The Role of Metabolic Therapy in the Treatment of Chronic Coronary Syndrome. Results of Own Research
Authors: Seliuk Mariana , Bychkova Svitlana , Kozachok Mykola , Yavorska Iryna , Kozhukharova Nataliia , Pylypenko Maryna , Khomych Sofiia , Didukh Vladyslav 
Published: January 2025

Ischemic heart disease (IHD) and stroke are the main causes of mortality and disability worldwide. One of the most controversial issues in modern cardiology is the feasibility of using metabolic drugs for the treatment of patients with angina. The main directions in metabolic therapy are optimization of energy production and expenditure and normalization of the balance between the intensity of free radical oxidation and antioxidant processes.
The objective: to determine the clinical effectiveness of combined metabolic therapy with domestic drugs meldonium, ethylmethylhydroxypyridine succinate and armadin in the complex treatment of military personnel with IHD.
Materials and methods. The study included 36 military personnel with coronary artery disease with stable angina pectoris of functional class II–III. Patients were treated in the cardiology department of the Military Medical Clinical Treatment and Rehabilitation Center (Irpin). All examined patients were male, the average age was 43.7 ± 2.7 years, the duration of the disease was 4.2 ± 2.3 years, the onset of angina attacks was 39.6 ± 2.8 years.
All patients received standard therapy in accordance with the ESC recommendation. Additionally intravenous drip infusions of meldonium (100 mg/ml, 5 ml per 100.0 saline), ethylmethylhydroxypyridine succinate (50 mg/ml, 2 ml intravenously in a 1:2 dilution in saline, slowly in a jet) and armadin (300 mg, 1 tablet in the evening for 2 weeks, then 1 tablet solution twice a day for 4 weeks) were prescribed.
The effectiveness of the prescribed complex was monitored based on the dynamics of clinical status, bicycle ergometry indicators, and Holter ECG monitoring before the start of treatment and after 14–16 days.
Results. The use of metabolic therapy significantly improved the general condition of patients, reduced the number of angina attacks, and reduced the need for nitroglycerin tablets. Analysis of the sample with dosed physical activity before the start of therapy revealed a significant percentage of patients with ST segment depression of 2 mm at the height of physical activity, and the total relative number of patients with ST segment depression of 1.5–2 mm was 72.2%. During the repeated examination ST segment depression was not determined in 94.4% of patients.
Before treatment, rhythm disturbances in the form of supraventricular and ventricular extrasystoles were recorded on the background of maximum exercise, and after treatment, no rhythm disturbances were detected.
In the dynamics of the therapy, it was possible to achieve a decrease in blood pressure (BP) indicators during exercise, the level of systolic BP decreased by 16.4%, and diastolic BP – by 9.4% (p < 0.05). Recovery time significantly decreased by 35.2%, but oxygen consumption and tolerance index significantly increased.
Conclusions. The results of the study demonstrated that combination therapy with domestically produced metabolic drugs (meldonium, ethylmethylhydroxypyridine succinate and armadine) with a combination of injectable and tablet forms showed high effectiveness in the treatment of military personnel with coronary artery disease.
The combination of drugs that patients received during the study demonstrated good tolerability and the absence of adverse reactions.