2016


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2016/№1

Antianginal and anti-atherosclerotic efficacy of the standard therapy for IHD, its combination with isosorbide dinitrate and nicorandil in patients with angina and obesity

Solodova Yu. A., Adamchik A. S.
State Budgetary Educational Institution of Higher Professional Education, “Kuban State Medical University” of the RF Ministry of Health Care, Sedina 4, Krasnodar 350063

Keywords: coronary heart disease, exertional angina, nicorandil, obesity, oxidative damage

DOI: 10.18087/rhj.2016.1.2170

Background. Due to continuously growing number of IHD patients, search for new approaches in the treatment of obese patients with angina is highly relevant. Aim. To study anti-ischemic and anti-atherosclerotic effects of a standard therapy for IHD, a treatment including nicorandil (Cordinik, PIK-FARMA) and isosorbide dinitrate in long-term treatment of patients with stable angina and obesity. Materials and methods. The study included 93 patients with FC II-III exertional angina randomized to three groups. All patients received a standard therapy for IHD. Isosorbide dinitrate was added to the therapy of group 2 patients, and nicorandil was added to the therapy of group 3 patients. Examination of patients included measurement of weight, height and BWI, EchoCG, cycle ergometry (СEM), Doppler ultrasound of carotid arteries (DUSCA), reactive hyperemia test, measurements of blood high-sensitivity C-reactive protein (hs-CRP), fibrinogen, total cholesterol, LDL, and TG; requirement for nitroglycerin was determined before and after 24 weeks of treatment. Results. The inclusion of nicorandil or isosorbide dinitrate into the standard therapy resulted in greater changes in the clinical course of disease, reduced endothelial dysfunction and atherogenic processes, and decreased levels of proinflammatory markers. These effects were more pronounced in subgroups with normal weight and overweight than in subgroups with obesity. Conclusion. High prevalence of obesity in the population and its role in the pathogenesis of IHD require more detailed study of this issue and a comprehensive approach to management of patients with angina in combination with overweight and obesity.
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Solodova Yu. A., Adamchik A. S. Antianginal and anti-atherosclerotic efficacy of the standard therapy for IHD, its combination with isosorbide dinitrate and nicorandil in patients with angina and obesity. Russian Heart Journal. 2016;15 (1):16–23

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