2015


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2015/№1

Remote effects of omega-3 polyunsaturated fatty acids (PUFA) on the course of IHD following ST elevation myocardial infarction associated with multivessel stenosing coronary atherosclerosis

Sinkova M. N.1, Pepeplyaeva T. V.2, Isakov L. K.1, Tarasov N. I.1, Teplyakov A. T.3, Mukharlyamov F. Yu.4
1 - State Budgetary Educational Institution of Higher Professional Education, "Kemerovo State Medical Academy" of the RF Ministry of Health Care, Voroshilova 22a, Kemerovo 650029
2 - Federal Government Institution of Health Care, "Medical Sanitary Unit of the RF Ministry of Internal Affairs for the Kemerovo Region", Kuzbasskaya 10a, Kemerovo 650099
3 - Federal State Budgetary Institution, "Research Institute of Cardiology" at the Siberian Division of the Russian Academy of Medical Sciences, Kievskaya 111a, Tomsk 634012
4 - State Budgetary Institution of Health Care, "Moscow Science and Practice Center for Medical Rehabilitation, Restorative and Sport Medicine at the Moscow City Department of Health Care", Zemlyanoy Val 53, Moscow 107120

Keywords: atherosclerosis, CAD, ST-segment elevation myocardial infarction, omega-3 fatty acids

DOI: 10.18087/rhj.2015.1.1994

Background. The ω-3 PUFA drug is presently proved to decrease mortality of patients with IHD; however, efficacy of this drug has not been studied in patients with multivessel coronary disease after a primary transcutaneous coronary intervention (TCI). Aim. To evaluate effects of the long-term ω-3 PUFA (Omacor, Solvay Pharma) treatment on the course of IHD after a primary TCI for multivessel coronary disease. Materials and methods. The study included 101 patients aged 35 to 70 who have had a primary TCI for ST segment elevation myocardial infarction (STEMI) and multivessel coronary disease. Patients were divided into 2 groups: group 1 (n=68), conservative tactics using a standard drug therapy; group 2, (n=33), standard drug therapy supplemented with ω-3 PUFA. Results. At 36 months, incidences of recurrent MI, decompensated CHF, progressive angina, and heart rhythm disorders were lower in the ω-3 PUFA treatment group. Thus, ventricular extrasystole >3 Lown’s grade was observed in 84.6 % of patients in group 1 and in63.6 % of patients in group 2 (OR, 0.75; 95 % CI, 0.64–0.87; р=0.05); atrial extrasystole was observed in 100 % and 90.9 % of patients, respectively (OR, 0.90; 95 % CI, 0.84–0.96; р=0.05). For the 36‑month observation period, patients of group 2 achieved a better anti-ischemic effect, which was evident as an 80.9 % decrease from baseline in angina rate (р<0.047) and a 27.6 % decrease from baseline in CHF severity. The increase in exercise tolerance by results of the 6‑min walk test was greater in group 2, 65 % (from 166.2 to 323.5 m). Conclusion. Long-term administration of ω-3 PUFA to patients with STEMI associated with multivessel coronary disease after a primary TCI resulted in improvement of their clinical condition, which was evident as increased exercise tolerance and improved quality of life.
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Sinkova M. N., Pepeplyaeva T. V., Isakov L. K. et al. Remote effects of omega-3 polyunsaturated fatty acids (PUFA) on the course of IHD following ST elevation myocardial infarction associated with multivessel stenosing coronary atherosclerosis. Russian Heart Journal. 2015;14 (1):3–7

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