myocardial infarction, metabolic syndrome, endothelial dysfunction, L-arginine


Background. Oxidative stress, endothelial dysfunction, dyslipidemia and low-grade inflammation induce the disorders of energy metabolism and ischemic damage to cardiomyocytes. It is an essential issue in pathogenesis of acute coronary syndrome/myocardial infarction (ACS/MI).

Objective. The aim of the study was to improve the existing pharmacological therapy in patients with ACS/MI combined with metabolic syndrome (MS).

Methods. The study enrolled 95 patients with acute myocardial infarction. The patients were divided into 2 groups depending on concomitant metabolic syndrome. All groups were divided to subgroups, where patients received typical standard treatment according to the Ukrainian unified and modified treatment regimen with addition of L-arginine and L-carnitine.

Results. In 79.2% of patients with ACS/MI + MS the course of underlying disease was associated with various complications: pericarditis epistenocardica was diagnosed in 39.8% of patients; arrhythmias were present in 35.5% of patients of the main group; left ventricular aneurysm was present in 15.9% of patients. At the same time, significant changes in the indicators of vascular endothelial function in patients with ACS (MI) were revealed (the level of endothelin-1 in the blood plasma was in 2.1 times higher than the reference norm) that was the justification for inclusion of L-arginine and L-carnitine in the complex therapy of comorbid patients.

Conclusions. The multi-modality treatment with inclusion of L-arginine and L-carnitine facilitated restoration of energy supply of myocardial contractility, endothelial function of blood vessels, and antioxidant protection of the body and ultimately resulted in a more favorable course of this comorbid problem.

Author Biography


PhD student of the Department of Emergency and Medical Care, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine


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How to Cite

Yastremska, I. O. (2021). ENDOTHELIAL DYSFUNCTION AND ITS MANAGEMENT IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION COMBINED WITH METABOLIC SYNDROME. International Journal of Medicine and Medical Research, 6(2), 37–43. https://doi.org/10.11603/ijmmr.2413-6077.2020.2.12012