medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2017-12-62-67

medsovet-2011

Research Article

ИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦА

ISHEMIC HEART DISEASE

ЛЕЧЕНИЕ СТАБИЛЬНОЙ СТЕНОКАРДИИ НАПРЯЖЕНИЯ ТРОЙНЫМИ КОМБИНАЦИЯМИ АНТИАНГИНАЛЬНЫХ ПРЕПАРАТОВ В ГЕРИАТРИЧЕСКОЙ ПРАКТИКЕ

THERAPY OF STABLE ANGINA OF EFFORT BY TRIPLE COMBINATIONS OF ANTIANGINAL DRUGS IN GERIATRIC PRACTICE

Канорский

С. Г.

Kanorsky

S. G.

д.м.н., профессор,

MD, Prof.

Смоленская

Н. В.

Smolenskaya

N. V.

Кубанский государственный медицинский университет Минздрава России, КраснодарРоссияKuban State Medical University of the Ministry of Health of Russia, KrasnodarRussian Federation

2017

02112017

0126267

2017

Канорский С.Г., Смоленская Н.В.

Kanorsky S.G., Smolenskaya N.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/2011

В проспективном рандомизированном исследовании эффективности и безопасности антиангинальной терапии сочетаниями бисопролола, ивабрадина и триметазидина или ранолазина участвовали 107 больных в возрасте от 60 до 79 лет с ишемической болезнью сердца и стенокардией напряжения II/III функционального класса. При сохранении стенокардии и/или безболевой ишемии миокарда на фоне приема бисопролола и ивабрадина после рандомизации дополнительно назначались триметазидин (35 мг 2 р/сут, n = 54) или ранолазин (500 мг 2 р/сут, n = 53). В течение 6 месяцев оба способа лечения хорошо переносились, существенно улучшали результаты теста с физической нагрузкой на тредмиле, показатели систолической и диастолической функций левого желудочка, структурного и функционального состояния крупных артерий, качества жизни больных. Триметазидин в большей степени уменьшал продолжительность безболевой депрессии сегмента ST по данным холтеровского мониторирования электрокардиограммы. Комбинации низкой дозы бета-адрено-блокатора с ивабрадином и триметазидином или ранолазином могут применяться для лечения рефрактерной стабильной стенокардии у пациентов пожилого и старческого возраста.

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.

стабильная стенокардия напряжениябисопрололивабрадинранолазинтриметазидин

stable angina of effortbisoprololivabradineranolazinetrimetazidine

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The authors declare that there are no conflicts of interest present.