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ЛЕЧЕНИЕ СТАБИЛЬНОЙ СТЕНОКАРДИИ НАПРЯЖЕНИЯ ТРОЙНЫМИ КОМБИНАЦИЯМИ АНТИАНГИНАЛЬНЫХ ПРЕПАРАТОВ В ГЕРИАТРИЧЕСКОЙ ПРАКТИКЕ

https://doi.org/10.21518/2079-701X-2017-12-62-67

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Аннотация

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.

 

 

 

Об авторах

С. Г. Канорский
Кубанский государственный медицинский университет Минздрава России, Краснодар
Россия

д.м.н., профессор, 



Н. В. Смоленская
Кубанский государственный медицинский университет Минздрава России, Краснодар
Россия


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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)