evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2022-4-82-89evrazkar-6352Research ArticleОБЗОРREVIEWМедикаментозное лечение стабильной стенокардии: место триметазидинаPharmacological treatment of stable angina pectoris: the place of trimetazidinehttps://orcid.org/0000-0003-2355-4906ТемниковаЕ. А.TemnikovaE. A.

Темникова Елена Андреевна, д.м.н., доцент, профессор кафедры поликлинической терапии и внутренних болезней

ул. Ленина, д. 12, г. Омск 644099

Elena A. Temnikova, Dr. of Sci. (Med.), Associate professor, professor of the Department of Polyclinic Therapy and Internal Diseases

st. Lenina, 12, Omsk 644099

temnikovaomsk@mail.ruГБОУ ВПО ОмГМУ Минздрава РоссииРоссияOmsk State Medical University of the Ministry of Health of RussiaRussian Federation202220122022048289Copyright © Темникова Е.А., 20222022Темникова Е.А.Temnikova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/6352

По данным международных эпидемиологических исследований, общее число зарегистрированных случаев сердечно-сосудистых заболеваний (ССЗ), с 1990 г. по 2019 г. возросло практически в два раза, достигнув 523 миллионов, а количество смертей от ССЗ в 2019 году увеличилось более, чем в полтора раза (18,6 миллионов). Основной вклад в это вносят ишемическая болезнь сердца (ИБС) и инсульт. В 2019 г. зарегистрировано 197 миллионов случаев ИБС, а количество смертей, вызванных ею, превысило половину всех случаев сердечно-сосудистой смертности (9,14 миллионов). Пациенты со стабильной стенокардией составляют большую часть больных с ИБС. Несмотря на существующие современные методы лечения пациенты с хронической ИБС продолжают страдать от ангинальных болей, что значительно снижает их толерантность к физическим нагрузкам и ухудшает качество жизни. В клинической практике, как показывают исследования, тяжесть и частота стенокардии у пациентов остаются недооцененными врачами, соответственно своевременно не корректируется медикаментозная терапия, не используются в полном объёме возможности комбинированной антиангинальной терапии. Триметазидин как антиангинальный препарат, действующий на метаболизм ишемизированной миокардиальной клетки (влияние на ишемический каскад путём уменьшения клеточного ацидоза и увеличения содержания АТФ), доказал свою эффективность и безопасность при лечении стенокардии независимо от механизма, вызвавшего ишемию при монотерапии и в комбинации, прежде всего с бета-адреноблокаторами (БАБ).

According to international epidemiological studies, the total number of reported cases of cardiovascular diseases (CVD) almost doubled from 1990 to 2019, reaching 523 million and the number of deaths from CVD in 2019 increased by more than 1.5 times (18,6 million). Coronary artery disease (CAD) and stroke are the main contributors to these unfavorable trends. The number of registered cases of coronary heart disease in 2019 amounted to 197 million, and the number of deaths caused by coronary artery disease exceeded half of all registered cases of cardiovascular death (9,14 million). Patients with stable angina are the majority of patients with CAD. Despite the existing modern methods of treating angina pectoris, patients with chronic coronary artery disease continue to suffer from anginal pain, which significantly reduces exercise tolerance and worsens their quality of life. In clinical practice, the severity and frequency of angina pectoris in patients remain underestimated by doctors, and drug therapy is not corrected in a timely manner, and the possibilities of combined antianginal therapy are not used. Trimetazidine, as an antianginal drug that acts on the metabolism of ischemic myocardial cells (influence on the ischemic cascade, by reducing cellular acidosis and increasing ATP content), is effective and safety for the treatment of angina pectoris, regardless of the mechanism that caused ischemia as monotherapy and in the combination, primarily with beta-blockers.

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The authors declare that there are no conflicts of interest present.