Results of adding metformin and orlistat to complex treatment of stable angina associated with metabolic syndrome

Abstract

Aim. To evaluate the complex therapy with the addition of metformin and orlistat in treatment of II-III functional class stable angina associated with metabolic syndrome. Methods. The study included 143 patients with stable angina at the age of 36 to 70 years (mean age 54.2±3.6). Of these, 59 patients (control group) received standard treatment (isosorbide 5-mononitrate 40 mg/day, amlodipine 5 mg/day, acetylsalicylic acid 100 mg/day, carvedilol 25 mg/day, atorvastatin 20 mg/day, eprosartan 600 mg/day), and 84 patients (study group) were additionally administered metformin 1000 mg/day and orlistat 360 mg/day. Clinical and laboratory examinations (serum glucose and lipid level measurements) as well as instrumental examinations (electrocardiography, Doppler echocardiography, 24-hour electrocardiography and blood pressure monitoring) were performed before the treatment, 3, 6 and 12 months after the treatment start. Results. After 12 months of treatment mean systolic blood pressure in patients of the main group reduced by 24.5%, diastolic - by 18.8%, fasting serum glucose level - by 14.3% compared to the baseline level. Cholesterol level reduced by 13.8%, triglycerides - by 14.7%, low density lipoproteins - by 14.0%, blood level of high density lipoproteins increased by 11.6%. Body weight index reduced by 10.3%. Conclusion. Adding of 1000 mg of metformin and 360 mg of orlistat daily decreased the fasting serum glucose level by 14.3%, body weight index by 10.3%, and reduced the number of angina episodes by 19.6%, of painless myocardial ischemia by 36.3%, as well as increased physical ability tolerance by 26.5%.