Use of Ethylmethylhydroxypyridine in Patients Presenting with Myocardial Infarction: Antiischemic, Antidepressant, Anxiolytic Effects

Abstract

The objective: to evaluate the efficiency of ethylmethylhydroxypyridine (Mexiprim, STADA Arzneimittel AG, Germany) in patients presenting with myocardial infarction at hospital and outpatient stage. Patients and methods. The study included 59 patients with coronary artery disease, acute coronary syndrome with ST1segment elevation in the first day of admission to the ICU, AH, 3-stage, 2 degrees, HF. To all patients basic therapy according to current ESH/ESC guidelines was prescribed. To 39 patients additionally intravenous infusion of 200 mg of mexiprim o.d. for 10 days, followed by 125 mg per os three times a day for next 60 days was administered. Another 20 patients presented control group and received only basic therapy. The study design included: 24-hour Holter monitoring to estimate the dynamics of changes in the ST segment, cardiac arrhythmias and heart rate variability, evaluation by the scale of Beck, Hamilton scale for the assessment of anxiety (HARS) and depression (HDRS), the common blood and urine tests, biochemical blood analysis, evaluation of therapeutic tolerability conducted before treatment and 60 days after treatment. Surveys on a scale SAN, assessment of cognitive impairment on the MMSE scale were performed on the 60th day of treatment. Efficiency criteria were: a 50% reduction of cardiac arrhythmias, a decrease in ischemia, a decrease by 50% or more from baseline average score by HARS, HDRS scales, dynamics of the mental state questionnaire and less than 9 points on a scale of depression, reducing in SAN scale score. Results. In pаtients of mexiprim group significant reduction of depression scores by 62% were observed. According to the dynamics of the mental state questionnaire patients of mexiprim group reported feeling better, that is, reduction of score by 45% . According to the Hamilton scale for the assessment of anxiety (HARS), in particular mental anxiety – decrease in the total score of 65%, somatic anxiety – by 35.5%, and a total of 50% were revealed. In the group of patients receiving additionally intravenous Mexiprim for 10 days significantly reduced the number of single and group PACs, as well as single and multiple PVCs, not only in comparison with these parameters before the treatment, but also in comparison with the control group. In patients treated with Mexiprim no evidence of residual ischaemia were noted, but in the control group statistically significant segment depression ST remained. Heart rate variability was not significantly changed in the control group, but increased in patients who received Mexiprim. Conclusion. Use of Mexiprim in patients with myocardial infarction reduces ST segment depression, amount of ventricular and supraventricular arrhythmias, improved heart rate variability, and the state of anxiety and depression.