| About the author: |
Jakimenko E. A., Kholopov L. S., Chumachenko N. V. |
| Heading |
CLINICAL MEDICINE |
| Type of article |
Scentific article |
| Annotation |
Objective: To investigate peculiarities of patients with coronary heart disease and metabolic syndrome (MS), underwent primary percutaneous coronary intervention (PCI) for acute coronary syndrome without ST-segment elevation (ACS nST); to increase the effectiveness of patients’ treatment by correcting of endothelial dysfunction (ED) with the additional long-term therapy by trimetazidine.
Materials and Methods: 66 patients (M / F = 46 / 66) were divided into two groups by simple randomization. Group I (n = 31) received standard therapy; group II (n = 35) was additionally treated with trimetazidine 35 mg BID for 1 year. Asymmetric Dimethyl-L-Arhynyn (ADMA) and high-sensitivity C-reactive protein (hs-CRP) blood levels were investigated in all patients.
Results. The period of follow-up was 11.2 ± 1.43 months. The number of patients with criteria of MS decreased to 24 (74.2 %) in group I and 27 (77.1 %) in group II. We received lower levels of low-density lipoproteins (3.96 ± 0.62, mmol / L) and very-low-density lipoproteins (0.78 ± 0.09, mmol / L) in group II compared to group I (4.29 ± 0.71, mmol / L and 0.78 ± 0.09, mmol / L, respectively), p <0.05. There has been distinguished lower levels of hs-CRP in group II (2.39 ± 0.31, nmol / L) compared to group I (3.12 ± 0.43, nmol / L), (p = 0.031); as well as ADMA level was significantly lower in group II (0.61 ± 0.09, mmol /L) compared to group I (0.65 ± 0.08, mmol / L), p <0.001, and HOMA-IR (8.60 ± 3.92, mU / mL) and (6.83 ± 2.04, mU / mL), p = 0.041 for groups I and II, respectively. Glomerular filtration rate (GFR) improved in group II (79.21 ± 8.11 mL / min / 1.73m2) compared to group I (74.14 ± 9.0 mL / min / 1.73m2), p = 0.023. Ejection fraction measured with segmental contractility of the left ventricle (LV) was significantly higher in group II patients (51.29 ± 4.14, %) compared to group I (50.71 ± 5.12, %), p = 0.043.
Conclusions. Additional long-term therapy with trimetazidine increases the effectiveness of treatment, reduces the endothelial dysfunction, vascular inflammation and insulin resistance, contributes to the stabilization of lipid metabolism, and improves segmental LV contractility.
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| Tags |
percutaneous coronary intervention, metabolic syndrome, endothelial dysfunction, trimetazidine |
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| Publication of the article |
«World of Medicine and Biology» №1(55), 2016 year, 113-118 pages, index UDK 616.132.2-008.64-089.819-06: 616.12-005.4-008.9]-08. |
