Changes in the Levels of Modern Biomarkers in Patients with Decompensated Heart Failure After Myocardial Infarction Under the Influence of Treatment with Succinic Acid and Arginine Preparations

Abstract

The prevalence of heart failure in Europe and worldwide is high. This syndrome is a common cause of hospitalization and has a significant impact on morbidity, mortality and healthcare costs in highly developed countries. The study of biomarkers in heart failure is of wide interest as they can improve diagnosis, predict the development of heart failure and its decompensation, and help in assessing treatment outcomes. 
 The objective of the research was to study the feasibility of using multiple biomarker strategy for diagnosing decompensated heart failure in the post-infarction period and to assess changes in these markers after treatment with succinic acid and arginine preparations.
 Materials and Methods. There were examined 120 patients with Q-QS wave and non-Q wave myocardial infarction complicated by decompensated heart failure. All the patients were divided into 2 groups (depending on Q-QS wave and non-Q wave myocardial infarction) and 4 subgroups (depending on rehabilitation therapy) being homogenous by age and gender.
 Results. When studying the dynamics of changes in blood level of N-terminal pro-B-type brain natriuretic peptide and ST2, there was observed its significant reduction in all the patients with prior Q-QS wave myocardial infarction complicated by decompensated heart failure after treatment. The most significant changes were observed in the patients of Group IV who, on the background of basic therapy, received succinic acid and arginine preparations according to the proposed scheme. The combined use of arginine preparations and succinic acid in combination therapy for decompensated heart failure secondary to prior Q-QS wave myocardial infarction allowed reducing blood levels of N-terminal pro-B-type brain natriuretic peptide under conditions of graded exercises. Similar tendencies were observed when determining this indicator in the patients with non-Q wave myocardial infarction complicated by decompensated heart failure after rehabilitation treatment. 
 Conclusions. The use of succinic acid and arginine preparations when treating the patients with prior Q-QS wave and non-Q wave myocardial infarction complicated by decompensated heart failure allowed us to significantly reduce the level of immunological enzymes such as N-terminal pro-B-type brain natriuretic peptide and ST2, which indicate the presence and development of decompensated heart failure after myocardial infarction.