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    Jakimenko E. A., Kholopov L. S., Chumachenko N. V.

    THE POSSIBILITY OF CORRECTION OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH CORONARY ARTERY DISEASE AND METABOLIC SYNDROME AFTER PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE CORONARY SYNDROME WITHOUT ST-SEGMENT ELEVATION


    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.
    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.