Рациональная фармакотерапия в кардиологии (Jan 2016)
COMPARISON OF EFFICACY AND SAFETY OF RAMIPRIL, MOLSIDOMINE AND THEIR COMBINATION IN PATIENTS WITH CHRONIC HEART FAILURE, WHICH COMPLICATED ISCHEMIC HEART DISEASE
Abstract
Aim. To study effects of ramipril, molsidomine and their combinations on morphofunctional heart indices and clinical status of patients with chronic heart failure (CHF), which complicated an ischemic heart disease (IHD).Material and methods. 41 patients with CHF class II-III (NYHA), which complicated IHD (postinfarction cardiosclerosis) were included in the study. Patients did not receive ACE inhibitors. Patients were split in 3 groups: patients of the 1st group received ramipril, patients of the 2nd group - molsidomine and patients of the 3rd group – combination of ramipril and molsidomine. Clinical examination, laboratory tests, electrocardiogram, cardiac ultrasonograthy, exercise tolerance test was performed before treatment and after 3 months and 1 year of treatment.Results. Improvement of clinical status and decrease of class NYHA was found in 38,5% of patients in ramipril group; in 33,3% of patients in molsidomine group and in 23,1 % of patients in combined therapy group. Increase of ejection fraction on 17 % from initial level was found in patients receiving combined therapy; on 25,2% - in patients receiving molsidomine; and on 12,4% - in patients receiving ramipril. Decrease of residual volumes of a left ventricle also was detected.Conclusion. All therapies (ramipril, molsidomine and their combination) in patients with CHF class II-III and postinfarction cardiosclerosis are clinically and hemodynamically effective in long term implementation.
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