокарда, которые обобщают мировые и отечественные данные доказательной медицины по проблеме и базируются на принципах этапности, непрерывности, преемственности, мультидисциплинарного подхода к ведению пациента. Большое внимание в настоящем обзоре уделено проблемам и недостаткам вторичной профилактики и кардиореабилитации на уровне пациента, врача и системы здравоохранения, а также описаны современные подходы к их устранению. Подчеркнута необходимость и важность индивидуального обучения и информирования пациентов, формирования у них устойчивой приверженности к здоровому образу жизни и лечебно-профилактическим мероприятиям, предписанным современными руководствами по данной проблематике.

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