Vol. 8, Issue 11 (2019)

Author(s):
Shved MI, Yastremska IO and Dobryansky TO

Abstract:
The aim of this work was to increase the effectiveness of treatment of patients with ACS by including L-carnitine and L-arginine in the complex therapy. The study included 103 patients with acute coronary syndrome (ACS) with ST segment elevation, of which 37 patients who underwent urgent coronary angiography followed by balloon angioplasty and heart attack-dependent coronary artery stenting, as well as an additional cytoprotective therapy, constituted the first studied group. 34 patients who used cytoprotective treatment without coronary arteries stenting made up the 2nd studied group. The control group consisted of 32 patients who received only standard protocol treatment for ACS (MI). The functional state of endothelium was determined by the concentration of endothelin-1 (ET-1) in blood plasma and the content of stable NO metabolites; the parameters of the general blood test were examined and the level of the MV fraction of creatine phosphokinase (MV-CPK). In patients with acute MI, expressed disturbances of the morphological and functional parameters of the heart are observed, namely, the progression of its post-infarction remodeling, followed by a disturbance of the systolic and diastolic functions of the heart and the progression of heart failure syndrome and endothelial vascular dysfunction. Structural and functional disorders of the heart parameters are accompanied by a more frequent progression of the complicated course of MI; on the first day after percutaneous coronary intervention, reperfusion syndrome with manifestations of acute left ventricular failure and rhythm disturbances (tachycardia, high grade extrasystole, fibrillation, was most often diagnosed with standard drug therapy)) and conductivity (left bundle branch block, AV blockade II-III degree). The additional inclusion of a mixture of L-arginine and L-carnitine in standard drug therapy significantly reduces the incidence and severity of MI complications such as reperfusion arrhythmias and acute left ventricular failure.