Combined cardioprotection in patients with high cardiovascular risk

Sizova Zh.M.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Skotnikov A.S.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Knyazeva S.A.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Rozhnova O.G.

Comorbidities research center «Rational medicine» Moscow, Russia

Hamurzova M.A.

Municipal polyclinic №6 branch №2 of the Healthcare Department of Moscow, Moscow, Russia

Combined cardioprotection in patients with high cardiovascular risk

Authors:

Sizova Zh.M., Skotnikov A.S., Knyazeva S.A., Rozhnova O.G., Hamurzova M.A.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2017;10(3): 23‑30

DOI: 10.17116/kardio201710323-30

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Sizova ZhM, Skotnikov AS, Knyazeva SA, Rozhnova OG, Hamurzova MA. Combined cardioprotection in patients with high cardiovascular risk. Russian Journal of Cardiology and Cardiovascular Surgery. 2017;10(3):23‑30. (In Russ.)
https://doi.org/10.17116/kardio201710323-30

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Aim — to determine role of the early appointment of combined cardioprotection on the quality of life and the prognosis of patients after ACS. Tasks — to study the practice of routine use of cardioprotectors in patients after ACS, appointed in the framework of complex therapy of coronary heart disease for the purpose of preventing attacks of angina pectoris; to evaluate the effectiveness of early use of combined cardioprotection for slowing the progression of coronary heart disease and chronic heart failure (CHF); to determine the safety of combined cardioprotection in outpatient settings. Material and metods. The authors observed patients (n=482) with a verified diagnosis of coronary heart disease, not less than 30 days and no more than 90 days ago after ACS with ST segment elevation (n=174) or without it (n=308) with outcome in unstable angina or myocardial infarction; without an anamnesis of post infarction angina and other complications of the post infarction period. Subgroup «A» (n=97) (monotherapy with trimetazidine), subgroup «B» (n=98) (combination of trimetazidine and meldonium) and subgroup «C» (n=74) (combination of trimetazidine and succinate) are further distinguished. Once every 3 months, within 1 year, clinical parameters were evaluated (death from all causes, recurrence of ACS, call for emergency medical care, emergency and planned hospitalization for decompensation of cardiovascular pathology, as well as the number of attacks of angina and its equivalents per week, the cardiac frequency, the level of systolic (SBP) and diastolic (DBP) blood pressure, the presence of signs of heart failure, the need for nitrates). Results. Over 360 days of outpatient observation, the majority of monitored parameters underwent change in the compared groups. None of the observed groups/subgroups of deaths (from any cause) were recorded. Combined cardioprotection with trimetazidine and meldonium during the first year after ACS is more effective than monotherapy with trimetazidine and than combinations of trimetazidine and succinate: with regard to the resumption of angina pectoris by 9.3 (p<0.05) and by 8.0% (p<0.05) respectively; to the number of attacks of angina and its equivalents in the week by 46.9 (p<0.05) and by 34.6% (p<0.05) respectively; with respect to the average amount of nitroglycerin by 34.1 (p<0.05) and by 17.1% (p<0.05) respectively; of development of paroxysms of atrial fibrillation by 21.7 (p<0.05) and 1.3% (p>0.05) respectively; of CHF progression by 3.2 (p>0.05) and by 1.7% (p>0.05) respectively; to the number of hospitalizations for decompensation of cardiovascular pathology by 6.2 (p<0.05) and by 5.4% (p<0.05) respectively; for new cases of ACS by 2.0 (p>0.05) and by 0.3% (p>0.05) respectively.

Keywords:

combined cardioprotection

acute coronary syndrome in the past

ischemic heart disease

comorbidity

meldonium

idrinol

Authors:

Sizova Zh.M.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Skotnikov A.S.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Knyazeva S.A.

I.M. Sechenov First Moscow state medical university, Institute of postgraduate professional education, Department of medical and social expertise, emergency and polyclinic therapy, Moscow, Russia

Rozhnova O.G.

Comorbidities research center «Rational medicine» Moscow, Russia

Hamurzova M.A.

Municipal polyclinic №6 branch №2 of the Healthcare Department of Moscow, Moscow, Russia

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