Česky
Do you have fresh data from the field to document the trend in patient growth? Is it possible to at least estimate how the number of patients at their workplace is evolving by type of disease, for example, over a five-year period?
Unfortunately, in the current health care system, there is no valid fresh data from the field on, for example, the increase in these patients. However, we are undoubtedly seeing an increase in the number of patients with chronic heart failure thanks to modern therapies, even in the field of cardiovascular disease. This disease is therefore often called the epidemic of the 21st century. These patients are also present in our region and constitute a significant and growing clientele requiring modern cardiological treatment (both pharmacological and non-pharmacological - e.g. by implanting ever-improving cardioverter devices).
What are the new developments in the treatment of the field in the region, e.g. what are the new tests and drugs in recent times? What new developments in diagnosis and treatment can be expected in about 2 years?
Undoubtedly, it is already well established comprehensive care (both diagnostics and treatment) for patients with acute coronary syndromes (acute heart attacks), starting with the crews of the Central Bohemian Rescue Service (properly staffed and technically equipped) with a direct link to the catheterization rooms of Prague cardiac centres.
As far as acute strokes are concerned, in addition to the so-called thrombolytic treatment (i.e. administration of a drug dissolving a blood clot in a cerebral artery), the so-called catheterisation thrombectomy with modern stent-retrievers is now being introduced in Prague University Hospitals thanks to the cooperation of cardiologists and neurologists (in principle, it is the removal of a blood clot in a cerebral artery, similar to the treatment of acute heart attacks). Thanks to the connection with these centres, patients from Central Bohemia can also benefit from this modern treatment. In the treatment of cardiac arrhythmias (heart rhythm disturbances) by pacing, in addition to catheterisation methods (so-called ablation), so-called lead-less pacemakers (i.e. the insertion of a small pacemaker via a vascular route directly into the heart, without the need to insert electrodes) are also being introduced (e.g. at the Na Homolka Cardiac Centre). So far, three patients of the Beroun internal medicine unit have tolerated this type of pacing very well. The future will show whether this method, which certainly has its limits, will have its further development.
I would also like to mention that, in accordance with the concept of cardiological care, a method of catheterisation valve implantation, called TAVI, is available for elderly patients with severe valve defects (aortic stenosis). This offers a different treatment option for patients who are not amenable to conventional cardiac surgery in the extracorporeal circulation.
What drugs in cardiology have now been approved in Europe and are awaiting reimbursement determination?
In drug therapy, we can expect especially more drugs for heart failure (e.g. many departments in the Central Bohemia region, including the Beroun hospital, have been participating in international studies on the treatment of this serious disease with new drugs for several years (e.g. Omecantiv mecarbil, Entresto, which is unfortunately economically demanding), or drugs to reduce blood fats. Currently, a biological treatment (monoclonal antibodies) for high blood fat levels (hyperlipoproteinaemia) is already available in Europe, but in our country it is not yet a drug (Repatha) covered by insurance companies.
By what percentage has the chance of survival of a person after a heart attack increased in the county in recent times?
Although the death rate from acute heart attacks has decreased significantly in recent years, according to various statistics, around 7%. Nevertheless, it is necessary to recall the great importance of preventive measures to prevent the development of atherosclerosis as the main cause of acute cardiovascular diseases. This means eliminating or at least reducing a number of risk factors for atherosclerosis, such as smoking, excess weight, high blood pressure, high levels of fats-cholesterol-in the blood, low physical activity, etc. Therefore, this issue is given great attention by professional medical societies, e.g. the Czech Cardiological Society, the Czech Society of Internal Medicine and others. However, it should be of particular interest to every one of our citizens. This is the only way to create the basic prerequisites not only for a longer life, but above all for a better quality of life.
