[Cardioprotective capabilities of drug meldonium in secondary prevention after percutaneous coronary intervention in patients with documented myocardial ischemia].

The purpose of research ­ analysis of capabilities in cytoprotective drug mеldonium, in complex in the cardioprotective effect of secondary prevention after percutaneous coronary intervention (PCI). Patients with stable coronary heart disease (n=35 ) aged ≤65 years with incomplete revascularization at 6 months after PCI and positive exercise test (SFI) were randomized 1:1 to groups controlled physical training (CPT) with intensity 80% and a duration of 2 weeks (10 SFI): group 1 (n=17; 53,9±6,2 years) and group 2 (n=18; 56,1±4,8 years). Patients in Group 1, in addition to SFI mеldonium administered at a dose of 1000 mg/ml intravenously. In the 1st group on the background mеldonium adjunctive therapy showed a significant increase in the duration from 15±2 to 32±7 min for the 10th CPT (p<0.05). Index of maximum oxygen consumption after 10 intense CPT increased to 20.8±1.06 ml/kg/min compared to baseline (18.6±1.1 ml/kg/min, p<0.05) and the control group (18.5±1.5 ml/kg/min, p<0.05). Use of meldonium was also associated with decrease of maximum ST-segment depression (from -0.18±0.1 to 0.10±0.2 mV), increases of exercise duration (from 364±22 to 556±29 s) threshold heart rate (from 118±12 to 132±5 bpm), decrease of time of ST segment recovery to baseline (from 385±32 to 242±22 s, p<0.05). Final level of free fatty acids in the meldonium group was significantly lower than that in the control group (0.248±0.047 vs. 0.265±0.031 mg/dl). Inclusion of meldonium in complex treatment after PCI potentiates cardioprotective effect of intensive CPT as evidenced by the positive dynamics of ECG and biochemical markers of myocardial ischemia.

[Clinico-economic aspects of physical rehabilitation of patients with coronary heart disease after endovascular interventions].

Physical rehabilitation is an important component of cardiorehabilitation and secondary prophylaxis programs for patients with coronary heart disease (CHD) especially after endovascular interventions. Of special importance among a variety of rehabilitative technologies under current conditions of financial crisis are those ensuring high-quality and cost-effective medical aid The clinico-economic analysis of the programs of long-term physical training is presented with reference to their application for rehabilitation of patients with CHD after endovascular intervention. The use of this approach on an individual basis is believed to promote the introduction of physical training methods into clinical practice, rational planning of secondary prophylaxis programs and reduction of financial burden on public health services.

[Rehabilitative and prophylactic measures including physical training for the correction of risk factors in patients presenting with ischemic heart disease following percutaneous coronary interventions].

The authors report the results of analysis of effectiveness of active rehabilitative and prophylactic measures undertaken at the outpatient treatment stage including long-term controlled physical training of moderate intensity in patients presenting with coronary heart disease following percutaneous coronary interventions. The emphasis was laid on the possibility to prevent traditional risk factors of cardiovascular diseases. It was shown that the proposed approach allows a few risk factors (dyslipidemia, hypodynamia, arterial hypertension, smoking, and obesity) to be simultaneously corrected.