Nitric Oxide Donators in Complex Treatment of Patients With Coronary Heart Disease and Anemia: Antiischemic and Antiarrhythmic Effects

. Coronary artery disease (CHD) is the most common cardiovascular disease in the world, the incidence of which increases with age. The prevalence of anemia also increases with age and is associated with a more severe condition in patients with CAD. This category of patients also has an increased risk of complications, including sudden cardiac death (RCD). Purpose: to evaluate the clinical and functional parameters of ischemia, the presence of pathological cardiac arrhythmias and the clinical efficacy of treatment with nitric oxide donors in patients with coronary artery disease and anemia. 95 patients with IHD were examined. The main group consisted of 53 IHD patients with iron deficiency anemia, which were divided into two subgroups. 24 patients of the first subgroup were recommended standard therapy for coronary artery disease and anemia. 29 patients of the second subgroup additionally took L-arginine. The control group consisted of 42 patients with coronary artery disease without anemia who received standard therapy. At the beginning of the study, the severity of ischemic changes and heart failure in patients of the main group was greater than in the control group. The median circadian heart rate index was less than normal in both groups, but in the main group this indicator was significantly lower. A greater average number of extraistols (both supraventricular and ventricular) was registered in the main group. The total number of patients with atrial fibrillation was also higher in the main group. During therapy, the indicator of «total ischemia burden» decreased in both groups and was comparable in the second subgroup (with L-arginine) and the control group (pk-2>0,05), but remained higher than the first subgroup (pk-1<0, 01; p1-2<0,05). The dynamics of the circadian index was similar: in all groups there was a decrease in CI HCC, but in the first subgroup the effect was lower than the control group and the second subgroup (pk-2>0,05; pk-1<0,01; p1-2<0,001). The number of extrasystoles decreased in both groups. The percentage of changes in the indicator of the number of extrasystoles in dynamics in the second subgroup was significantly higher than in the first, and then comparable with the indicator of the control group (pk-1<0,001; pk-2>0,05, pk-1<0,001).