CYTOPROTECTIVE EFFECT OF MELDONIUM ON CARDIOMYOCYTE

Abstract

Background. The use of myocardial cytoprotectors (meldonium) in patients with exertional angina is a scientific-practical dilemma.

Material and methods. An open randomized clinical trial was conducted involving 160 patients with chronic heart failure (117 men and 43 women) aged 37 to 81 years. Of them, 142 patients had angina pectoris of stable effort from different functional classes, and 21 – unstable angina pectoris. Study groups were comparable according to the frequency of indication of background drugs and meldonium.

Results. The results of our study indicate the activation of oxidative stress in patients with stable angina pectoris, relevant in this regard being the changes of malonic dialdehyde, catalase and superoxide-dismutase, which become more pronounced in the first 24 hours after the start of the treatment and, although, by the 6^th month an attenuation of the activity of the prooxidant status is detected, it intensifies by 12 months it intensifies.

Discussions. All results completes the vision based on the link between the antioxidant defense and the aggravated cardiovascular evolution. Another consolidated aspect is to demonstrate the superior effectiveness of meldonium administration. There was demonstrated the effectiveness feasibility of meldonium vis-à-vis the markers of oxidative stress, endothelial dysfunction and comparable systemic inflammation.

Conclusions. The inclusion of metabolic drugs in the complex treatment of patients with stable angina increases the clinical effectiveness of basic pharmacotherapy 4 times when prescribing meldonium (p <0,001), mainly due to increased antianginal actions.