The effect of meldonium on arterial stiffness and the level of C-reactive protein in complex therapy of chronic heart failure and chronic obstructive pulmonary disease


DOI: https://dx.doi.org/10.18565/therapy.2020.5.94-101

Statsenko M.E., Lopushkova Yu.Е., Derevyanchenko M.V., Urlapova E.I.

Volgograd State Medical University of the Ministry of Healthcare of Russia
The aim of the study was to examine the effect of meldonium on C-reactive protein (CRP) level and magistral arteries’ rigidity in patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD).
Material and methods. A prospective, randomized, comparative study included 65 patients of both genders having CHF and COPD and aged from 45 to 70 years. The main group of patients (n=31) received meldonium as part of the complex therapy, the control group (n=34) received only the basic drugs for the treatment of CHF and COPD. Initially and after 12 weeks of therapy, changes in the level of highly sensitive CRP in the blood, as well as the indexes of vascular wall rigidity were estimated by calculating the pulse wave velocity through the vessels of the elastic (PWV ev) and muscle (PWV mv) types. In addition, the incidence rate of patients with CRP ≥10 mg/ml and with PWV ev values >10 m/s and PWV mv 10 m/s, since PWV >10 m/s is a risk factor for cardiac mortality, was taken into account. Differences were considered to be significant at p <0,05.
Results. In the main group of patients who used meldonium as part of the complex therapy of CHF and COPD, in comparison with the control group, there was a positive dynamics, expressed in a significant decrease in the magistral arteries rigidity and a decrease in the CRP level. In studied groups, a correlation between vascular rigidity and the concentration of CRP in the blood (p <0,05) was found.
Conclusion. Use of meldonium as part of the complex therapy of CHF and COPD contributes to a statistically significant regression of the severity of inflammation, which manifests itself in a significant decrease in CRP along with an improvement in the elasticity of the main arteries in the form of PWV decrease both in the vessels of the elastic and muscle types in comparison with the control group, where statistically significant changes of parameters were not observed.
Keywords: non-alcoholic fatty liver disease, adhesion molecules, treatment, pentoxifylline, metformin, phosphogliv forte
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About the Autors

Mikhail E. Statsenko, MD, professor, Vice-Rector for research, head of the Department of internal medicine of pediatric faculty/dental faculty of Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshih Bortscov Sq. Tel.: +7 (8442) 38-53-57; 53-23-35. E-mail: mestatsenko@rambler.ru
Yulia E. Lopushkova, postgraduate student of the Department of internal medicine of pediatric faculty/dental faculty of Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400117, Volgograd, 37 Cosmonauts Str. Tel.: +7 (905) 393-13-53. E-mail: yulija.89@bk.ru
Maria V. Derevyanchenko, PhD, associate professor, associate professor of the Department of internal medicine of pediatric faculty/dental faculty of Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400001, Volgograd, 5G Pugachevskaya Str. Tel.: +7 (902) 386-69-40. E-mail:derevjanchenko@gmail.com (the Contact person).
Ekaterina I. Urlapova, 6th year student of pediatric faculty of Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 47 Sovetskaya Str. E-mail: katuha.irbis.yi@yandex.ru

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