THERAPY OF STABLE ANGINA OF EFFORT BY TRIPLE COMBINATIONS OF ANTIANGINAL DRUGS IN GERIATRIC PRACTICE
The prospective randomized study of the efficacy and safety of antianginal therapy with a combination of bisoprolol, ivabradine and trimetazidine or ranolazine included 107 patients aged 60 to 79 years with coronary heart disease and angina of effort of functional class II-IIIs. If the angina and/or myocardial ischemia sine dolore in patients receiving bisoprolol and ivabradine after randomization was additionally administered Trimetazidine (35 mg 2 p/day, n = 54) or ranolazine (500 mg 2 p/day, n = 53). Within 6 months both the treatment was well tolerated, significantly improved the results of treadmill exercise test, systolic and diastolic functions of the left ventricle, the structural and functional state of large arteries, quality of life of patients. Trimetazidine largely reduced the duration of painless depression of the ST segment according to Holter electrocardiogram. Combination of low-dose beta-blocker with ivabradine and trimetazidine or ranolazine can be used for the treatment of refractory stable angina in patients of elderly and senile age.