scholarly journals PROSPECTS OF MELDONIUM AND FOLIC ACID USING TO IMPROVE THE CONDITION OF PATIENTS WITH ISCHEMIC HEART DISEASE AND CONCOMITANT HYPERTENSION

2021 ◽  
pp. 13-19
Author(s):  
D. A. Volynsky
Keyword(s):  
Oxidative Stress ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Folic Acid ◽  
Stable Angina ◽  
Antioxidant Properties ◽  
Complex Treatment ◽  
Basic Therapy ◽  
Concomitant Hypertension ◽  
Basic Treatment

Coronary heart disease (CHD) is a leading cause of high mortality, disability and reduced quality of life for patients. At the heart of coronary heart disease - ischemia and activation of oxidative stress. With concomitant hypertension, the condition of patients and the prognosis for the course of their disease deteriorates significantly. The prognosis of coronary heart disease, the occurrence of new hospitalizations or deaths from cardiovascular disease can be further assessed by monitoring ST2 and malonic dialdehyde (MDA). Traditional treatment of coronary heart disease does not always guarantee the achievement of the desired clinical results. That is why it is advisable to use in the complex treatment of patients with coronary heart disease and concomitant hypertension cytoprotectors and drugs that have antioxidant properties, such as meldonium and folic acid. The aim of the research. Detect anti-ischemic activity in meldonium and folic acid and evaluate the effect of these drugs on the level of ST2, MDA in the blood in patients with coronary heart disease and concomitant hypertension. Materials and methods. The research included 80 patients (women - 4, men - 76, aged 57,7 ± 9,8 years) with diagnoses of coronary heart disease: stable angina, functional class II-III (FC), chronic heart failure (CHF) I-IIa, FC II-III ", with concomitant arterial hypertension II-III stages, 2-3 degrees, risk 4 (very high), CHF I-IIa, FC II-III". Patients were divided into 4 groups of 20 patients, respectively: 1) patients who, in addition to basic therapy, were prescribed folic acid at a dose of 0.8 mg / d for six months; 2) patients who, in addition to basic treatment, were prescribed meldonium at a dose of 750.0 mg / d for six months; 3) patients who, in addition to basic treatment, were prescribed folic acid at a dose of  0.8 mg / d and meldonium at a dose of 750.0 mg / d for six months; 4) patients who were prescribed only basic antianginal, disaggregating, hypolipidemic treatment.The number of anginal attacks and doses of nitroglycerin during the day were determined, the results of the test with a 6-minute walk and the plasma concentration of ST2 and MDA before and after 6 months of treatment with meldonium and folic acid were evaluated. Results. Found anti-ischemic activity in meldonium and its combination with folic acid. The combination of these drugs as an adjunct to basic therapy significantly reduced the concentration of ST2. Both drugs alone or in combination reduced the concentration of MDA in the blood of patients. Conclusions. Our research showed the presence of anti-ischemic activity in meldonium, both when added to the basic therapy of patients with coronary heart disease and concomitant hypertension, and when used together with folic acid. In the groups of patients where these drugs and their combinations were used, the frequency of anginal attacks and the number of doses of nitroglycerin used during the day were significantly reduced. The combined use of folic acid and meldonium when added to the basic therapy after 6 months significantly reduced the concentration of ST2 in the blood. Folic acid and meldonium showed pronounced antioxidant properties. At separate adding of these medications to basic therapy or their combined adding significantly decreased the concentration of MDA - a marker of oxidative stress. Therefore, we consider it appropriate to use folic acid and meldonium in the complex treatment of patients with coronary heart disease with stable angina and concomitant hypertension.

scholarly journals Influence of Meldonium on Blood Lipid Spectrum and Echocardiography Parameters in Patients with Coronary Heart Disease and or Withoutconcomitant Arterial Hypertension

2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 50-57
Author(s):  
D. Volynskyi ◽  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Arterial Hypertension ◽  
Total Cholesterol ◽  
Stable Angina ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Positive Effect ◽  
Lipid Spectrum ◽  
Concomitant Hypertension

Introduction. Coronary heart disease (CHD) is one of the main causes of high mortality, disability and reduced quality of life for patients in both Europe and Ukraine. Modern drug therapy of coronary heart disease in combination with arterial hypertension (AH) does not always achieve a satisfactory therapeutic effect. The use of meldonium, which has antioxidant properties, has a positive effect on NO release and has a lipid-lowering effect is promising for patients with AH. The aim of the study. To evaluate the influence of meldonium on lipid metabolism and echocardiography parameters in combination therapy in patients with CHD with stable angina and concomitant AH. Materials and methods. We examined 66 patients with CHD, stable angina pectoris II-III functional class, 40 of them with concomitant AH stage II-III. Patients were divided into 2 groups of 40 and 26 patients, respectively. The first group included patients with CHD and concomitant AH, the second - without pre-existing hypertension. Each of the groups was further divided into 2 subgroups: 1) Patients who were prescribed meldonium at a dose of 750.0 mg/d for 6 months in addition to the basic therapy of the underlying disease (n = 20 for CHD + AH and n = 14 for CHD without hypertension). 2) Patients who continued basic antianginal, disaggregating, hypolipidemic therapy (n = 20 for CHD + AH and n = 12 for CHD without hypertension). Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol were assessed. Indicators of cardiac hemodynamics were determined by echocardiography with assessment of left ventricular end systolic and diastolic volumes and diameters (LVESV, LVEDV, LVESD, LVEDD respectively), the thickness of the interventricular septum and posterior wall of the left ventricle (IVST, LVPWT respectively), pulmonary artery pressure (PAP), LV myocardial mass (LVM) and LV myocardial mass index (LVMI). Results. The use of meldonium for 6 months in patients with CHD and concomitant AH led to a decrease in the concentration of total cholesterol from 5.07 to 4.34 mmol/l and LDL from 2.07 to 1.70 mmol/l. In the group of patients without concomitant hypertension there was a decrease in the concentration of total cholesterol from 4.80 to 3.93 mmol/l, LDL from 1.62 to 1.18 mmol/l and an increase in HDL from 1.18 to 1.37 mmol/l. At 6-month administration of meldonium as a part of combination therapy of patients with CHD with concomitant AH, there is a decrease in LVM from 216.90 g to 181.50 g and LVMI from 109.10 g/m2 up to 91.20 g/m2. In patients without concomitant hypertension, a decrease in LVM from 232,20 g to 183.90 g and LVMI from 121.50 g/m2 to 96.40 g/m2 was observed. Conclusions. Our study showed that meldonium has a positive effect on lipid metabolism and echocardiography. In the group of patients with coronary heart disease and concomitant hypertension on the background of additional use of meldonium for six months, we registered a decrease in TC, LDL and AI. LVPWT, PAP, LVM and LVMI also significantly decreased. In the group of patients with coronary heart disease without concomitant hypertension, we registered a decrease in TC, LDL, AI and an increase in HDL. LVM and LVMI also decreased significantly. Therefore, we consider it appropriate to use meldonium in the complex treatment of patients with coronary heart disease with stable angina and concomitant hypertension. Keywords: coronary heart disease, arterial hypertension, meldonium, echocardiography, blood lipid spectrum.

Association between novel oxidative stress markers and C-reactive protein among adults without clinical coronary heart disease

2005 ◽  
Vol 178 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Jerome L. Abramson ◽  
W. Craig Hooper ◽  
Dean P. Jones ◽  
Salman Ashfaq ◽  
Steven D. Rhodes ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Oxidative Stress Markers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Stress Markers

scholarly journals Relationship Between gamma-Glutamyltransferase (gamma-GT) with High Sensitive C-Reactive Protein (hs-CRP), Oxidized (Ox-LDL) and Glutathione Peroxidase (GPx) on Coronary Heart Disease (CHD) Patient

2009 ◽  
Vol 1 (2) ◽  
pp. 51 ◽  
Author(s):  
Marissa Arifin ◽  
Marsetio Donosepoetro ◽  
Sutomo Kasiman
Keyword(s):  
Oxidative Stress ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Glutathione Peroxidase ◽  
Medical Center ◽  
Oxidized Ldl ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Hs Crp

BACKGROUND: Recent clinical studies have suggested that γ-glutamyltransferase (γ-GT) can trigger oxidative stress within the plaque. This study aimed to investigate whether serum γ-GT might be as a risk factor of coronary heart disease (CHD), and measure the associations of serum γ-GT with high sensitive C-Reactive Protein (hs-CRP), Oxidized LDL (Ox-LDL) and Glutathione Peroxidase (GPx).METHODS: This study recruited 48 patients aged 30-70 year who underwent coronary angiography at Haji Adam Malik Medical Center at Medan between February and April 2008 and who presented at least one coronary stenosis of > 50% of the luminar diameter. The sample subjects were consecutively selected.RESULTS: γ-Glutamyltransferase was positively associated (r = 0.546) with hs-CRP as a marker of chronic inflammation after careful adjustment for other established risk factors in CHD patient. But, there was no significant difference between γ-GT in male and female patients. Further, there were no correlations between γ-GT and Ox-LDL and GPx. Ratio of γ-GT/GPx was measured as well, and it was associated with hs-CRP.CONCLUSIONS: Ratio of γ-GT/GPx was associated with inflammation process in coronary heart disease patients.KEYWORDS: γ-glutamyltransferase (γ-GT), inflammation, oxidative stress, coronary heart disease

Chronic Stable Angina

2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

scholarly journals The Role of Traditional Chinese Medicine in the Regulation of Oxidative Stress in Treating Coronary Heart Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Xinyu Yang ◽  
Tianmai He ◽  
Songjie Han ◽  
Xiaoyu Zhang ◽  
Yang Sun ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Antioxidant Treatment ◽  
Molecular Systems ◽  
Artery Disease ◽  
Signal Activation

Oxidative stress has been closely related with coronary artery disease. In coronary heart disease (CHD), an excess of reactive oxygen species (ROS) production generates endothelial cell and smooth muscle functional disorders, leading to a disequilibrium between the antioxidant capacity and prooxidants. ROS also leads to inflammatory signal activation and mitochondria-mediated apoptosis, which can promote and increase the occurrence and development of CHD. There are several kinds of antioxidative and small molecular systems of antioxidants, such as β-carotene, ascorbic acid, α-tocopherol, and reduced glutathione (GSH). Studies have shown that antioxidant treatment was effective and decreased the risk of CHD, but the effect of the treatment varies greatly. Traditional Chinese medicine (TCM) has been utilized for thousands of years in China and is becoming increasingly popular all over the world, especially for the treatments of cardiovascular diseases. This review will concentrate on the evidence of the action mechanism of TCM in preventing CHD by modulating oxidative stress-related signaling pathways.

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