Vol. 9, Issue 2 (2020)

Author(s):
Iryna Kupnovytska and Nelya Romanyshyn

Abstract:
The article studied clinical effectiveness of the sinus node If-channel inhibitor – ivabradine in combination with background therapy preparations in the patients with chronic single-vessel or multivessel coronary artery disease, heart failure with preserved left ventricular ejection fraction, who underwent myocardial revascularization surgery. The study included 120 patients randomized according to the number of the affected coronary arteries, the method of treatment and the duration of the postoperative period following carotid artery stenting. One month after myocardial revascularization for single-vessel or multivessel coronary artery disease, the dynamics of coronary artery disease manifestations in the patients receiving ivabradine and background therapy preparations (the main group) was almost similar to that in the patients undergoing background therapy only (p>0.05) On the 12^th month of treatment, the patients with single-vessel and multivessel coronary artery disease, who received background therapy only, developed a greater need for additional use of nitroglycerine as compared to the patients who received background therapy in combination with ivabradine (р<0.05). At the end of the observation, the patients of the control group, who underwent single and multiple coronary artery stenting, walked 1.1, 1.2 times lower distance as compared to the patients of the main group (р<0.05). Twelve months after angioplasty with carotid artery stenting, the patients, who underwent multiple carotid artery stenting and received background therapy, required 62.2% more nitroglycerine tablets per week. After 1 month of treatment, according to the Seattle Angina Questionnaire and the Minnesota Living with Heart Failure Questionnaire, quality of life was almost similar in both groups. However, according to theMinnesota Living with Heart Failure Questionnaire and the Seattle Angina Questionnaire, on the 6^th month of treatment, quality of life was 7.9% and 6.3% worse than that in the patients of the main group (р<0.05). After 12 months of treatment, the difference between the main and control groups, according to both questionnaires, was 10.9% and 29.3% (both р<0.05). During the observation, 10 (17.2%) patients of the main group sought medical attention for anginal pain during excessive exercises, while in the control group, there were 23 (37.1%) cardiac events (3 patients, including one with non-fatal MI, underwent angioplasty with re-stenting, 3 patients were hospitalized for angina pectoris exacerbation to functional class III and 16 individuals sought medical attention for stable angina signs). There were no cases of functional class IV angina pectoris according to the Canadian Cardiovascular Society Angina Grading Scale (2013), coronary artery bypass grafts, restenosis or fatal cardiovascular events.