ТЕРАПЕВТИЧНІ ПЕРСПЕКТИВИ У КУРАЦІЇ ПАЦІЄНТІВ ІЗ ХРОНІЧНИМ КОРОНАРНИМ СИНДРОМОМ

Aim. To evaluate the effectiveness of including lercanidipine and enalapril as part of the "polypill" drug or lercanidipine and enalapril as part of the "polypill" drug and ranolazine or ramipril and ranolazine in the complex therapy of chronic coronary syndrome (CCS).Material and methods. 90 patients with CCS were involved in the study, who were randomized into three groups depending on the treatment received: group I (LE) - as part of complex treatment (beta-blockers, antiplatelet agents, statins, nitrates), lercanidipine and enalapril were taken as part of the "polypill" drug; group II (LE+Rn) - lercanidipine and enalapril as part of the "polypill" drug and ranolazine; group III (Rm+Rn) - ramipril and ranolazine. Each group consisted of 30 people. Research methods: filling out the EQ-5D-5L questionnaire with the EQ-VAS visual analogue scale, HADS anxiety and depression scales, general and biochemical blood tests, echocardiography, digital processing of the electrocardiogram using the Smart-ECG program, statistical methods. Results. According to the EQ-VAS scale, in group I (LE) there was an improvement in the quality of life by +6.67% (р=0.043), in group II (LE+Рn) - by Δ +6.67% (р=0.014), in group III (Pm+Pn) - Δ +7.14% (р=0.014). According to the differentiation of the digitalized ECG, a decrease in left ventricle ejection fraction (LVEF) in lead V2 was observed in all groups (р<0.05), while an increase in LVEF in the ischemic zone was observed only in group II (LE+Рn) by Δ +17.65% (р<0.001) and group III (Pm+Pn) - Δ +12.79% (р<0.001).Conclusions. In patients with CCS of all groups, an increase in the quality of life, a decrease in anxiety and depression, normalization of lipid levels, optimization of echocardiographic structural parameters of the heart, and a decrease in hypertrophic modifications of the LV, according to the data of the digitalized ECG, were observed. The addition of lercanidipine and enalapril as part of the "polypill" drug and ranolazine in the complex therapy of CCS best optimizes the contractile capacity of the myocardium in accordance with the dynamics of LVEF and contributes to the most intensive increase in the LVEF index in the ischemic zone, which indicates a decrease in ischemic manifestations and a decrease in the destabilization of electrogenesis in conditions of primary changes phases of repolarization.