INDEX OF FUNCTIONAL CHANGES IN ASSESSMENT OF ADAPTATION STATUS OF PATIENTS WITH COMORBIDITY FOR INCLUSION OF TRIMETAZIDINE IN COMPLEX THERAPY

Aim. The aim of the study was to assess the clinical effectiveness of treating patients with coronary heart disease in combination with diabetes mellitus with trimetazidine. Materials and Methods. 115 Patients with IHD and III FC stable exertional angina were observed. The first group included patients with IHD and III FC stable exertional angina – 56 patients. The second group included 59 individuals with IHD, exertional angina and type 2 diabetes mellitus. The mean age of patients involved into the study was 52±4.2 years. According to the protocol of study, in addition to therapy of IHD and type 2 DM, patients received preductal OD at a standard dose 80 mg once a day within 3 months. Examination included common blood count, common urine analysis, biochemical blood analysis, ECG in 12 standard leads (calculation of QT duration in seconds, depression of ST), echo-CG, US of internal organs, Holter monitoring of ECG , measurement of arterial pressure, height and weight, calculation of BMI. In all patients selective coronary angiography was conducted with evaluation of the number of coronary arteries affected by atherosclerotic lesion and the extent of evidence. The level of functioning of the myocardium was evaluated by dispersion ECG mapping. The method was realized using Caridovisor-06 device being a part of Ecosan-2007 complex. For dispersion ECG mapping technical and software means were used developed by TOO Medical Computer systems, and the package of Cardiovisor-06c application programs (Zelenograd). Statistical analysis, graphs, and diagrams were performed using the built-in package of EXCEL-2010 program, and of Statistica 8.0 package for Windows. Results. A statistically significant decrease in myocardial index(MI) as compared to the two pre-vious groups was noted on the 2nd and 3d visits both in the IHD group without diabetes mellitus, and to a greater extent in patients with IHD and type 2 diabetes mellitus. Here, MI levels reach practically normal values, as in healthy individuals. Conclusion. According to the data of dispersion mapping, a favorable effect of the inclusion of the preductal OD to the complex therapy of patients with ischemic heart disease in combination with type 2 diabetes mellitus was found, which is associated with a partial switching of the energetic mechanism of ATP synthesis from fatty acids to the glucose pathway.