Русский
Influence of fixed combination of perindopril and amlodipine at cardiovascular remodeling in patients with stable ischemic heart disease after percutaneous coronary intervention
DOI: https://dx.doi.org/10.18565/therapy.2024.9.39-48
Iskenderov B.G., Lokhina T.V., Denisova A.G., Berenshtein N.V., Molokova E.A.
Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia
The aim: to evaluate the effect of a fixed combination of perindopril and amlodipine in a dose of 5/5 mg/day in addition to lipid-lowering and antiplatelet therapy at cardiac and vascular remodeling, as well as at clinical outcomes in patients with stable coronary artery disease who underwent PCI.
Material and methods. 108 patients (68 male and 40 female persons) aged 47–69 years (mean age 54.3 ± 5.8 years) who underwent primary PCI with stenting were examined. Patients were randomized into 2 groups – control (n = 40) and main (n = 68). Depending on the initial blood pressure (BP) levels, the participants in the main group were additionally divided into 2 subgroups: 40 individuals with stage I arterial hypertension (AH) and 28 without it. The patients were prescribed antiplatelet drugs and statins; in the main group, a combined drug of perindopril and amlodipine in a dose of 5/5 mg/day was additionally used. All participants underwent echocardiography and Doppler examination of the brachial and carotid arteries before and 12 months after primary PCI performing.
Results. Repeated studies 12 months after PCI showed more significant morphofunctional changes in the heart and vascular wall in the main group, especially in patients with baseline hypertension. Thus, the left ventricular (LV) myocardial mass index decreased by an average of 11.8% (p = 0.011), the LV ejection fraction increased by 10.3% (p = 0.017), and the cardiac index by 12.7% (p = 0.012). In the main group, more significant were the dynamics of transmitral diastolic flow and vascular wall parameters. Thus, in patients with baseline hypertension, the intima-media complex value decreased by an average of 15.6% (p = 0.007), and the endothelium-dependent vasodilation index increased by 30.9% (p <0.001).
Conclusion. It has been shown that the use of a combination drug of perindopril and amlodipine at a dose of 5/5 mg/day in patients who underwent PCI, regardless of the dynamics of blood pressure, causes reverse remodeling of the heart and vascular wall and thereby improves cardiovascular prognosis.
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About the Autors
Bakhram G. Iskenderov, MD, Dr. Sci. (Medicine), professor, head of the Department of therapy, cardiology, functional diagnostics and rheumatology, Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 440060, Penza, 8A Stasova St.
E-mail: iskenderovbg@mail.ru
ORCID: https://orcid.org/0000-0003-3786-7559
Tatiana V. Lokhina, MD, Dr. Sci. (Medicine), professor of the Department of therapy, cardiology, functional diagnostics and rheumatology, Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 440060, Penza, 8A Stasova St.
E-mail: ltv-13@mail.ru
ORCID: https://orcid.org/0000-0002-9493-444X
Alla G. Denisova, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of therapy, cardiology, functional diagnostics and rheumatology, deputy director for science and development, Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 440060, Penza, 8A Stasova St.
E-mail: denisovaag@piuv.ru
ORCID: https://orcid.org/0000-0002-7453-8335
Natalia V. Berenshtein, MD, PhD (Medicine), associate professor of the Department of therapy, cardiology, functional diagnostics and rheumatology, Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 440060, Penza, 8A Stasova St.
E-mail: berenshtein2011@yandex.ru
ORCID: https://orcid.org/0000-0002-1589-2799
Elena A. Molokova, MD, PhD (Medicine), associate professor of the Department of therapy, cardiology, functional diagnostics and rheumatology, Penza Institute for Further Training of Physicians – a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia. Address: 440060, Penza, 8A Stasova St.
E-mail: tolilen@yandex.ru
ORCID: https://orcid.org/0000-0002-1174-9426
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