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  • Title: [Clinicopathogenetic features of coronary heart disease combined with chronic obstructive pulmonary diseases and efficiency of therapy with trimetazidin].
    Author: Kolomoets NM, Baksheev VI, Uvaĭsova KU.
    Journal: Klin Med (Mosk); 2008; 86(6):38-43. PubMed ID: 18720710.
    Abstract:
    Based on retrospective analysis of 2446 in-patient cards, autopsy protocols, outpatient medical documentation, prevalence and features of clinical manifestation of cardiorespiratory pathology (CRP): coronary heart disease (CHD) combined with chronic obstructive pulmonary disease (COPD)--1 stage of study, and also (after randomization and forming of main and control groups), efficiency of myocardial cytoprotector trimetazidin (TMZ) at its long-term use (1 year) in combined therapy (2 stage of study): 135 CHD patients (stable exertional angina functional class II-III: 92 and 43 persons respectively) with COPD of medium severe (111 persons) and severe course (24 persons), were studied. It is shown that CRP is prevailed in elder age groups (after 45 years) and noticed in 56.7% CHD patients. More sevenre course with great risk of myocardial infarction with Q wave (twice, p < 0.001), prolongation of painless ischemia (62.4+/-11.5 min/day vs. 22.8+/-11.1 min/day), inclination to complicated rhythm disturbances (38 vs. 21.9, p < 0.05) and earlier clinical manifestations of heart failure (4.3+/-0.6 years earlier, p < 0.001) is typical for CHD with COPD vs. patients without pulmonary pathology. In one year after beginning of treatment with TMZ (35 mg) number of weekly pain attacks was decreased in patients of 1st group vs. 2nd group (at the average -50.8% -29.3% vs. +12.5% +16.6% respectively); significant (p < 0.05) decrease in duration of painless myocardial ischemia was registered. Decrease in number of supraventricular and ventricular extrasystoles (42.7+/-1.48 vs. 20.5+/-1.07 cases in a day, a < 0.0001), significant (p < 0.05) increase in ejection fraction and decrease in left ventricle end-diastolic volume (12.2+/-0.4% E 12.2+/-0.3% respectively), in dimensions of left (10.9+/-0.03%) and right (8.8+/-0.9%) atrium, in risk of development of acute coronary syndrome were noticed in the patients of main group received TMZ. Thus, long-term (not less then 1 year) use of TMZ (35 mg) in combined treatment assists to normalization of cardiovascular indices, decreases cardiovascular complication occurrence, improves disease prognosis and do not has negative side-effects.
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