EFFICACY ANALYSIS OF DIFFERENT ANTIANGINAL REGIMENS IN ISCHEMIC HEART DISEASE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Aim. Assessment of effectiveness of different treatment regimens application for angina in coronary heart disease patients (CHD) with frequent exacerbations of chronic obstructive pulmonary disease (COPD).Material and methods. Totally, 60 patients included, with CHD and COPD, with frequent exacerbations (2 and more per year). All patients received ivabradine, the I f -channels inhibitor (Coraxan). Taken the second antianginal drug, patients were selected into 2 groups: 1st group consisted of 30 patients, receiving together with basic CHD and COPD therapy Coraxan with trimetazidine (Preductal MB), 2nd group — 30 patients with inclusion of prolonged nitrates. All patients were monitored for clinical picture of CHD, Holter ECG, echocardiography and laboratory studies. Follow-up period — 6 months.Results. After comparatory analysis, there was demonstrated significantly more prominent decrease of anginal attacks per day and times of short nitrates be taken (p<0,05), improvement of functional class (FC) of angina in patients receiving Coraxan with Preductal MB. By the end of follow-up, in the 1st group 20% of patients had I FC of angina, 53,3% — II FC, 26,7% — III FC. Patients from 2nd group had I GC in 6,7% cases, II FC — 33,3%, III — 60%. Holter monitoring analysis revealed the decrease 4,7 times the quantity of ventricular and 4,5 times supraventricular extrasystoles at the background of long-term intake of Coraxan and Preductal MB, significantly less prominent dynamics was shown in the 2nd group. Only in the group of Coraxan with Preductal MB, there was improvement of systolic and diastolic function of the left ventricle.Conclusion. In CHD and COPD patients with common exacerbations it is feasible to apply antianginal therapy that includes Coraxan and Preductal MB, and that not only facilitates prominent decrease of clinical symptoms, improvement of life quality, but also helps to reduce heart rhythm disorders, improves systolic and diastolic left ventricle function, hence preventing cardiovascular complications.

Keywords

• antianginal therapy
• ischemic heart disease
• chronic obstructive pulmonary disease