Analysis of Mexicor Application in Patients with Acute Coronary Syndrome
Materials and methods. The study involved two groups of patients with acute coronary syndrome. The first group included 48 patients with unstable angina (UA) aged 58.5 ± 3.8 years. UA diagnosis was verified on the basis of complaints of patients and changes in the electrocardiogram (ECG) - increase or depression of an interval by 1 mm for no more than 3 days, absence of hypokinesis zones during ultrasound of the heart, a negative troponin test. The second group consisted of 45 patients with acute myocardial infarction (AMI). The diagnosis was verified by a troponin test and ECG changes. This group included patients with Q-positive AMI. Men - 83.2 %, women - 16.8 %. The average age of patients was 60.3 ± 1.2 years. Posterobasal localization was detected in 40.2 % of patients, anterior - in 59.8 %. 70 % of the patients had a history of II stage hypertension. The duration of ischemic heart disease averaged 10.8 ± 4.5 years. 80 % of patients in this group were treated repeatedly in cardiological hospitals for exacerbations of ischemic heart disease. 38.5 % of patients had supraventricular and ventricular (extrasystole) arrhythmias at the admission. Results. Application of Mexicor in patients with AMI significantly improved the systolic function of the heart, which manifested in significant differences reflecting its basic parameters (ejection fraction, circumferential fiber shortening velocity, cardiac output) and related parameters in patients of the control group. These favorable changes were also identified when studying the dynamics of indicators of diastolic heart function, determined by transmitral flow velocity. Discussion. These changes we associate with the restoration or improvement of contractility of ischemic myocardium and functional state of the so-called intact parts of the heart compensating by their activity the loss of contractile function in necrotic areas. This is confirmed by the dynamics of the state of akinesia and dyskinesia zones in patients with MI, where there is a recovery of contractility of some parts of the heart against application of Mexicor (transition of areas bordering with infarction zones from the state of akinesia to hypokinesis, hypokinesis - to normokinesis) and almost the inverse dynamics in patients of the control group. Mexicor helped to improve the clinical course of MI, which was manifested in a limited size of necrosis and stimulation of reparative processes, improving the contractile function of the heart and the gas exchange, reducing the incidence of prolonged and recurrent course, the risk of heart aneurysm and cases of heart failure, arrhythmias and conduction disorders, circulatory failure and ultimately mortality. According to the results of Holter monitoring in patients with UA, Mexicor accelerated the stabilization of angina and decreased, in comparison with the control group, the daily incidence and duration of periods of myocardial ischemia, arrhythmia episodes, favorably influenced the changes of ST deviation and the ratio of painful/painless periods of ischemia. Conclusions. Inclusion of Mexicor in the conventional therapy of acute coronary syndrome enables already on the prehospital stage to reduce significantly the manifestations of oxidative stress, contributes to the normalization of the cardiovascular system activity and improves the clinical course of the disease.