The Influence of Combined Pharmacotherapy with the Use of Trimetazidine and Potassium and Magnesium Salts of Gluconic Acid in Patients with Chronic Heart Failure of Ischemic Origin
Abstract
The objective of the research was to improve the efficiency of treatment of patients with chronic heart failure (CHF) of ischemic genesis by adding potassium and magnesium salts of gluconic acid and trimetazidine to the background therapy (BT).
Materials and methods. Registration of electrocardiogram (ECG) and ECG Holter Monitoring (ECG HM) was performed in order to achieve the aim. The study involved 84 patients with postinfarction cardiosclerosis with CHF. Patients were randomized into four groups depending on treatment characteristics. The first group included patients with heart failure of ischemic genesis treated with BT; the second group consisted of patients with CHF, who were treated with BT and potassium and magnesium salts of gluconic acid; the third group included patients with CHF who were prescribed trimetazidine on the background of BT; the fourth group consisted of patients treated with BT in combination with potassium and magnesium salts of gluconic acid and trimetazidine.
Results of the research. The proposed treatment regimens were proved to be effective in reducing ischemic parameters after 6 and 12 months of treatment. Anti-ischemic treatment using a combination of potassium and magnesium salts of gluconic acid and trimetazidine on the background of BT led to the most significant change in the average number of myocardial ischemia episodes in examined patients. Indicator of the average daily number of ischemic episodes before the research in the first group decreased after treatment by 29.21 %. The average number of myocardial ischemia episodes during the day in the second group decreased by 38.50 % and constituted (2.78±0.10) after treatment. The addition of trimetazidine to BT in patients of III group was accompanied by significant anti-ischemic effect reducing the average daily number of ischemic episodes by 43.8 % (p<0.001). It should be noted that the anti-ischemic treatment of group IV patients using a combination of BT, potassium and magnesium salts of gluconic acid and trimetazidine resulted in the most statistically significant change in this indicator in examined patients, namely by 48.90 % (p<0.001).
Conclusions. Thus, a more significant anti-ischemic effect was observed when using combined treatment with potassium and magnesium salts of gluconic acid and trimetazidine compared with BT in a separate combination with each of these drugs.References
Netiazhenko VZ, Malchechevska TY, Myshanych HI [et al.] Choice of metabolic therapy in the treatment of patients with coronary artery disease. Oryhinalni doslidzennia. 2010; 3: 38-42.
Handziuk VA. Analysis of the incidence of coronary artery disease in Ukraine. Ukraiinskyi kardiolohichnyi zhurnal. 2014; 3: 45-52.
Voronkov LH, Amosova KM, Bahrii AE [et al.] Recommendations for the diagnosis and treatment of chronic heart failure. Kyiv. 2012; 106.
Zhang L, Lu Y, Jiang H [et al.]Additional use of trimetazidine in patients with chronic heart failure: a meta-analysis. J. Am. Coll. Cardiol. 2012; 59: 913–922. doi:10.1016/j.jacc.2011.11.027
Iyengar SS, Rosano GM. Effect of antianginal drugs in stable angina on predicted mortality risk after surviving a myocardial infarction: a preliminary study (METRO). Am. J. Cardiovasc. Drugs. 2009; 9: 293–297. doi: 10.2165/11316840-000000000-00000.
Fragasso G, Perseghin G, De Cobelli F [et al.] Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine adenosine triphosphate ratio in patients with heart failure. European Journal of Heart Failure. 2006; 27: 942-948. doi: http://dx.doi.org/10.1093/eurheartj/ehi816
Roger VL, Go AS, Lloyd-Jones DM [et al.]. Executive summary: heart disease and stroke statistics – 2012 update: a report from the American Heart Association. Circulation. 2012; 125: 188-197. doi: 10.1161/CIR.0b013e3182456d46.
Thygesen K, Alpert JS, Jaffe AS. [et al.] Third universal definition of myocardial infarction. Circulation. 2012; 126: 2020-2035. doi: 10.1161/CIR.0b013e31826e1058
Deaton C, Froelicher E, Wu L [et al.]. The Global Burden of Cardiovascular Disease. Journal of Cardiovascular Nursing. 2011; 26: S5-S14. doi: 10.1016/S1474-5151(11)00111-3.
Gao D, Ning N, Niu X [et al.]. Trimetazidine: a metaanalysis of randomised controlled trials in heart failure. Heart. 2011; 97: 278-286. doi: 10.1136/hrt.2010.208751
Di Napoli P, Di Giovanni P, Gaeta MA [et al.]. Trimetazidine and reduction in mortality and hospitalization in patients with ischemic dilated cardiomyopathy: a post hoc analysis of the Villa Pini d`Abruzzo Trimetazidine Trial. J. Cardiovasc. Pharmacol. 2007; 50: 585-589.
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