ABILITY OF THIOCTIC ACID IN THE TREATMENT OF PATIENTS WITH TYPE TWO DIABETES AFTER ACUTE MYOCARDIAL INFARCTION
https://doi.org/10.21518/2079-701X-2017-11-152-155
Abstract
Relevance: diabetic cardiovascular autonomic neuropathy (CAN) is considered as one diabetes-associated mechanism complicating the course and prognosis of myocardial infarction (MI). Objective: to assess the effect of thioctic acid (TA) on the dynamics of indices of heart rate variability (HRV) in patients with Type 2 diabetes mellitus 2 type (DM2) after acute IM.
Materials and methods: we conducted an open randomized prospective study. It included 50 patients with T2DM after MI. For 10–14 days from the date of MI development a study of heart rate variability was done. Group 1 consisted of 10 patients with CAN, and they received TA (Thiogamma, Worwag Pharma GmbH & Co. KG (Germany) oral tablets at a dose of 600 mg per day for 3 months, 19 patients with CAN (Group 2) and 20 patients without CAN (Group 3) didn’t receive TA, 1 patient dropped out.
Results: improvement of HRV after 3 months were in groups with low baseline area of the scatterogram clouds: in Group 1 the baseline value is 290 ms2 [202; 415] vs. 1025,5 ms2 [620; 1546] after 3 months (p = 0.005); in Group 2: 238 ms2 [162; 239] vs 531 ms2 [339; 795], p < 0.001. In Group 3 no significant changes were identified: 948,5 MS2 [783; 1642] vs 1220 MS2 [805; 1610] (p = 0,88). In patients with CAN, the largest increase of parameters of HRV was found in the group of TA intake: 706 ms2 [285; 1131] in group 1 vs 284 ms2 [80; 506] in Group 2, p = 0,02.
Conclusions: the use of TA at a dose of 600 mg for 3 months to treat a CAN in DM2 patients after acute MI is accompanied by a significant improvement of HRV indices.
About the Authors
A. V. Bushueva
Nizhny Novgorod State Medical Academy
Russian Federation
Russian Federation
S. N. Botova
Nizhny Novgorod State Medical Academy
Russian Federation
PhD in medicine
Russian Federation
PhD in medicine
I. G. Pochinka
Nizhny Novgorod State Medical Academy
Russian Federation
PhD in medicine
Russian Federation
PhD in medicine
L. G. Strongin
Nizhny Novgorod State Medical Academy
Russian Federation
MD
Russian Federation
MD
References
1. Yusuf S, Hawken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004, 364: 937-952.
2. McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med, 2011, 124(1): 40–47.
3. Franklin K, Goldberg RJ, Spencer F, et al. Implications of diabetes in patients with acute coronary syndrome. The Global Registry of Acute Coronary Events. Arch Intern Med, 2004, 164: 1457-1463.
4. Hasin T, Hochadel M, Gitt AK et al. Comparison of treatment and outcome of acute coronary syndrome in patients with versus patients without diabetes mellitus. Am J Cardiol, 2009, 103: 772-778.
5. Vujosevic S, Zamaklar M, Belada N, Stamatovic S. Mortality after acute myocardial infarction: significance of cardiovascular diabetic autonomic neuropathy (CDAN). Med Arch, 2012, 66(5): 296–299.
6. Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care, 2003, 26(5): 1553–1579.
7. Стронгин Л.Г., Ботова С.Н., Починка И.Г. Способ диагностики кардиоваскулярной автономной нейропатии у больных сахарным диабетом, страдающих хронической сердечной недостаточностью. Патент РФ 2336811. 2008.
8. Бушуева А.В., Ботова С.Н., Починка И.Г., Морозова Е.П., Фролов А.А., Стронгин Л.Г. Диагностика кардиоваскулярной автономной нейропатии у больных сахарным диабетом 2 типа с подострой стадией инфаркта миокарда с подъемом сегмента ST. Современные технологии в медицине, 2016, 8(2): 53-58.
9. Ziegler D, Ametov A, Barinov A, Dyck PJ, Gurieva I et al. Oral Treatment with Alpha-Lipoic Acid Improves Symptomatic Diabetic Polyneuropathy-The SYDNEY 2 Trial. Diabetes Care, 2006, 29: 2365-2370.
10. Ziegler D, Schatz H, Conrad F, Gries FA et al. Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Diabetes Care, 1997, 20(3): 369-373.
11. Стручкова Ю.В., Починка И.Г., Морозова Е.П. Применение тиоктовой кислоты при диабетической кардиоваскулярной автономной нейропатии у больных сахарным диабетом 2 типа, страдающих хронической сердечной недостаточностью. Медицинский альманах, 2011, 3(16): 168-171.
12. Nolan J, Batin PD, Andrews R et al. Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation, 1998, 98(15): 1510-1516.
Review
For citations:
Bushueva AV, Botova SN, Pochinka IG, Strongin LG. ABILITY OF THIOCTIC ACID IN THE TREATMENT OF PATIENTS WITH TYPE TWO DIABETES AFTER ACUTE MYOCARDIAL INFARCTION. Meditsinskiy sovet = Medical Council. 2017;(11):152-155. (In Russ.) https://doi.org/10.21518/2079-701X-2017-11-152-155
Views:
746
Email this article 