Abstract

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.

Highlights

  • Coronary artery disease (CAD) remains one of the leading causes of mortality and disability in Ukraine and abroad [1, 2]

  • The aim of the work was to evaluate the antianginal activity of meldonium in the complex therapy of patients with coronary artery disease with stable angina and concomitant arterial hypertension

  • The use of meldonium led to a decrease in the frequency of angina attacks and the need for nitroglycerin

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Summary

Introduction

Coronary artery disease (CAD) remains one of the leading causes of mortality and disability in Ukraine and abroad [1, 2]. The treatment of coronary artery disease often remains a difficult task, due to the limited capabilities of antianginal drugs and the presence of a number of contraindications for cardiac surgery. This is especially true for patients with concomitant hypertension, which significantly worsens the patient’s condition and increases the risk of complications. The pharmacokinetics of modern cytoprotectors are based on their ability to increase myocardial resistance to ischemia, to maintain the viability of ischemic tissues and to restore their functional activity [6]. One of them is (2019), «EUREKA: Health Sciences» Number 6 the stimulation of endothelial nitric oxide (NO) synthesis, which provides natural vasodilation and helps to reduce blood pressure [7, 8]

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