CORRECTION OF PROOXIDANT-ANTIOXIDANT SYSTEM IN PATIENTS WITH ACUTE CORONARY SYNDROME IN COMBINATION WITH OBLITERATING ATHEROSCLEROSIS AND CRITICAL ISCHEMIA OF THE LOWER LIMBS
DOI:
https://doi.org/10.11603/mcch.2410-681X.2021.i1.12107Abstract
Introduction. Unfavorable prognosis in the ocasion of multifocal atherosclerosis (MFA) is associated with severe, complicated course of the disease, limitation of invasive coronary interventions, contraindications to active cardiorehabilitation measures that determines the tactics of active analysis of the role of triggers and risk factors in the pathogenesis of this comorbid pathology, development of its separate complications and ways of correction these pathological processes.
The aim of the study – to investigate the possibility of correction of lipid profile and balance of prooxidant-antioxidant system in patients with acute coronary syndrome in combination with chronic critical ischemia of the lower extremities and a high risk of reperfusion complications.
Research Methods. The work is based on the analysis of a comprehensive examination and surgical (percutaneous coronary intervention) treatment of 67 patients with acute coronary syndrome in combination with obliterating atherosclerosis of the main arteries of the lower extremities. The lipid profile and the activity of the components of the prooxidant-antioxidant system were determined using spectrophotometric methods, the optical density on a spectrophotometer "Biomat 5" (UK).
Results and Discussion. Intravenous infusions of arginine-carnitine mixture (4.2+2.0, respectively) were prescribed in order to correct the lipid profile and prooxidant-antioxidant balance in the pre- and postoperative periods. In particular, the activity of free radical oxidation decreased significantly in the peri- and postoperative period, such as active products of thiobarbituric acid in the serum decreased by a 1.3-fold (p<0.05), superoxide dismutase activity with increasing activity of catalase and ceruloplasmin decreased in 1.5-fold (p<0.05). The results of the study also confirm that the revascularization of the coronary arteries increases the activity of free radical oxidation, which justifies the continuation of antioxidant cytoprotective therapy in the postoperative period. There was a decrease in reperfusion complications and stabilization of the clinical condition of comorbid patients In the postoperative period after PCI by reducing the incidence of arrhythmias by 53.3 %, and manifestations of acute heart failure by 44.4 %.
Conclusion. The use of arginine-carnitine complex in the pre- and postoperative periods in patients with acute coronary syndrome in combination with obliterating atherosclerosis and critical ischemia of the lower extremities with a high operative risk contributes to a significant reduction in the activity of free radicals, arrhythmias and conduction by 53.3 %, and manifestations of acute heart failure by 44.4 %.
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