Abstract:
Summary.
Objectives. To assess the efficacy and harmlessness of
the cytoprotective treatment with meldonium of ischemic
heart disease by developing personalized approaches.
Materials and methods. Our study included 160 patients with IHD (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. The average age of patients was 59.26±0.74
years. All patients were divided into 2 groups: 1 group
(n=80) only with background treatment and 2 group included (n=80) with background treatment and meldonium. The
observation period was 12 months (one year).
Results. Significant differences were found in the pathogenesis of the underlying pathology and in the effectiveness
of meldonium treatment in men and women. In this way, for
men on the background of exertion angina is characteristic
of more frequent occurrence of myocardial infarction, and
for women – heart failure and diabetes mellitus, but meldonium remain the same effectiveness for both groups. Men
smoke 16 times more, and women suffer from abdominal
obesity 2 times more, which could be the cause of the more
atherogenic lipid profile in them. According to the survey,
the hereditary predisposition to cardiovascular diseases is
higher in women, although most likely women are simply
better informed about the pathologies of relatives and they
were more disciplined in treatment with meldonium.
Discussions. The effectiveness of treatment in women
is significantly better according to the indicators of subjective and objective improvement compared to men, which is
confirmed by many existing studies. Sex factor determines
the presence of a number of pathogenetic peculiarities of the
course of ischemic heart disease, and therefore can be considered as one of the criteria for personalizing pharmacotherapy, however, for the individual choice of metabolic corrector,
this factor is not significant. The age factor determines some
pathogenetic peculiarities of the course of ischemic heart disease and the effectiveness of pharmacotherapy, however, it is
not decisive for the choice of metabolic corrector.
Conclusions. The standard criteria for the personalization of pharmacotherapy in cardiology - sex, age, environmental risk factors, the presence of an underlying disease
and concomitant pathology, pharmacogenetic and psychological profile - affect the pathogenesis of the development
of coronary artery disease, to some extent determining the
sensitivity of patients to meldonium, but they are not decisive for a personalized choice of metabolic corrector.
