The effect of Mexidol on the improvement of cognitive status and quality of life parameters in the complex therapy of patients with chronic heart failure II-III functional class

Objective. Evaluation of the effect of mexidol as part of the complex therapy of heart failure for 10 weeks on cognitive status, quality of life parameters, asthenic syndrome and anxiety level in patients with CHF of functional class II-III (according to NYHA classification) Methods. The open randomized study included 60 comorbid patients with ischemic heart disease (CHD) and stable chronic heart failure (CHF) with cognitive impairment (CI) ≤24 points on the Montreal Cognitive Function Assessment Scale (MoCA). The average age of patients was 73.4±8.6 years, 53% were male, the average ejection fraction was 43.5±10.6%. 30 patients were included in the group of standard CHF therapy with additional administration of mexidol (500 mg intravenously once a day for 14 days, then 250 mg 3 times a day for 8 weeks) and 30 patients in the standard therapy group. Initially and at the end of the study, the effect of therapy on the cognitive status of patients was assessed according to the Montreal Cognitive Function Assessment Scale (MoCA), the level of anxiety on the Beck scale, the severity and dynamics of asthenic syndrome on the subjective asthenia assessment scale (MFI-20), the health profile according to the EQ-5D-5L questionnaire and the quality of life parameters according to the results of the assessment of the Minnesota (MLHFQ), Kansas (Kansas City Cardiomyopathy Questionnaire, KCCQ) and the SF36 questionnaire «Quality of life Assessment». Results. Patients who received mexidol in addition to standard therapy showed a significant improvement in cognitive function by 21%, a decrease in anxiety by 38% and the severity of asthenic syndrome by 12%, an improvement in general well-being by 25% according to the EQ-5D-5L questionnaire, as well as the quality of life according to the Minnesota questionnaire by 48%, according to the Kansas questionnaire — by 39%. Conclusion. Mexidol, when added to the standard therapy of patients with CHF of functional class II-III, significantly improves cognitive status, quality of life parameters, reduces the severity of asthenic syndrome and anxiety levels.