Affiliation:
1. Volgograd State Medical University
Abstract
Introduction. Type 2 diabetes (T2D) increases the risk of developing cardiovascular diseases, which leads to a high mortality in this category of patients. Issues regarding the prevention of the onset and progression of coronary heart disease (CHD) and chronic heart failure (CHF) in patients with T2D and/or metabolic syndrome (MS) are still not fully understood. The use of metabolic drugs with cardioprotective effects, in particular Mildronate®, is one of the possibilities to improve the effectiveness of combination treatment of CHD and CHF.Aim. To study the effect of Mildronate® on the quality of life (QoL) of patients with CHD and CHF, suffering from T2D and/or MS.Materials and methods. A total of 2.084 patients with co-occurring two (or more) disorders: obesity, type 2 diabetes, angina pectoris, CHT, and CHF were included in the INDICOR observational study conducted in real-life clinical practice settings. Group 1 received therapy with disease-modifying agents prescribed due to CHD and T2D; Group 2 received Mildronate® at a dose of 1000 mg per day in addition to the same therapy. The studied lab test results were assessed at baseline and 42 days of therapy.Results. A 42-day course of therapy in patients receiving Mildronate® at a dose of 1000 mg per day in addition to disease-modifying therapy (DMT) contributed to a percentage increase in the number of patients with CHD, FC (functional class) I angina pectoris (Δ,% + 63%, p < 0.001 ) as compared to the control group with no significant changes (Δ,% + 7%, p > 0.5). A significant increase in the number of patients with FC I CHF was recorded in Group 2 (from 23.5 to 42.1%, Δ,% + 79%) as compared to Group 1, where no significant changes were detected (22.7 to 23.7%, Δ,% + 4%). The QoL in patients with CHF based on data collected using the Minnesota Questionnaire and QoL in patients with CHD based on data collected using the Seattle Questionnaire significantly improved in the groups that received Mildronate® in addition to DMT, as compared with the group of patients who were only on DMT.Conclusion. Results from the Seattle and Minnesota questionnaires showed that the use of Mildronate® as part of combination therapy in patients with CHD and CHF, suffering from T2D and/or MS, contributed to a significant reduction in the frequency of angina attacks and lowering angina FC, CHF FC, and also enhanced the quality of life in this category of patients.
Reference22 articles.
1. Dedov II, Shestakova MV, Vikulova OK, Zheleznyakova AV, Isakov MA, Sazonova DV, Mokrysheva NG. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022. Diabetes Mellitus. 2023;26(2):104–123. (In Russ.) https://doi.org/10.14341/DM13035.
2. Bertoni AG, Hundley WG, Massing MW, Bonds DE, Burke GL, Goff DCJr. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care. 2004;27(3):699–703. https://doi.org/10.2337/diacare.27.3.699.
3. Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020;25(11):4083. (In Russ.) https://doi.org/10.15829/1560-4071-2020-4083.
4. Statsenko ME, Turkina SV, Lopushkova YuE. New data on well-known drug: focus on meldonium. Meditsinskiy Sovet. 2021;(14):110–117. (In Russ.) https://doi.org/10.21518/2079-701X-2021-14-110-117.
5. Dzerve V, Matisone D, Pozdnyakov Y, Oganov R. Mildronate improves the exercise tolerance in patients with stable angina: results of a long term clinical trial. Sem Cardiovasc Med. 2010;16(3):1–8. Available at: https://www.semanticscholar.org/paper/Mildronate-improves-the-exercise-tolerance-in-with-Dzērve-Matisone/e7709fd78ef2e653f7aad85cd9b7f83244cdfb4e.