Outpatient monitoring of patients with stable coronary artery disease by a primary care physician. Guidelines

These guidelines describe the management of outpatient monitoring of patients with stable coronary artery disease by a general practitioner and include modern approaches to diagnosis — clinical and paraclinical methods — as well as treatment and prevention of complications.

These guidelines will enable physicians to make informed clinical decisions within outpatient monitoring for patients with stable coronary artery disease based on the related algorithm presented (examinations, consultations).

The guidelines are intended for general practitioners, family doctors, as well as for mid-level health providers working with the above-mentioned doctors, for paramedics performing the doctor functions regarding organizing and conducting outpatient follow-up. These guidelines can be used by healthcare executives, heads of primary care facilities, and their departments.

1. Drapkina OM, Kontsevaya AV, Kalinina AM, et al. Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines. Cardiovascular Therapy and Prevention. 2024;23(3):3996. (In Russ.) doi:10.15829/1728-8800-2024-3996.

2. Samorodskaya IV, Klyuchnikov IV, Shepel RN, et al. Regional variability of male and female mortality from three types of coronary artery disease: comparison of two periods 2017-2019 and 20202022. Cardiovascular Therapy and Prevention. 2024;23(4):3984. (In Russ.) doi:10.15829/1728-8800-2024-3984.

3. Drapkina OM, Kontsevaya AV, Kalinina AM, et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022;21(4):3235. (In Russ.) doi:10.15829/1728-8800-2022-3235.

4. Boytsov SA, Provatorov SI. Possibilities of dispensary observation in reducing mortality from coronary heart disease. Terapevticheskii arkhiv. 2023;95(1):5-10. (In Russ.) doi:10.26442/00403660.2023.01.202038.

5. Shepel RN, Samorodskaya IV, Kakorina EP, et al. Dynamics and structure of mortality from chronic coronary artery disease among men and women in the Russian Federation in 2014-2023. Russian Journal of Cardiology. 2024;29(12S):6198. (In Russ.) doi:10.15829/1560-4071-2024-6198.

6. Shepel RN, Samorodskaya IV, Kakorina EP, et al. Regional changes and variability of mortality rates from chronic ischemic heart disease in the Russian Federation in 2014-2023. Cardiovascular Therapy and Prevention. 2025;24(4):4366. (In Russ.) doi:10.15829/1728-8800-2025-4366.

7. Kotova EG, Kobyakova OS, Alexandrova GA, et al. Morbidity of the Entire Population of Russia in 2021: Statistical Materials. Moscow: Federal State Budgetary Institution "Central Research Institute for Epidemiology and Microbiology" of the Ministry of Health of the Russian Federation, 2022. 146 p. (In Russ.) КISBN: 978-5-94116-072-3. EDN: BVSZOD.

8. Vaisman DSh, Enina EN. Coronary artery disease mortality rates in the Russian Federation and a number of regions: dynamics and structure specifics. Cardiovascular Therapy and Prevention. 2024; 23(7):3975. (In Russ.) doi:15829/1728-8800-2024-3975. EDN: GRQJEM.

9. Barbarash OL, Karpov YuA, Panov AV, et al. 2024 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2024;29(9):6110. (In Russ.) doi:10.15829/1560-4071-2024-6110. EDN: HHJJUT.

10. Shepel RN, Ipatov PV, Drozdova LYu, et al. Algorithm of appointment (examination, consultation) of patients under follow-up care by a general practitioner. Cardiovascular Therapy and Prevention. 2025;24(3):4372. (In Russ.) doi:10.15829/1728-8800-2025-4372.

11. Kamkin EG, Karakulina EV, Bakulin PS, et al. Organization of registration for an appointment with a doctor, including through a single portal of state and municipal services and single regional call centers (third edition, revised and supplemented). Guidelines. Moscow, 2023, р. 65. (In Russ.) КISBN: 978-5-94116-135-5. EDN: AVCXUJ.

12. Gorbunov VM, Smirnova MI, Kurekhyan AS, et al. Evaluation of office and ambulatory blood pressure in the practice of a primary care physician. Guidelines. Cardiovascular Therapy and Prevention. 2023;22(7):3666. (In Russ.) doi:10.15829/1728-8800-2023-3666.

13. Drapkina OM, Boytsov SA, Golukhova EZ, et al. Outpatient followup of patients with atrial fibrillation and flutter by a primary care physician. Guidelines. Primary Health Care (Russian Federation). 2024;1(1):134-78. (In Russ.) Дdoi:10.15829/3034-4123-2024-24.

14. Drapkina OM, Shepel RN, Orlov SA, et al. Organization of primary health care using telemedicine technologies in a district hospital/ central district hospital. Methodological recommendations. M.: ROPNIZ, LLC "Silicea-Polygraph". 2023. 32 p. (In Russ.) doi:10.15829/ROPNIZ-d85-2023. EDN: DBMIOR.

15. Drapkina OM, Shepel RN, Orlov SA, et al. Organization of primary health care using telemedicine technologies in an outpatient clinic/office of a general practitioner (family doctor)/the center (department) of general medical practice (family medicine). Methodological recommendations. M.: ROPNIZ, LLC "SiliceaPolygraph". 2023. 32 p. (In Russ.) doi:10.15829/ROPNIZ-d84-2023. EDN: LDRQHG.

16. Drapkina OM, Shepel RH, Orlov SA, et al. Organization of primary health care using telemedicine technologies in a paramedicobstetric (paramedic) station. Methodological recommendations. Moscow: ROPNIZ, Silicea-Polygraph LLC. 2023. 32 p. (In Russ.) doi:10.15829/ROPNIZ-d83-2023. EDN: OCLUPE.

17. Drapkina OM, Boytsov SA, Kamkin EG, et al. "School" for patients with coronary artery disease and acute myocardial infarction. Guidelines. Primary Health Care (Russian Federation). 2026; 3(1S):6-24. (In Russ.) doi:10.15829/3034-4123-2025-106. EDN: QEIAAM.

18. Lukina YV, Kutishenko NP, Martsevich SY, et al. The questionnaire survey method in medicine on the example of treatment adherence scales. Rational Pharmacotherapy in Cardiology. 2020; 17(4):576-83. (In Russ.) doi:10.20996/1819-6446-2021-08-02.

19. Golukhova EZ, Golitsyn SP, Mikhailov EN, et al. 2025 Clinical practice guidelines for Atrial fibrillation and flutter. Russian Journal of Cardiology. 2025;30(11):6668. (In Russ.) doi:10.15829/1560-4071-2025-6668. EDN: MGXGON.

20. Drapkina OM, Demko VV, Kalinina AM, Shepel RN. Preventive counseling of patients with risk factors for noncommunicable diseases in clinical practice. Analytical review. Cardiovascular Therapy and Prevention. 2024;23(12):4154. (In Russ.) doi:10.15829/1728-8800-2024-4154.

21. Drapkina OM, Drozdova LYu, Ipatov PV, et al. Follow-up monitoring of second health status group persons with high and very high cardiovascular risk. Guidelines. Cardiovascular Therapy and Prevention. 2024;23(6):4076. (In Russ.) doi:10.15829/1728-8800-2024-4076. EDN: WNZCUQ.

22. Drapkina OM, Drozdova LYu, Kontsevaya AV, et al. Providing medical care to patients with risk factors for chronic non-communicable diseases in adult health centers. Guidelines. Moscow: ROPNIZ, SILITSEYA-POLIGRAF LLC 2025. 164 p. (In Russ.) doi:10.15829/ROPNIZ-d108-2025. EDN: HKMNQW.

23. Drapkina OM, Drozdova LYu, Kalinina AM, et al. Organization of Preventive Medical Examinations and Dispensary Examinations of Certain Groups of the Adult Population. Guidelines, 2nd Edition. Moscow: Federal State Budgetary Institution "National Medical Research Center for Preventive Medicine" of the Ministry of Health of the Russian Federation, 2020. 232 p. (In Russ.) ISBN: 978-5-6043991-1-8. EDN: QWHFZK.

24. Dezhurny LI, Shoigu YuS, Neudakhin GV, et al. First Aid: A Training Manual for Persons Providing First Aid in Accordance with the Procedure for Providing First Aid. Moscow: N. I. Pirogov National Medical and Surgical Center of the Russian Ministry of Health, 2025. 118 p. (In Russ.)

25. Ipatov PV, Boytsov SA. First Aid in Acute Coronary Syndrome as a Priority Direction for Reducing Mortality from Acute Forms of Ischemic Heart Disease. Current Issues in Heart and Vascular Diseases. 2009;2:41-59. (In Russ.) EDN: SCITHZ.

26. Drapkina OM, Briko NI, Namazova-Baranova LS, et al. Immunoprophylaxis. Guidelines (second edition). Primary Health Care (Russian Federation). 2025;2(3):135-262. (In Russ.) doi:10.15829/3034-4123-2025-76. EDN: DBKJIQ.

27. Avdeev SN, Alyeva MH, Baranov AA, et al. Federal Clinical Guidelines on Vaccination of pneumococcal infection in children and adults. Russian Journal of Preventive Medicine. 2023;26(92):3-23. (In Russ.) doi:10.17116/profmed2023260923.

28. Kobalava ZhD, Konradi AO, Nedogoda SV, et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117. (In Russ.) doi:10.15829/1560-4071-2024-6117. EDN: GUEWLU.

29. Drapkina OM, Boytsov SA. Ershova AI, et al. Outpatient monitoring of patients with lipoprotein metabolism disorders and other lipidemias by a general practitioner in primary care. Guidelines. Cardiovascular Therapy and Prevention. 2024;23(12):4285. (In Russ.) doi:10.15829/1728-8800-2024-4285.