Mexidol effects in patients with chemical and heart failure II - III functional class

Authors:
A.V. SHCHULKIN², E.R. KAZAKHMEDOV¹, S.A. GALOCHKIN¹, V.V. TOLKACHEVA¹, J.D. KOBALAVA¹

¹Peoples' Friendship University of Russia, Moscow;
²Ryazan State Medical University named after Academician I.P. Pavlov of the Ministry of Health of the Russian Federation, Ryazan

Place of publication:
CARDIOLOGY AND CARDIOVASCULAR SURGERY, 2020, Vol. 13, No. 5

Abstract:
Objective. To study the effect of Mexidol on the level of N-terminal propeptide of brain natriuretic hormone (NT-proBNP), the severity of oxidative stress, inflammatory response and endothelial dysfunction in patients with CCI and CHF II-III functional class (FC) according to the NYHA classification with sequential intravenous and oral administration of Mexidol for 13 weeks against the background of standard background therapy. Material and methods. The study included 44 patients with CCI and CHF II-III functional class according to NYHA, ejection fraction less than 50%. The average age was 65.5±11.8 years, 75% of patients were male. Twenty-one patients were included in the basic therapy group for CHF with additional administration of Mexidol (1000 mg intravenously by drip once a day for 7 days, then 250 mg 3 times a day for 12 weeks) and 23 patients in the basic therapy group. A total of 34 patients completed the study. Ten patients had their final visit as a phone call due to the epidemiological situation. At baseline, on day 7 and week 13, blinded laboratory assessments were performed of the N-terminal propeptide of brain natriuretic hormone (NT-proBNP) level, oxidative stress parameters (malondialdehyde (MDA) and superoxide dismutase (SOD) activity), inflammatory response (C-reactive protein (CRP) and tumor necrosis factor α (TNFα) levels), as well as homocysteine ​​levels and cystatin C levels. Results. In patients receiving Mexidol in addition to the basic therapy, a significantly more pronounced decrease in the NT-proBNP level, a decrease in the MDA concentration, a decrease in the CRP and TNFα levels and an increase in SOD activity on the 7th day and after 13 weeks of therapy were revealed compared to the group receiving only basic therapy. Conclusion. Mexidol, when added to the basic therapy of patients with CCI and CHF II-III FC, reduces the level of NT-proBNP, has a reliable antioxidant activity, reduces the severity of the inflammatory response, slows down the increase in homocysteine ​​​​levels, does not affect kidney function (cystatin C). Key words: chronic cerebral ischemia, heart failure, oxidative stress, antioxidants, N-terminal propeptide of brain natriuretic hormone (NT-proBNP), malondialdehyde, superoxide dismutase, CRP, TNFα, ethyl methylhydroxypyridine succinate, Mexidol.