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THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA

Year 2018, Volume: 5 Issue: 3, 58 - 63, 01.10.2018

Abstract

Aims: The objective of our study is to investigate the antianginal activity of meldonium and its influence on the hemodynamics and clinical parameters in patients with stable angina who fall under III-IV functional classes according to the classification of the Canadian Heart Association.

Methods:The study was carried out including 105 patients with stable angina pectoris who were in III-IV functional classes at the age of 42-72 years. The first group (n=52) was administered the standard treatment (beta-blockers, aspirin, atorvastatin). The second group of patients (n=53) were given a combination of basic therapy along with meldonium 10% solution of 5 ml intravenously for 10 days then 1000 mg per day orally for 10-12 weeks. Suitable healthy people were selected as the control group (n=36).

Results: Patients with stable angina pectoris were characterized with the reduction of workload, double work, time loading on bicycle ergometer, increased specific and total peripheral vascular resistance, increased central sympathetic activity on heart, decreased vagal and humoral activity on heart rate. The analysis of the data indicated a decrease in the frequency of anginal attacks after treatment in the first group by 45% and reduced daily nitroglycerin requirement by 48%. Combination therapy resulted in a decrease of the parameters by 71.8% and 76%, respectively.

Conclusion: After the treatment in both groups, we detected an improvement in physical exertion tolerance, reduction in total peripheral vascular resistance and sympathetic activity of the heart. Combination therapy with meldonium significantly reduced the central smypathetic activity and peripheral vascular resistance, also increased the workload, run time compared to the basic therapy.

References

  • 1. World Health Organization. Cardiovascular diseases (CVDs). Available from URL:http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (17/05/2017).
  • 2. Centre for disease control. National Center for Health Statistics. National Health Interview Survey, 2016. (cited 2018 Sep 21). Available from URL: https://www.cdc.gov/nchs/nhis/shs/tables.htm.
  • 3. Dzerve V, Matisone D, Pozdnyakov Y et al. Mildronate improves the exercise tolerance in patients with stable angina: results of a long term clinical trial. Seminars in Cardiovascular Medicine 2010;16:3.
  • 4. Liepinsh E, Makarova E, Sevostjanovs E et al. Carnitine and γ‐butyrobetaine stimulate elimination of meldonium due to competition for octn2‐mediated transport. Basic Clin Pharmacol Toxicol 2017;120(5):450-6.
  • 5. Lindquist C, Bjørndal B, Rossmann CR et al. A fatty acid analogue targeting mitochondria exerts a plasma triacylglycerol lowering effect in rats with impaired carnitine biosynthesis. PLoS ONE 2018;13(3):1-16.
  • 6. Dzerve V, MILSS I Study Group. A dose-dependent improvement in exercise tolerance in patients with stable angina treated with mildronate: a clinical trial “MILSS I”. Medicina (Kaunas) 2011;47(10):544-51.
  • 7. Zhernakova NI, Olesya V, Romaschenko et al. The importance of the smoking factor in personalized complex pharmaco- therapy of ischemic heart disease with the use of metabolic correctors. International Journal of Advanced Biotechnology and Research 2018;9(1):1016-21.
  • 8. Canadian Cardiovascular Society. “Canadian Cardiovascular Society grading of angina pectoris”. (cited 2018 Sep 25). Available from URL: http://www.ccs.ca/images/Guidelines/Guidelines_POS_Library/Ang_Gui_1976.pdf.
  • 9. Electrocardiographic complex CARDIOLABS. (cited 2018 Sep 25). Available from URL: http://xai-medica.com/cardiolab+/.
  • 10.Veloergometer SECA CARDIOTEST. (cited 2018 Sep 24). Available from URL: http://www.esus.ru/php/content.php?id=3134.
  • 11. Danilenko LM, Klochkova GN, Kizilova IV et al. Metabolic cardioprotection: new concepts in implementation of cardioprotective effects of meldonium. Research result 2016;2(3):95-100.
  • 12. Zhu Y, Zhang G, Zhao J et al. Efficacy and safety of mildronate for acute ischemic stroke: a randomized, double-blind, active-controlled phase II multicenter trial. Clin Drug Investig 2013;33:755.
  • 13. Sakharchuk II, Denisenko GT, Grushko VS et al. The use of mildronat in heart failure in patients with chronic ischemic heart disease. Vrach Delo 1989;9:21-3.
  • 14.Dudko VA, Koshel’skaia OA, Sokolov AA. The use of mildronat with stenocardia patients. Vrach Delo 1989;10:64-7.
  • 15.Ol’binskaia LI, Golokolenova GM. Use of mildronate in cardiac insufficiency in patients with ischemic heart disease. Klin Med (Mosk) 1990;68:39-42.
  • 16.Karpov RS, Dudko VA, Shipulin VM et al. The clinical instrumental evaluation of treatment efficacy in patients with concomitant atherosclerosis of the coronary, cerebral and peripheral arteries. Ter Arkh 1991;63:90-3.
  • 17.Teplyakov AT, Sankevitch TV, Stepatcheva TA et al. The use of fatty acid beta- oxidation inhibitor mildronate as monotherapy or incombination with atenolol in patients with left ventricular dysfunction after myocardial infarction. Kardiologiia 2003;43:15-8.
  • 18.Enina G, Timofeeva T, Egere D et al. Medicinal effects and indications to mildronate application in neuro angiologic practice. Experimental and Clinical Pharmacotherapy 1991;19:164-71.
Year 2018, Volume: 5 Issue: 3, 58 - 63, 01.10.2018

Abstract

References

  • 1. World Health Organization. Cardiovascular diseases (CVDs). Available from URL:http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (17/05/2017).
  • 2. Centre for disease control. National Center for Health Statistics. National Health Interview Survey, 2016. (cited 2018 Sep 21). Available from URL: https://www.cdc.gov/nchs/nhis/shs/tables.htm.
  • 3. Dzerve V, Matisone D, Pozdnyakov Y et al. Mildronate improves the exercise tolerance in patients with stable angina: results of a long term clinical trial. Seminars in Cardiovascular Medicine 2010;16:3.
  • 4. Liepinsh E, Makarova E, Sevostjanovs E et al. Carnitine and γ‐butyrobetaine stimulate elimination of meldonium due to competition for octn2‐mediated transport. Basic Clin Pharmacol Toxicol 2017;120(5):450-6.
  • 5. Lindquist C, Bjørndal B, Rossmann CR et al. A fatty acid analogue targeting mitochondria exerts a plasma triacylglycerol lowering effect in rats with impaired carnitine biosynthesis. PLoS ONE 2018;13(3):1-16.
  • 6. Dzerve V, MILSS I Study Group. A dose-dependent improvement in exercise tolerance in patients with stable angina treated with mildronate: a clinical trial “MILSS I”. Medicina (Kaunas) 2011;47(10):544-51.
  • 7. Zhernakova NI, Olesya V, Romaschenko et al. The importance of the smoking factor in personalized complex pharmaco- therapy of ischemic heart disease with the use of metabolic correctors. International Journal of Advanced Biotechnology and Research 2018;9(1):1016-21.
  • 8. Canadian Cardiovascular Society. “Canadian Cardiovascular Society grading of angina pectoris”. (cited 2018 Sep 25). Available from URL: http://www.ccs.ca/images/Guidelines/Guidelines_POS_Library/Ang_Gui_1976.pdf.
  • 9. Electrocardiographic complex CARDIOLABS. (cited 2018 Sep 25). Available from URL: http://xai-medica.com/cardiolab+/.
  • 10.Veloergometer SECA CARDIOTEST. (cited 2018 Sep 24). Available from URL: http://www.esus.ru/php/content.php?id=3134.
  • 11. Danilenko LM, Klochkova GN, Kizilova IV et al. Metabolic cardioprotection: new concepts in implementation of cardioprotective effects of meldonium. Research result 2016;2(3):95-100.
  • 12. Zhu Y, Zhang G, Zhao J et al. Efficacy and safety of mildronate for acute ischemic stroke: a randomized, double-blind, active-controlled phase II multicenter trial. Clin Drug Investig 2013;33:755.
  • 13. Sakharchuk II, Denisenko GT, Grushko VS et al. The use of mildronat in heart failure in patients with chronic ischemic heart disease. Vrach Delo 1989;9:21-3.
  • 14.Dudko VA, Koshel’skaia OA, Sokolov AA. The use of mildronat with stenocardia patients. Vrach Delo 1989;10:64-7.
  • 15.Ol’binskaia LI, Golokolenova GM. Use of mildronate in cardiac insufficiency in patients with ischemic heart disease. Klin Med (Mosk) 1990;68:39-42.
  • 16.Karpov RS, Dudko VA, Shipulin VM et al. The clinical instrumental evaluation of treatment efficacy in patients with concomitant atherosclerosis of the coronary, cerebral and peripheral arteries. Ter Arkh 1991;63:90-3.
  • 17.Teplyakov AT, Sankevitch TV, Stepatcheva TA et al. The use of fatty acid beta- oxidation inhibitor mildronate as monotherapy or incombination with atenolol in patients with left ventricular dysfunction after myocardial infarction. Kardiologiia 2003;43:15-8.
  • 18.Enina G, Timofeeva T, Egere D et al. Medicinal effects and indications to mildronate application in neuro angiologic practice. Experimental and Clinical Pharmacotherapy 1991;19:164-71.
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Varahabhatla Vamsi This is me

Maganty Virajitha This is me

Lihasenko Ivetta This is me

Publication Date October 1, 2018
Submission Date September 18, 2018
Published in Issue Year 2018 Volume: 5 Issue: 3

Cite

APA Vamsi, V., Virajitha, M., & Ivetta, L. (2018). THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA. Turkish Medical Student Journal, 5(3), 58-63.
AMA Vamsi V, Virajitha M, Ivetta L. THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA. TMSJ. October 2018;5(3):58-63.
Chicago Vamsi, Varahabhatla, Maganty Virajitha, and Lihasenko Ivetta. “THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA”. Turkish Medical Student Journal 5, no. 3 (October 2018): 58-63.
EndNote Vamsi V, Virajitha M, Ivetta L (October 1, 2018) THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA. Turkish Medical Student Journal 5 3 58–63.
IEEE V. Vamsi, M. Virajitha, and L. Ivetta, “THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA”, TMSJ, vol. 5, no. 3, pp. 58–63, 2018.
ISNAD Vamsi, Varahabhatla et al. “THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA”. Turkish Medical Student Journal 5/3 (October 2018), 58-63.
JAMA Vamsi V, Virajitha M, Ivetta L. THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA. TMSJ. 2018;5:58–63.
MLA Vamsi, Varahabhatla et al. “THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA”. Turkish Medical Student Journal, vol. 5, no. 3, 2018, pp. 58-63.
Vancouver Vamsi V, Virajitha M, Ivetta L. THE INFLUENCE OF METABOLIC THERAPY ON CLINICAL AND HEMODYNAMIC PARAMETERS IN PATIENTS WITH STABLE ANGINA. TMSJ. 2018;5(3):58-63.