Терапевтический архив (Aug 2015)
Preventive cytoprotection in social diseases
Abstract
Among many cytoprotective drugs, only a few of them that have a targeted metabolic effect include agents that partially inhibit oxidation of free fatty acids, the so-called p-FOX inhibitors (partial fatty acid oxidation inhibitors). Aim. To develop a procedure for the preventive use of meldonium dihydrate in day-hospital patients with comorbidity. Subjects and methods. The investigation enrolled 189 patients (116 men and 73 women; mean age, 55.9±4.4 years) who were followed up for initial manifestations of cardiovascular and/or another somatic disease and were at high risk for unfavorable cardio- and cerebrovascular events, as well as complications of emergency alcohol-related conditions. The investigation of the efficacy and safety of meldonium dihydrate was planned as an open-label clinical trial in three parallel groups different in the directivity patterns of potential complications («Cardio», «Cerebro», «Alco»). The drug’s dosage averaged 500 to 1000 mg/day. Results. The day-hospital use of meldonium dihydrate demonstrated high safety profile and a positive role in the prevention of cardio- and cerebrovascular catastrophes and complications of emergency alcohol-related conditions and chronic alcoholic visceropathy, leading to delayed dyslipidemia progression, diminished insulin resistance, improved blood rheological properties, and suppressed chronic systemic inflammation and also proving its role in the prevention of renal vascular injury and toxic (ethanol) encephalopathy. Meldonium therapy showed positive effects in delaying the progression of dyslipidemia, diminishing insulin resistance, improving blood rheological properties, and suppressing chronic systemic inflammation and also proved its role in preventing renal vascular injury and toxic (ethanol) encephalopathy, which confirmed the versatility of the cytoprotective effect of meldonium. Conclusion. The drug has proved to be effective and safe in hemodynamic, electrolytic, hepatic, and other parameters, which makes it expedient to include meldonium in the day-hospital formulary of drugs for a preventive parenteral cycle according to the developed regimen (a 10-day cycle at least 1—2 times a year) for patients at high risk for social diseases and their complications.
