The influence of Mexidol in the composition of complex therapy on the perception of life by a patient with heart failure

Authors:
TOLKACHEVA V.V., KARAPETYAN L.V., KHUTSISHVILI N.I., GALOCHKIN S.A., KAZAKHMEDOV E.R., KOBALAVA Zh.D.

Place of publication: Cardiology and cardiovascular surgery / Vol. 16, No. 6, 2023

FGAOU in Russian University of Friendship of Peoples named after Patrice Lumumba ", Moscow, Russia

Resume

The aim of the study was to examine the effect of Mexidol as part of combination therapy on the life perception of patients with heart failure (HF).

Material and methods. The open randomized study included 60 comorbid patients with coronary artery disease (CAD) and stable chronic heart failure (CHF) with cognitive impairment (CI) ≤24 points on the Montreal Cognitive Assessment (MoCA). The mean age of patients was 73.4±8.6 years, 53% were male, the mean left ventricular ejection fraction was 43.5±10.6%. 30 patients were included in the standard therapy group for CHF with additional prescription of mexidol (500 mg intravenously by drip once a day for 14 days, then 250 mg 3 times a day for 8 weeks) and 30 patients in the standard therapy group. Life perception was assessed at baseline and at the end of the study. The survey included 4 main areas: (1) the relative importance of disease-related goals, (2) problems associated with living with heart failure (HF) and taking HF medications, (3) the decision-making process associated with the use of HF medications, and (4) awareness of and concerns about available HF medications.
Results. The main problems associated with living with HF and taking HF medications were that all patients, regardless of the treatment group, at baseline and after 10 weeks of therapy noted the effectiveness of treatment in reducing HF symptoms, in decreasing the number of HF hospitalizations and mortality. Other problems that were most relevant for patients were shortness of breath, edema, and fatigue, followed by anxiety about the disease, the need to take a large number of medications, and the inability to do what they wanted. The least bothered patients were depression, the inability to work, the need for help from relatives, the cost of medications, and coping with side effects of medications. A favorable effect of Mexidol as part of combination therapy on patient perception of life with HF was shown. Improved cognitive status in patients treated with Mexidol facilitates a rethinking of the primary treatment goals to more global ones: the drug's effectiveness in reducing mortality, hospitalizations, and heart failure symptoms, reducing life-limiting factors such as edema and dyspnea, and, consequently, increasing the patient's physical activity. The only limiting factor is the need for daily administration of a large number of medications and the desire to reduce their dosage.
Conclusion. There is a discrepancy between patients' priorities and awareness of proven optimal drug therapy. Patients are poorly acquainted with heart failure therapy, and those who are familiar have concerns about its safety and efficacy. Long-term sequential therapy with Mexidol, when added to standard therapy in patients with chronic heart failure functional class II-III (according to the NYHA classification) with moderate cognitive impairment, significantly improves cognitive status and quality of life parameters and positively impacts the patient's perception of life with heart failure.

Key words: heart failure, cognitive status, quality of life, mexidol, life perception.

Author information:
Tolkacheva V.V. — https://orcid.org/0000-0001-6847-8797
Karapetyan L.V. — https://orcid.org/0000-0002-6697-2393
Khutsishvili N.I. — https://orcid.org/0009-0009-2669-8092
Galochkin S.A. — https://orcid.org/0000-0001-7370-8606
Kazakhmedov E.R. — https://orcid.org/0000-0002-6274-8933
Kobalava Zh.D. — https://orcid.org/0000-0002-5873-1768
Corresponding author: Tolkacheva V.V. — e-mail: tolkacheva-vv@rudn.ru

How to cite:
Tolkacheva V.V., Karapetyan L.V., Khutsishvili N.I., Galochkin S.A., Kazakhmedov E.R., Kobalava Zh.D. The effect of Mexidol as part of complex therapy on the perception of life in a patient with heart failure, Cardiology and cardiovascular surgery. 2023; 16(6): 642–651. https://doi.org/10.17116/kardio202316061642