The influence of myocardoprotection on the course of postinfarction chronic heart failure
Objective. To study the effect of Thiotriazoline in patients with post-infarction chronic heart failure (CHF).
Materials and methods. We examined 46 patients with ischemic heart disease (IHD) who had undergone myocardial infarction. The average age was 50.8±3.2 years; men – 32 (70 %), women – 14 (30 %). All patients were examined in the form of anamnesis and examination, general clinical and biochemical studies, electrocardiography. The assessment of CHF manifestations in patients of both groups was carried out according to the New York classification based on the results of the 6-minute walk test. The distribution into two groups was carried out according to the following parameters: the 1st group included 26 (56.5 %) patients (men – 19 [73.1 %], women – 7 [26.9 %]), who, along with basic therapy, received Thiotriazoline at a dose of 8.0 intravenously jet for 10 days; the 2nd (control) group included 22 (43.5 %) patients (men – 14 [63.6 %], women – 8 [36.4 %]) who received standard therapy (β-blockers, angiotensin-converting enzyme inhibitors, calcium antagonists, nitrates). Distribution by class of CHF at the time of inclusion in the study was observed in 1st group in 21 (80.7 %) patients: I functional class (FC) – 2 (9.5 %), II FC – 11 (52.4 %), III FC – 6 (28.6 %) and IV FC – 2 (9.5 %). In 2nd group – (77.3 %) patients: I FC – 3 (17.6 %), II FC – 6 (35.3 %), III FC – 7 (41.2 %) and IV FC – 1 (5.9 %) patients. According to the Minnesota questionnaire in group 1, the quality of life indicators (average value in points) were 71.1±1.8 points (p<0.05). The 2nd group had 67.9±1.9 points (p<0.05).
Results and discussion. Positive hemodynamics and assessment of CHF manifestations by FC served as a clear statement of improvement in the quality of life. In the group receiving Thiotriazoline, the number of patients with II FC increased from 11 (42.3 %) to 14 (54 %), I FC – from 2 (9.5 %) to 6 (23 %) compared to the initial data due to patients from III FC and IV FC. The number of patients with III FC decreased to 2 (7.8 %) and IV FC – to 1 (3.8 %), and in the control group there was a slight negative dynamic (III FC – to 2 (9.5 %) and IV FC – without changes). The quality of life according to the Minnesota questionnaire indicated a positive trend. In group 1, the quality of life indicators improved from 71.1±1.8 to 53.3±0.6 points (p<0.01); in group 2 – from 67.9±1.9 to 63.3±1.9 points (p<0.05).
Conclusions. Thiotriazoline is a cytoprotector of the highest class, in particular, a myocardoprotector, which, when used (from 10 days in a hospital and then up to 1 month), improves the metabolism of the heart muscle, stabilizing intracellular mechanisms. Thiotriazoline is indicated for all patients with IHD who have suffered a myocardial infarction in the early stages of CHF.
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