Терапевтический архив (Sep 2011)

Pharmacological protection of the myocardium with reamberin in coronary artery bypass grafting in patients with postinfarction angina

  • Georgiy Ivanovich Sidorenko,
  • Lyudmila Grigor'evna Gelis,
  • Elena Aleksandrovna Medvedeva,
  • Yuriy Petrovich Ostrovskiy,
  • Irina Valentinovna Lazareva,
  • Tat'yana Vasil'evna Sevruk,
  • Natal'ya Aleksandrovna Shibeko,
  • Yuriy Petrovich Petrov,
  • G I Sidorenko,
  • L G Gelis,
  • E A Medvedeva,
  • Yu P Ostrovsky,
  • I V Lazareva,
  • T V Sevruk,
  • N A Shibeko,
  • Yu P Petrov

Journal volume & issue
Vol. 83, no. 9
pp. 35 – 40

Abstract

Read online

Aim. To assess efficacy of reamberin in preoperative preparation and after coronary bypass (CB) in patients with macrofocal myocardial infarction (MI) complicated with postinfarction angina. Material and methods. A total of 45 patients with Q-positive MI complicated with postinfarction angina pectoris entered the trial. The study group consisted of 20 (44.4%) patients given 200-400 ml injections of 1.5% reamberin solution for 3 days before coronary artery bypass grafting (CABG) and 3-5 days after it. The control group consisted of 25 (55.6%) patients given basic therapy without cardioprotection. ECTG-60, echocardiography, CM-ECG, laboratory tests were made before CABG. CABG was made in conditions of artificial blood circulation in all the patients. Results. Clinical stabilization was observed after direct myocardial revascularization in hospitalized 25 (100%) patients of the study group and 22 (88%) patients of the control group. Early postoperative acute cardiac failure (ACF) developed in 3 (12%) patients from the study group and 9 (36%) from the control group (p = 0.04), arrhythmia occurred in 2(8%) and 8(32%) patients, respectively (p = 0.03). Two (8%) control patients died in early postoperative period from acute cardiac failure. Perioperative MI occurred in 2(8%) control patients. After 12 months of the follow-up, patients of the study group had no recurrent angina pectoris, while among the controls 4(16%) patients had recurrent angina of FC III. After surgical intervention at discharge and 12 months after treatment patients of both groups improved systolic and diastolic functions of the left ventricle. Normalization of the diastolic function was registered in 80% patients of the study group (p < 0.001) and in 44% from the control group (p < 0.001) after 1 year follow-up. Conclusion. Reamberin reduces the number of postoperative complications, ischemic damage to the myocardium, significantly improves systolic and diastolic functions of the left ventricle.

Keywords