[Clinical and Economic Aspects of Meldonium as Part of Physical Rehabilitation Programs in Patients With Coronary Heart Disease After Percutaneous Coronary Interventions]

Kardiologiia. 2016 Aug;56(8):13-18. doi: 10.18565/cardio.2016.8.13-18.
[Article in Russian]

Abstract

Purpose: to analyze clinical and economical effectiveness of meldonium as component of integrated program of cardio-rehabilitation in patients with ischemic heart disease (IHD) in the early period after percutaneous coronary intervention (PCI) with incomplete revascularization.

Material and methods: A program of controlled physical training (CPT) was carried out in patients with stable IHD and positive post PCI exercise test (n=48, age less or equal 65 years) starting 8-10 days after PCI. CRT program consisted of 2 phases - inhospital (exercise on treadmill with max heart rate [HR] 80% of that achieved in initial test, 10 times during 2 weeks) and home (exercise on treadmill with max HR 60% of HR achieved in initial test, 3 times a week for 2 months). Before initiation of CRT patients were distributed into 2 groups: CRT without (n=23; 56.7+/-7.1 years) and with (n=25; 54.6+/-6.8 years) administration of meldonium (1000 mg/day intravenously). Control group (n=24; 50+/-8.4 years) consisted of patients who were under outpatient observation, received similar drug therapy, but were not subjected to CRT. After completion of CRT (in 2.5 months) all patients underwent clinical-instrumental examination with determination of exercise tolerance.

Results: Exercise duration and metabolic equivalent (MET) increased by 43.9, 36.6, 4.1% and 42.1, 34.8, 3.4% in CRT+ meldonium, CRT only, and control groups, respectively.

Conclusion: In patients with documented ischemia after PCI inclusion of meldonium in the scheme of rehabilitation was associated with improved physical performance and optimal cost-effectiviness.

Keywords: cardio-rehabilitation; clinical and cost-effectiveness; coronary heart disease; meldonium.

MeSH terms

  • Cardiovascular Agents / economics
  • Cardiovascular Agents / therapeutic use*
  • Coronary Disease / economics
  • Coronary Disease / physiopathology
  • Coronary Disease / rehabilitation*
  • Coronary Disease / surgery
  • Exercise Test
  • Exercise Tolerance
  • Female
  • Humans
  • Male
  • Methylhydrazines / economics
  • Methylhydrazines / therapeutic use*
  • Middle Aged
  • Myocardial Ischemia / economics
  • Myocardial Ischemia / physiopathology
  • Myocardial Ischemia / rehabilitation
  • Myocardial Ischemia / surgery
  • Percutaneous Coronary Intervention
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Methylhydrazines
  • 3-(2,2,2-trimethylhydrazine)propionate