ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Coronary Atherosclerosis in Men with Metabolic Syndrome: Risk Factors and the Role of Myocardial Cytoprotective Agents

Bibliography link: Rudakova D. M., Veselovskaya N. G., Chumakova G. A. Coronary Atherosclerosis in Men with Metabolic Syndrome: Risk Factors and the Role of Myocardial Cytoprotective Agents. Doctor.Ru. 2017. 10(139): 15–20.
20 October 00:00

Study Objective: To study risk factors (RF) for coronary atherosclerosis in men with metabolic syndrome (MetS) and assess the efficacy of trimetazidine in patients with stable, effort-induced angina and MetS.

Study Design: This was a randomized prospective study.

Materials and Methods: Eighty-two men with MetS, aged 39 to 73 (mean age 56.42 ± 7.3), were included in the study. Group I consisted of 40 patients with MetS, grade II or III effort-induced angina, and coronary atherosclerosis diagnosed by coronary angiography. Group II was made up of 42 patients with MetS who did not have effort-induced angina or coronary atherosclerosis (based on multi-slice spiral computed tomography of the coronary arteries). Additional analysis of Group I was done to assess the efficacy of treatment with trimetazidine for three months.

Study Results: The following parameters were higher in Group I than in Group II: HOMA-IR (4.07 ± 0.16 vs. 2.36 ± 0.10 conventional units), insulin (13.40 ± 0.40 µIU/mL vs. 9.08 ± 0.50 µIU/mL; р < 0.001 for both comparisons), apolipoprotein B (114.62 ± 5.30 mg/dL vs. 90.47 ± 3.40 mg/dL), lipoprotein (a) (Lp(a)) (48.81 ± 6.40 mg/dL vs. 39.13 ± 4.20 mg/dL), interleukin-6 (6.35 ± 0.31 pg/L vs. 3.45 ± 0.02 pg/L), tumor necrosis factor-α (5.5 ± 0.36 pg/mL vs. 3.41 ± 0.2 pg/mL), and high-sensitivity C-reactive protein (hsCRP) (8.78 ± 0.43 mg/L vs. 6.44 ± 0.4 mg/L; р < 0.05 for all comparisons). The following parameters were lower in Group I than in Group II: apolipoprotein A1 (84.27 ± 2.80 mg/dL vs. 98.16 ± 4.10 mg/dL;р < 0.05) and apelin (0.17 ± 0.15 pg/L vs. 0.46 ± 0.15 pg/L; р < 0.001). After three months of treatment with trimetazidine, Group I patients had a lower frequency of angina attacks, less need for short-acting nitrates, a lower class of effort-induced angina, and higher exercise tolerance as assessed by a stationary bicycle exercise test (р < 0.05 for all comparisons), than patients in the group who did not take trimetazidine.

Conclusion: In patients with MetS the development of coronary atherosclerosis is associated with higher insulin resistance, higher levels of insulin and HOMA-IR, significantly higher levels of proinflammatory cytokines and hsCRP, and lower levels of apelin. Apolipoprotein and Lp(a) levels also play a role. Trimetazidine is effective in patients with grade II or III stable effort-induced angina and MetS.


D. M. Rudakova — Altai State Medical University, Barnaul. Altai Territorial Clinical Hospital, Barnaul. E-mail: g.a.chumakova@mail.ru

N. G. Veselovskaya — Altai State Medical University, Barnaul. Research Institute for Complex Issues of Cardiovascular Disease, Kemerovo. E-mail: nadezhda100@rambler.ru

G. A. Chumakova — Altai State Medical University, Barnaul. Research Institute for Complex Issues of Cardiovascular Disease, Kemerovo. E-mail: g.a.chumakova@mail.ru


Доктор.ру
20 October 00:00
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