Efficacy of various combined treatment regimens in patients with stable effort angina, functional classes II-III

Abstract

Introduction: Inflammation and metabolic disorders of cardiomyocytes are undoubtedly important pathogenetic links in the development of coronary heart disease and its complications. Our study assessed the effect of various combined treatment regimens on cycle ergometry performance and plasma concentrations of pro- and anti-inflammatory interleukins in patients with stable effort angina, functional classes II-III.

Materials and Methods: The clinical study included 120 patients diagnosed with coronary heart disease: stable effort angina, functional classes II–III, and 40 healthy participants who met the inclusion criteria. Further, four groups were randomly formed: a group receiving the standard treatment; a group receiving Mexicor for 10 days in addition to the standard treatment; a group receiving Mexicor and Phosphogliv for 10 days in an addition to the standard treatment; and a group receiving Mexicor and Polyoxidonium for 10 days in addition to the standard treatment. After the treatment, cycle ergometry performance and plasma concentrations of pro- and anti-inflammatory cytokines were assessed in the patients. Mathematical statistical analysis was carried out using Statistica 10.0 software. The statistical significance of differences between the qualitative indicators was assessed using the χ2 test. The results of the statistical analysis were considered statistically significant at p<0.05.

Results: The combined treatment with using the above-mentioned pharmacological agents resulted in a statistically significant improvement in cycle ergometry indicators: Mexicor made it possible to increase the threshold load power by 43.0% and the total load power – by 70.3%. In the groups of patients with coronary heart disease who had received Mexicor and Phosphogliv or Mexicor and Polyoxidonium, there was an increase in the load duration by an average of 69.0% and in the rate-pressure product – by 25%, respectively. When analyzing the dynamics of plasma concentrations of pro-inflammatory cytokines, it was found that a statistically significant decrease in the concentrations of tumor necrosis factor-α, interleukin-1ß, interleukin-6 and interleukin-10 was registered only in the groups receiving Mexicor and Phosphogliv or Mexicorand Polyoxidonium in addition to the standard treatment.

Conclusion: Applying the combined treatment regimens using Mexicor and Phosphogliv or Polyoxidonium results in the most effective improvement of the cycle ergometry performance and the dynamics of plasma concentrations of pro- and anti-inflammatory interleukins in patients with stable effort angina, functional classes II-III.

Graphical Abstract