Effect of Mexidol on the quality of life and functional status of patients with chronic cerebral ischemia and chronic heart failure with reduced left ventricular ejection fraction
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Author:
V.V. TOLKACHEVA1, E.R. KAZAKHMEDOV1, ZH.D. KOBALAVA1, S.A. GALOCHKIN1, A.V. SHCHULKIN2
1Peoples’ Friendship University of Russia, Moscow, Russia;
2Pavlov Ryazan State Medical University, Ryazan, Russia
Effect of Mexidol on the quality of life and functional status of patients with chronic cerebral ischemia and chronic heart failure with reduced left ventricular ejection fraction
Author:
V.V. TOLKACHEVA1, E.R. KAZAKHMEDOV1, ZH.D. KOBALAVA1, S.A. GALOCHKIN1, A.V. SHCHULKIN2
1Peoples’ Friendship University of Russia, Moscow, Russia;
2Pavlov Ryazan State Medical University, Ryazan, Russia
Summary:
Objective. To study the effect of Mexidol on the functional state of myocardium, NT-proBNP level, exercise tolerance, quality of life, severity of oxidative stress, inflammatory response and endothelial dysfunction in patients with chronic brain ischemia and chronic heart failure NYHA class II-III in a 13-week sequential (intravenous and oral) therapy with Mexidol® and standard therapy. Material and methods. The study included 44 patients with chronic brain ischemia and chronic heart failure NYHA class II—III. Mean age was 65.5±11.8 years, men accounted 75%. The group of Mexidol + standard therapy of chronic heart failure included 21 patients, the group of standard therapy — 23 patients. Echocardiography parameters, exercise tolerance test (six minute walk test, SMWT), patient’s clinical condition according to SHOKS scale (modification by V. Yu. Mareev), NT-proBNP concentration, markers of oxidative stress (malonic dialdehyde (MDA), superoxide dismutase (SOD)), inflammatory reaction (C-reactive protein (CRP), tumor necrosis factor α (TNFα)), homocysteine and cystatin C were examined initially, after 7 days and 13 weeks. The quality of life was assessed initially and at the end of the study using the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). Results. «Mexidol + standard therapy» group was characterized by more significant improvement in the quality of life, better SMWT data and SHOKS scores, significant decrease in end-diastolic and end systolic LV dimensions, as well as NT-proBNP level after 7 days and 13 weeks compared to the basic therapy group. Mexidol administration reduced MDA concentration and increased SOD activity after 7 days and 13 weeks. We also observed a significant decrease in CRP and TNFα levels after 7 days and 13 weeks in the same group. Less augmentation of homocysteine was revealed in the Mexidol therapy group. There were no significant between-group differences in cystatin C levels. Conclusion. Mexidol in addition to standard therapy of chronic brain ischemia and chronic heart failure class II-III has a favorable effect on the quality of life, functional status, improves clinical condition and intracardiac circulation, decreases concentration of NT-proBNP, promotes antioxidant activity, reduces inflammatory reaction, slows down increase of homocysteine and does not influence kidney function. Keywords: chronic brain ischemia, heart failure, quality of life, cognitive status, oxidative stress, ethyl-methyl-hydroxypyridine succinate, Mexidol, inflammation, endothelial dysfunction.
Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with ischemic stroke
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Author:
M.V. ZHURAVLEVA1,2, I.A. SHCHUKIN3, M.S. FIDLER3, A.B. PROKOFIEV2, S.YU. SEREBROVA2, N.S. VASYUKOVA4, E.YU. DEMCHENKOVA1, V.V. ARKHIPOV1,2
1Research Centre for Examination of Medical Devices, Moscow, Russia;
2Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
3Pirogov Russian National Research Medical University, Moscow, Russia;
4Federal Scientific Center — All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Skryabin and Ya.R. Kovalenko, Moscow, Russia
Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with ischemic stroke
Author:
M.V. ZHURAVLEVA1,2, I.A. SHCHUKIN3, M.S. FIDLER3, A.B. PROKOFIEV2, S.YU. SEREBROVA2, N.S. VASYUKOVA4, E.YU. DEMCHENKOVA1, V.V. ARKHIPOV1,2
1Research Centre for Examination of Medical Devices, Moscow, Russia;
2Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
3Pirogov Russian National Research Medical University, Moscow, Russia;
4Federal Scientific Center — All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Skryabin and Ya.R. Kovalenko, Moscow, Russia
Summary:
Stroke is still the most significant problem of the modern medicine and the leading cause of mortality and morbidity. There is the great experience of neuroprotection in patients with stroke in the Russian Federation. In clinical practice it’s important to follow conditions, where neuroprotection will have maximum safety and effectiveness. The clinical trials of ethylmethylhydroxypyridine succinate (mexidol) in patients with acute ischemic stroke are described in the present review. Early management (in the first 6 hours) with mexidol significantly improve recovery dynamic and stroke outcome. Therapy with mexidol increases neurological recovery, improves vital activity and quality of life of patients with stroke. Furthermore, mexidol demonstrates high safety profile. Keywords: ischemic stroke, thrombolytic therapy, clinical trial, disability, antioxidant system, ethylmethylhydroxypyridine succinate, Mexidol.
The efficacy of ethylmethylhydroxypyridine succinate in patients with cerebrovascular pathology complicated with diabetes mellitus and metabolic syndrome
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Author:
E.V. EKUSHEVA1,2, E.V. BIRYUKOVA3
1Academy of Postgraduate Education under the Federal State Budgetary Unit «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency», Moscow, Russia;
2Belgorod State National Research University, Belgorod, Russia;
3Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
The efficacy of ethylmethylhydroxypyridine succinate in patients with cerebrovascular pathology complicated with diabetes mellitus and metabolic syndrome
Author:
E.V. EKUSHEVA1,2, E.V. BIRYUKOVA3
1Academy of Postgraduate Education under the Federal State Budgetary Unit «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency», Moscow, Russia;
2Belgorod State National Research University, Belgorod, Russia;
3Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
Summary:
Arterial hypertension, diabetes mellitus, obesity and dyslipidemia continue to be the main risk factors for diseases of the circulatory system and the leading causes of mortality in the world, the combination of these diseases significantly increases the likelihood of the development and more rapid progression of cardiovascular and cerebrovascular pathology. Improving approaches to the diagnosis and treatment of these diseases is a priority problem in modern medicine. Currently, there is no universal drug that can influence all stages of pathological process in both cerebrovascular diseases and diabetes mellitus, and the problem of rational use of drugs in patients with comorbid pathology has not been completely resolved. A difficult clinical task includes not only the timely detection of the disease and the correct diagnosis, but also the choice of the safest and most effective medicine. A number of clinical studies have demonstrated the efficacy of mexidol in the treatment of this category of patients, which is determined by its complex, pleiotropic and multimodal mechanisms of action. Keywords: cerebrovascular diseases, diabetes mellitus, metabolic syndrome, antioxidant therapy, mexidol.
Effectiveness and safety of mexidol forte 250 in the sequential therapy in patients with chronic ischemia
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Author:
N.G. KATAEVA1, T.A. ZAMOSHCHINA1,2, M.V. SVETLIK1,2
1 Siberian State Medical University , Tomsk, Russia;
2 National Research Tomsk State University , Tomsk, Russia
Effectiveness and safety of mexidol forte 250 in the sequential therapy in patients with chronic ischemia
Author:
N.G. KATAEVA1, T.A. ZAMOSHCHINA1,2, M.V. SVETLIK1,2
1 Siberian State Medical University , Tomsk, Russia;
2 National Research Tomsk State University , Tomsk, Russia
Summary:
Objective. To study of efficacy and safety of mexidol used as intravenous infusion for 14 days, followed by per os treatment with mexidol FORTE 250 for 60 days in patients with chronic brain ischemia (CHM) complicated with arterial hypertension and atherosclerosis. Material and methods. The mexidol group included 27 patients (24 women and 3 men) with CHM I—II gr and the combination of arterial hypertension and atherosclerosis who received intravenous infusions of mexidol (500 mg once daily) within 14 days, with the subsequent per os treatment with mexidol FORTE 250 in a daily dose of 750 mg (1 tablet 3 times a day) for 60 days. The comparison group consisted of 30 patients (22 women and 8 men) with CHM I—II gr, comparable in age, nature of risk factors and expression of neurological manifestations. Patients in both groups received basic medications to treat their risk factors. Motor activity (Tinetti test), cognitive functions (MoCa test), anxiety and depression (Hamilton anxiety and depression scale), clinical condition (General Clinical Impression scale) were assessed. Results and conclusion. Inclusion of mexidol (500 mg iv infusion once a day within 14 days with the subsequent oral administration of 750 mg (1 tablet 3 times a day) for 60 days) in standard therapy of arterial hypertension with atherosclerosis and chronic brain ischemia is expedient. The results show greater clinical efficacy and sufficient safety of such combination therapy. By the end of therapy (day 74), patients in the mexidol group have a reliable improvement in motor activity, cognitive function and psychoemotional sphere, as well as a decrease in fatigue and neurological manifestations compared with the comparison group. Keywords: chronic ischemia of a brain, mexidol, mexidol FORTE 250.
The trial of the efficacy and safety of sequential therapy with mexidol forte 250 in acute and early recovery stages of hemispheric ischemic stroke
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Author:
M.A. LOSKUTNIKOV, M.A. DOMASHENKO, T.M. VAKIN, I.A. TRUSHINA, V.I. KONSTANTINOV, O.S. PROSKURYAKOVA, E.P. SHCHUKINA
Magnitogorsk Irong&Steel Clinical Hospital, Magnitogorsk, Russia
The trial of the efficacy and safety of sequential therapy with mexidol forte 250 in acute and early recovery stages of hemispheric ischemic stroke
Author:
M.A. LOSKUTNIKOV, M.A. DOMASHENKO, T.M. VAKIN, I.A. TRUSHINA, V.I. KONSTANTINOV, O.S. PROSKURYAKOVA, E.P. SHCHUKINA
Magnitogorsk Irong&Steel Clinical Hospital, Magnitogorsk, Russia
Summary:
Objective. To evaluate the efficacy and safety of sequential therapy with mexidol (solution for intravenous and intramuscular injections) and mexidol forte 250 (coated tablets) in acute and early recovery stages of hemispheric ischemic stroke. Material and methods. The changes in scores on the modified Rankin Scale (mRs) (primary endpoint), the National Institute of Health Stroke Scale (NIHSS), the Bartel Index (BI), the Montreal Cognitive Assessment (MoCa), the Beck Depression Inventory (BDI), the EuroQol Quality of Lifes Scale ( EQ–5D) were assessed in the end of treatment (secondary endpoint). Results and Conclusion. Prolonged and sequential therapy with mexidol at the dose 500 mg daily during 14 days (saturation phase) and mexidol forte 250 at the dose of 250 mg three times a day during 60 days (maximum therapeutic effect) provides additional opportunities for a more complete recovery in acute and early recovery stages of hemispheric ischemic stroke (increases quality of life, improves movement and cognitive functions). Keywords: hemispheric ischemic stroke, mexidol forte 250, acute and early recovery stages, quality of life.