DEPRESSIVE DISORDERS MANAGEMENT IN ISCHEMIC HEART DISEASE PATIENTS

OBJECTIVE: To study the dynamics of clinical, instrumental and psychological parameters in patients with ischemic heart disease (IHD) and comorbid depressive disorders on the stages of standard baseline therapy and additional tianeptine intake to develop proposals to improve management of such patients. METHODS: 142 patients (77 males and 65 females) with the painful form of IHD in age from 45 to 60 years were examined. Quality of life (QoL), levels of depression, anxiety, pain perception; functional classes (FC) of stable angina pectoris and HRV indices were studied in patients with IHD in groups with a presence and absence of the depressive disorders at the beginning, in 3 weeks, 3, 6 and 12 months of baseline therapy and before and after 4 weeks of tianeptine adding to baseline therapy. RESULTS: It was determined, that the depressive disorders result in worsening of QoL and HRV indexes. It was shown, that basic IHD therapy in the group of depressed patients with positive dynamics doesn’t allow to achieve QoL and HRV indexes registered in the group of non-depressed patients. Also adding of tianeptine to baseline IHD therapy in depressed patients allows not only to improve QoL and HRV indexes, but also to attain the values of the proper indexes as in non-depressed group. CONCLUSIONS: Patients with IHD should be examined for the presence of depressive disorders. In pa-tients with IHD and clinically significant depression diagnosed antidepressant tianeptine must be added to baseline therapy.