[Pleotropic Effects of Atorvastatin in Patients With Chronic Ischemic Heart Disease].

Examined 52 patients with a diagnosis Ischemic heart disease: stable angina II-III FC CHF I-IIA stage, in combination with hypercholesterolemia aged 53-65 years (58,2+/-6,5), receiving together with traditional antianginal therapy generic atorvastatin Torvakard in the dose of 10 mg/day (20 people) with the level of total cholesterol from 5.0 to 6.50 mmol/l, patients with cholesterol levels from is 6.51 to 8.0 mmol/l was taking Torvakard 20 mg/day (32 person). As a result of 3 months therapy with low doses of Torvakarda decreased level of CRP, endothelin-1, IMT, improving the parameters of endothelium-dependent vasodilation, which shows the positive impact of the drug on morphological and functional parameters of the vascular wall.

[Cytoprotection in Cardiology: Achievements and Prospects].

Currently, pharmacotherapy of coronary heart disease, based on antianginal drugs directly improve coronary blood flow, antiplatelet, and lipid-lowering drugs, includes a new class of drugs - cardiocytoprotectors. Recent ischemic cardiomyocytes improve security in the ATP, by optimizing the energy metabolism by reducing the need for oxygen cardiomyocytes and has an antioxidant effect, protecting cellular structures and enzymes from oxidative stress accompanying hypoxia.

[Optimization of anticoagulation therapy for venous thromboembolism]. / Optimizatsiia antikoaguliantnoi terapii venoznogo tromboémbolizma.

OBJECTIVE: To optimize anticoagulation therapy for venous thromboembolism by means of dabigatran etexilate. MATERIAL AND METHODS: From 2006 to 2012, within the framework of the international trials RE-COVER and RE-COVER II aimed at evaluating efficacy and safety of dabigatran etexilate compared to warfarin, a total of 95 patients meeting the inclusion and exclusion criteria were enrolled in our study. As part of the RE-COVER trial, we carried out analysis of comprehensive examination and treatment of 55 patients with venous thromboembolism (VTE), who were randomly divided into two groups. Group I (Control Group) consisted of 30 patients receiving initial therapy with heparin for seven days followed by taking warfarin for six months. Group II (Study Group) comprised 25 patients taking dabigatran etexilate instead of warfarin. RESULTS: There were no cases of recurrent VTE in the Control Group, and one (4%) patient of the Study Group was found to have a relapse of the disease owing to resistance to anticoagulation therapy and congenital thrombophilia. Undesirable events of anticoagulation therapy developed in 20% of the Control Group patients an in 16% of the Study Group patients. In two Control Group patients and one Study Group patient anticoagulation therapy was discontinued due to the development of complications. After 2 years, 36.7% of the Control Group patients and 40% of the Study Group patients had no manifestations of chronic venous insufficiency (CVI). The degree of CVI was similar in the both groups. CONCLUSION: Dabigatran proved non-inferior to warfarin regarding efficacy, possessing, however, a series of advantages: it has a predictable anticoagulant effect, requires neither monitoring of the haemostasis system, nor dose adjustment, and is administered at standard dosages.

[Efficiency of meldonium in the complex therapy of acute coronary syndrome].

We examined 140 patients (mean age 54.8±3.1 years) with ST elevation acute coronary syndrome resulting in Q-wave myocardial infarction of the left ventricle. From the first hours complex therapy of these patients comprised meldonium (1 g/day intravenously for 2 weeks then orally until 1.5 months). Therapy with meldonium accelerated restoration of left ventricular diastolic function what was in agreement with lowering of NT-proBNT concentration in blood. It was established that administration of meldonium led to reduction of number of high grade ventricular extrasystoles during first 6 hours after thrombolysis, to lowering of blood concentration of lipoperoxide degradation products. Early use of meldonium decreases probability of emergence of fatal arrhythmias and improves prognosis of hospital stage of rehabilitation of patients with acute coronary syndrome resulting in Q-wave myocardial infarction.

[Application of coenzyme Q(10) in combination therapy of arterial hypertension].

We studied effect of coenzyme Q(10) on 24-hour blood pressure profile and function of vascular endothelium in patients with essential hypertension. Coenzyme Q(10) was used as a component of combination therapy comprising angiotensin converting enzyme inhibitor enalapril. Administration of coenzyme Q(10) in combination with traditional antihypertensive therapy promoted normalization of vascular endothelial function and more effective correction of 24-hour blood pressure profile. These findings allow to consider the use of coenzyme Q(10) as promising component of combination therapy of arterial hypertension.

[Efficiency of combined therapy with myocardial cytoprotector mexicor in hypertensive patients with acute cerebrovascular disturbances].

Sixty hypertensive patients (mean age 64.9 +/- 1.5) with acute ischemic stroke were randomized into 2 groups. Both groups received conventional therapy (Aspirin Cardio, Trental, Prestarium, Arifon), which in the test group was added by Mexicor (0.3 gper day for 3 weeks). Circadian blood pressure (BP) and its variability were monitored in all patients at 1, 5, 10, 14, and 21 days after the stroke. NIH Stroke Scale, the Barthel ADL Index, Rankin Scale, Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) were used for the neurological status assessment. Mexicor was shown to accelerate the systolic and diastolic BP lowering, reduction of BP variability (mainly nocturnal) and improvement of circadian BP profile (more patients showed dipper type hypertension and less - non-dipper, over-dipper and night-peaker patterns, compared with the control group). Mexicor had a positive effect on neurological status, cognitive function and focal neurological deficit severity.

[Lipid peroxidation and antioxidant defense in patients with ischemic heart disease: correction with free-load bicycle exercise].

AIM: To study changes in lipid peroxidation-antioxidant defense (LPO-AOD) system in patients with various clinical forms of ischemic heart disease (IHD) in response to free-load bicycle exercise (FBE). MATERIAL AND METHODS: A total of 185 IHD patients aged 46-76 years (mean age 68.4 +/- 1.6 years, 99 males and 86 females) were randomized into two groups. Group 1 consisted of 90 patients who received standard medication and FBE. Group 2 of 95 patients received only standard medication. Thirty four healthy controls entered the control group. Each group was divided into subgroups by a clinical form of IHD. LPO was assessed by plasma levels of lipid peroxide (LP), malonic dialdehyde (MDA), AOD--by total antioxidant activity (TAA) in plasma red cells, activity of superoxide dismutase (SOD) and catalase in red cells. RESULTS: Irrespective of a clinical form of IHD, conventional therapy stimulated AOD and decreased LP by 15.1% (p < 0.05), MDA by 21.4% (p < 0.05), on the average, but still these parameters were higher than in healthy controls. The addition of FBE reduced AOD to the levels of that of healthy controls, enhanced AOD the activation of which depended on a clinical form of IHD. CONCLUSION: FBE elevates antiradical potential of blood in trained patients with different clinical forms of IHD. The highest effect was observed on enzymatic link of the AOD system.

[Efficacy of cytoprotective agent Mexicor in urgent cardiology]. / éffektivnost' tsitoprotektora Meksikora v neotlozhnoi kardiologii.

AIM: To study efficacy of cytoprotector mexicor in patients with unstable angina (UA), acute myocardial infarction (MI), hypertensive crises (HC) in combined therapy with conventional drugs. MATERIAL AND METHODS: An open randomized study included 338 patients with acute forms of ischemic heart disease (IHD) and arterial hypertension running with crises. Combined therapy of 20 patients with UA, 90 patients with MI and 43 patients with HC (study groups) was supplemented with mexicor in a dose 6-9 mg/kg/day. The control matched patients (20, 86 and 79 patients, respectively) received conventional treatment alone. The effects of the treatments were assessed by ultrasound investigation of the heart in M-, B- and Doppler modes, by ECG and arterial pressure 24-h monitoring, by activity of lipid peroxidation (LPO). RESULTS: Adjuvant therapy of urgent cardiological conditions with mexicor diminished oxidant stress, left ventricular dysfunction. In MI patients mexicor promoted reduction of the akinesia zones, recovery of disturbed segmentary contractility. In UA patients mexicor contributed to more pronounced decrease in the frequency, duration and severity of myocardial ischemia, enhanced stabilization of angina. In HC patients mexicor promoted earlier normalization of a 24-h AP profile and variability of cardiac rhythm, recurrence rate of HC decreased 2-fold. CONCLUSION: The addition of mexicor to conventional therapy of UA, MI, HC improves clinical course of these diseases, reduces oxidant stress, accelerates recovery of cardiac contractility and left ventricular diastolic function, normalization of central hemodynamics.

[The antioxidant probucol as a regulator of the intensity of free-radical lipid peroxidation processes in the blood of patients with coronary atherosclerosis]. / Antioksidant probukol kak reguliator intensivnosti protsessov svobodnoradikal'nogo perekisnogo okisleniia lipidov v krovi bol'nykh koronarnym aterosklerozom.

Two series of studies were made to assess probucol medicines (lipomal, "Alkaloid"; fenbutol "Akrikhin") effect on clinical symptoms, lipid metabolism, primary and secondary products of lipid peroxidation, activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase) in atherosclerotic patients with hyperlipidemia type IIA and IIB. In both series probucol reduced frequency of anginal attacks, content of total cholesterol and LDL cholesterol. HDL cholesterol remained unchanged or reduced insignificantly. Lipoperoxides and malonic dialdehyde levels in plasma progressively lowered against activation of antioxidant enzymes. These biochemical parameters returned to initial values within 3 months since the drug discontinuation. It is evident that antiatherogenic effect of probucol is due to indirect activation of natural defense systems responsible for enzymic detoxication of active oxygen forms and lipoperoxides rather than to direct interaction of this synthetic antioxidant with lipid radicals.

[The effect of propranolol on the apoprotein spectrum of the blood plasma in patients with ischemic heart disease]. / Vliianie propranolola na spektr apoproteinov plazmy krovi bol'nykh ishemicheskoi bolezn'iu serdtsa.

The authors studied the effect of anaprilin monotherapy (dose: 160-200 mg/daily for 10 months) on the level of atherogenic apolipoproteins (apo A, apo B) and fractions of plasma cholesterol in 34 patients with ischemic heart disease, stable exertion angina pectoris (class 2-3). It was established that changes in the plasma lipid and apoprotein spectrum result in an increase of apo B, decrease of apo 1, increase of apo B/apo A1, decrease of high-density lipoprotein cholesterol (HDLCS) and a different dynamics of HDLCS/apo A1. The established changes in the lipid metabolism are of atherogenic character.