USE OF MELDONIUM IN THE TREATMENT OF PATIENTS WITH CORONARY ARTERY DISEASE AND CONCOMITANT ARTERIAL HYPERTENSION
Coronary artery disease (CAD) remains one of the leading causes of mortality and disability in Ukraine. Arterial hypertension (AH) is one of the most common diseases and a leading risk factor for coronary artery disease.
The aim of the work is to evaluate the antianginal activity of meldonium in the complex therapy in patients with CAD with stable angina and concomitant AH.
Materials and methods. The study included 82 patients with CAD, stable angina pectoris II–III functional class, including 52 patients with concomitant AH stage II. The patients were divided into 2 groups. Patients in group 1 were prescribed meldonium at a dose of 750 mg/d for 2 months in addition to basic therapy for the underlying disease. Patients in group 2 continued basic antianginal, disaggregant, hypolipidemic therapy.
Results. The use of meldonium led to a decrease in the frequency of angina attacks and the need for nitroglycerin. From the 1st month of therapy and up to 2 months treatment decreased it consumption by 63 and 82.3 % respectively. Adding meldonium to basic therapy led to a likely reduction in shortness of breath, episodes of palpitations, tinnitus, and headache. In all patients, after the treatment, an increase in exercise tolerance was observed, which was more pronounced in the group where patients were receiving meldonium. In the group of patients receiving meldonium, normalisation of blood pressure was faster and more pronounced.
Conclusions. Meldonium has antianginal activity, which is manifested by an increase in the physical tolerance of patients, a decrease in the frequency of angina attacks, the need for sublingual nitroglycerin intake and improvement in the well-being of patients. Additional use of meldonium promotes faster and better normalization of blood pressure. The use of meldonium in the complex therapy of patients with stable angina and concomitant AH allows to increase the effectiveness of traditional antianginal therapy and to improve the quality of life of such patients.
Anikeeva, T. V. (2012). Coronary artery lesions in patients with extracardial atherosclerosis. Issues of experimental and clinical medicine, 16, 21–24.
Shalnova, S. A., Oganov, R. G., Deev, A. D., Imaeva, A. E., Lukyanov, М. М., Artamonova, G. V. et. al. (2015). Comorbidities of ischemic heart disease with other non-communicable diseases in adult population: age and risk factors association. Cardiovascular Therapy and Prevention, 14 (4), 44. doi: http://doi.org/10.15829/1728-8800-2015-4-44-51
Shalnova, S. A., Oganov, R. G., Steg, F. G., Ford, J. (2013). Ischemic heart disease. Modern reality by data of World Register CLARIFY. Cardiology, 53, 28–33.
Gorbas, I. M. (2011). The program of response and use of arterial hypertension in Ukraine: results of research. Health of Ukraine, 3, 32–34.
Gorbas, I. M., Smirnova, O. O., Kvasha, I. P., Dear, A. P. (2010). Evaluation of the effectiveness of the "Program for the prevention and treatment of hypertension in Ukraine" according to epidemiological studies. Arterial Hypertension, 6, 51–82.
Mikhin, V. P., Tyurikov, P. Y. (2016). Anti-ischemic and antioxidant activity of meldonium in ihd patients with stable angina. Medical Council, 13, 56–60. doi: http://doi.org/10.21518/2079-701x-2016-13-56-60
Gordeev, I. G., Lusov, V. A., Bekchiu, E. A., Volov, N. A., Ilina, E. E., Lebedeva, A. Y. (2006). Myocardial cytoprotection and ischemic myocardial dysfunction correction in stable angina patients after transluminal balloon angioplasty or coronary artery stenting. Russian Journal of Cardiology, 1, 33–39.
Netyazhenko, V. Z. (2007). Treatment of stable angina in accordance with the recommendations of the European Society of Cardiologists. Changes and current provisions. Medicine and pharmacy news, 11 (217), 14–17.
Mkrtchyan, V. R. (2008). Tactics of the use of means that improve the energy metabolism of the myocardium: training allowance. 20.
Mildronate (MET-88) – Antianginal, Cardioprotectant (2001). Drugs Fut, 26 (1), 82–86.
Calvinsh, I. Y. (2002). Mildronate and trimethazidine: similarity and difference in their action. Terra medica nova, 3, 3–15.
Khlebodarov, F. E., Turikov P.Y., Mikhin, V. P. (2009). Endothelial dysfunction and its correction wit cytoprotectors in patients with stable effort angina and arterial hypertension. Russian Journal of Cardiology, 6, 34–39.
Vasquez Abanto, H. E. (2015). Hypertension: familiar concepts, new perspectives. Medicine and pharmacy news, 541, 11–18.
Vizir, V. A., Goncharov, O. V. (2008). Activity of inflammatory processes in patients with hypertension. Ukrainian Medical Almanac, 1, 68–70.
Golyachenko, O. M. (2011). Demographic processes in Ukraine in the years of independence. Bulletin of scientific research, 4, 38–41.
Inglis, S., Stewart, S. (2006). Metabolic Therapeutics in Angina Pectoris: History Revisited with Perhexiline. European Journal of Cardiovascular Nursing, 5 (2), 175–184. doi: http://doi.org/10.1016/j.ejcnurse.2006.01.001
Dzerve, V., Matisone, D., Kukulis, I. et. al. (2005). Mildronate improves peripheral circulation in patients with chronic heart failure: results of clinical trial (the first report). Sem. Сardiol., 11 (2), 56–64.
Vilskersts, R., Liepinsh, E., Kuka, J., Cirule, H., Veveris, M., Kalvinsh, I., Dambrova, M. (2009). Myocardial Infarct Size-Limiting and Anti-Arrhythmic Effects of Mildronate Orotate in the Rat Heart. Cardiovascular Drugs and Therapy, 23 (4), 281–288. doi: http://doi.org/10.1007/s10557-009-6179-2
Neri, M., Fineschi, V., Paolo, M., Pomara, C., Riezzo, I., Turillazzi, E., Cerretani, D. (2015). Cardiac Oxidative Stress and Inflammatory Cytokines Response after Myocardial Infarction. Current Vascular Pharmacology, 13 (1), 26–36. doi: http://doi.org/10.2174/15701611113119990003
Statsenko, M. (2017). Efficacy of Short-Term Therapy With Meldonium in Patients With Chronic Heart Failure of Ischemic Etiology and Type 2 Diabetes Mellitus. Kardiologiia, 57 (4), 58–63.
Copyright (c) 2019 Denys Volynskyi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.