ABSTRACT

Aims:

The objective of our study is to investigate the antianginal activity of meldonium and its influence on the hemodynamics and clinical parameters in patients with stable angina who fall under III-IV functional classes according to the classification of the Canadian Heart Association.

Methods:

The study was carried out including 105 patients with stable angina pectoris who were in III-IV functional classes at the age of 42-72 years. The first group (n=52) was administered the standard treatment (beta-blockers, aspirin, atorvastatin). The second group of patients (n=53) were given a combination of basic therapy along with meldonium 10% solution of 5 ml intravenously for 10 days then 1000 mg per day orally for 10-12 weeks. Suitable healthy people were selected as the control group (n=36).

Results:

Patients with stable angina pectoris were characterized with the reduction of workload, double work, time loading on bicycle ergometer, increased specific and total peripheral vascular resistance, increased central sympathetic activity on heart, decreased vagal and humoral activity on heart rate. The analysis of the data indicated a decrease in the frequency of anginal attacks after treatment in the first group by 45% and reduced daily nitroglycerin requirement by 48%. Combination therapy resulted in a decrease of the parameters by 71.8% and 76%, respectively.

Conclusion:

After the treatment in both groups, we detected an improvement in physical exertion tolerance, reduction in total peripheral vascular resistance and sympathetic activity of the heart. Combination therapy with meldonium significantly reduced the central smypathetic activity and peripheral vascular resistance, also increased the workload, run time compared to the basic therapy.