Инвазивная кардиология имеет большие перспективы в плане улучшения качества и прогноза жизни больных с ишемической болезнью сердца, но при всей ее значимости остается большой круг пациентов, которым проведение процедур реваскуляризации ограничено. Обоснованная медикаментозная терапия становится единственной альтернативой для этой категории больных, а для прошедших инвазивные манипуляции – многолетней. В этом плане перспективен активатор калиевых каналов препарат Кординик (никорандил) с доказательными исследованиями, подтвердившими его эффективность у пациентов с ишемической болезнью сердца.
Invasive cardiology has a great opportunity to improve the quality of life and the prognosis of patients with ischaemic heart disease, but with all significance, revascularization procedures are limited in large group of patients. Optimal medical therapy becomes the only alternative option for this group of patients, and for patients who already survived invasive manipulation this procedure can lasting many years. The potassium channels activator Cordinik (nicorandil) has many statistically significant opportunities; the efficacy of this drug has been shown in patients with ischaemic heart disease.
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6. Murry CE, Jenning RD, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 1986; 74 (5): 1122–36.
7. Kharbanda RK. Cardiac conditioning: a review of evolving strategies to reduce ischemia-reperfusion injury. Heart 2010; 96: 1179–86.
8. Jaffe MD, Quinn NK. Warm-up phenomenon in angina pectoris. Lancet 1980; 2: 934–6.
9. Li JJ, Huang CX, Jiang H et al. Ischemic preconditioning detected by treadmill exercise tests in patients with stable angina. Angiology 2003; 54 (1): 45–50.
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16. Kinoshita M, Sakai K. Pharmacology and Therapeutic Effects of Nicorandil. Cardiovasc Drugs Ther 1990; 4: 1075–88.
17. Meany TB, Richardson P, Camm AJ et al. Exercise capacity after single and twice-daily doses of nicorandil in chronic stable angina pectoris. Am J Cardiology 1989; 63: 66–70.
18. Airaksinen KE, Huikuri HV. Antiarrhythmic effect of repeated coronary occlusion during balloon angioplasty. J Am Coll Cardiol 1997; 29 (5): 1035.
19. Sakamoto T, Kaikita K, Miyamoto S et al. Effects of nicorandil on endogenous fibrinolytic capacity in patients with coronary artery disease. Circ J 2004; 68: 232–56.
20. Izumiya Y, Kojima S, Araki S et al. Long-term use of oral nicorandil stabilizes coronary plaque in patients with stable angina pectoris. Atherosclerosis 2011; 214 (2): 415–21.
21. Markham A, Plosker GL, Goa KL. Nicorandil. An updated review of its use in ischaemic heart disease with emphasis on its cardio-protective effects. Drugs 2000; 60: 955–74.
22. Sekiya M, Sato M, Funada J et al. Effects of the long-term administration of nicorandil on vascular endothelial function and the progression of arteriosclerosis. J Cardiovasc Pharmacol 2005; 46 (1): 63–7.
23. Kasama S, Toyama T, Sumino H et al. Long-term nicorandil therapy improves cardiac sympathetic nerve activity after reperfusion therapy in patients with first acute myocardial infarction. J Nucl Med 2007; 48 (10): 1676–82.
24. Kasama S, Toyama T, Hatori T et al. Comparative effects of nicorandil with isosorbide mononitrate on cardiac sympathetic nerve activity and left ventricular function in patients with ischemic cardiomyopathy. Am Heart J 2005; 150 (3): 477.e1–477.e8.
25. The IONA Study Group. Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomised trial. Lancet 2002; 359: 1269–75.
26. ВНОК. Рациональная фармакотерапия больных ССЗ. Российские рекомендации. Кардиоваск. терапия и профилактика. 2009; 8 (6; Прил. 4): 12. / VNOK. Ratsional'naia farmakoterapiia bol'nykh SSZ. Rossiiskie rekomendatsii. Kardiovask. terapiia i profilaktika. 2009; 8 (6; Pril. 4): 12. [in Russian]
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28. Резванова Ю.А., Адамчик А.С. Оценка антиишемической и кардиопротективной эффективности никорандила у пациентов со стабильной стенокардией. Кардиология. 2015; 8 (55): 21–5. / Rezvanova Iu.A., Adamchik A.S. Otsenka antiishemicheskoi i kardioprotektivnoi effektivnosti nikorandila u patsientov so stabil'noi stenokardiei. Kardiologiia. 2015; 8 (55): 21–5. [in Russian]
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31. Саката Я. и др. Снижение смертности у больных после острого инфаркта миокарда, связанное с пероральной терапией никорандилом при выписке из стационара. Рос. кардиол. журн. 2012; 5 (97): 90–7. / Sakata Ia. i dr. Snizhenie smertnosti u bol'nykh posle ostrogo infarkta miokarda, sviazannoe s peroral'noi terapiei nikorandilom pri vypiske iz statsionara. Ros. kardiol. zhurn. 2012; 5 (97): 90–7. [in Russian]
32. Hausenloy DJ, Yellon DM. Preconditioning and postconditioning: united at reperfusion. Pharmacol Ther 2007; 116 (2): 173–91.
33. Granfeld A, Lefer DJ, Vinten-Johansen J. Protective ischemia in patients: preconditioning and postconditioning. Cadiovasc Res 2009; 83 (2): 234–46.
34. Van Vunren D, Lochner A. Ischemic preconditioning: from bench to bedside… Cardiovasc J Afr 2008; 19 (6): 311-20.
35. Национальные клинические рекомендации «Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы: реабилитация и вторичная профилактика». КардиоСоматика. 2014; 5 (Прил. 1). / Natsional'nye klinicheskie rekomendatsii «Ostryi infarkt miokarda s pod"emom segmenta ST elektrokardiogrammy: reabilitatsiia i vtorichnaia profilaktika». Cardiosomatics. 2014; 5 (Suppl. 1). [in Russian]
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1.Barbarash L.S., Artamonova G.V., Murashkovskii A.L. i dr. Organizatsionnye podkhody k okazaniiu pomoshchi patsientam s ostrym koronarnym sindromom. Doktor.Ru. 2013; 6 (84): 24–8. [in Russian]
2. Buza V.V., Karpov Iu.A. Chreskozhnye koronarnye vmeshatel'stva u bol'nykh stabil'noi IBS – 2012. Rus. med. zhurn. Kardiologiia. 2012; 25: 1270–4. [in Russian]
3. Boden WE, O’Rourke RA, Teo KK et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356: 1503–16.
4. Dagenais GR, Lu J, Faxon DP et al. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Study Group. Effects of optimal medical treatment with or without coronary revascularization on angina and subsequent revascularizations in patients with type 2 diabetes mellitus and stable ischemic heart disease. Circulation 2011; 123: 1492–500.
5. Nishigaki K, Yamazaki T, Kitabatake A et al. Japanese Stable Angina Pectoris Study Investigators. Percutaneous coronary intervention plus medical therapy reduces the incidence of acute coronary syndrome more effectively than initial medical therapy only among patients with low–risk coronary artery disease a randomized, comparative, multicenter study. JACC Cardiovasc Interv 2008; 1: 469–79.
6. Murry CE, Jenning RD, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 1986; 74 (5): 1122–36.
7. Kharbanda RK. Cardiac conditioning: a review of evolving strategies to reduce ischemia-reperfusion injury. Heart 2010; 96: 1179–86.
8. Jaffe MD, Quinn NK. Warm-up phenomenon in angina pectoris. Lancet 1980; 2: 934–6.
9. Li JJ, Huang CX, Jiang H et al. Ischemic preconditioning detected by treadmill exercise tests in patients with stable angina. Angiology 2003; 54 (1): 45–50.
10. Kay IP, Kittelson J, Stewart RA. Collateral recruitment and “warm-up” after first exercise in ischemic heart disease. Am Heart J 2000; 140: 121–5.
11. Aronov D.M., Lupanov V.P. Funktsional'nye proby v kardiologii. M: Medpress-Inform, 2007; s. 212–3. [in Russian]
12. Opie LH. Preconditioning and metabolic antiishemic agents. Eur Heart J 2003; 24: 1854–6.
13. Petrishchev N.N., Shliakhto E.V., Tsyrlin V.A. i dr. Rol' svobodnykh radikalov kisloroda v mekhanizmakh lokal'nogo i distantnogo ishemicheskogo prekonditsionirovaniia miokarda. Vestn. RAMN. 2006; 8: 10–5. [in Russian]
14. Hausenloy DJ, Ong SB, Yellon DM. The mitochondrial permeability transition pore as a target for preconditioning and postconditioning. Basic Res Cardiol 2009; 104 (2): 189–202.
15. Boitsov S.A. Patogenez khronicheskoi formy ishemicheskoi bolezni serdtsa. V kn.: Rukovodstvo po aterosklerozu i ishemicheskoi bolezni serdtsa. Pod red. E.I.Chazova i dr. M.: Media Medika, 2007; s. 330–48. [in Russian]
16. Kinoshita M, Sakai K. Pharmacology and Therapeutic Effects of Nicorandil. Cardiovasc Drugs Ther 1990; 4: 1075–88.
17. Meany TB, Richardson P, Camm AJ et al. Exercise capacity after single and twice-daily doses of nicorandil in chronic stable angina pectoris. Am J Cardiology 1989; 63: 66–70.
18. Airaksinen KE, Huikuri HV. Antiarrhythmic effect of repeated coronary occlusion during balloon angioplasty. J Am Coll Cardiol 1997; 29 (5): 1035.
19. Sakamoto T, Kaikita K, Miyamoto S et al. Effects of nicorandil on endogenous fibrinolytic capacity in patients with coronary artery disease. Circ J 2004; 68: 232–56.
20. Izumiya Y, Kojima S, Araki S et al. Long-term use of oral nicorandil stabilizes coronary plaque in patients with stable angina pectoris. Atherosclerosis 2011; 214 (2): 415–21.
21. Markham A, Plosker GL, Goa KL. Nicorandil. An updated review of its use in ischaemic heart disease with emphasis on its cardio-protective effects. Drugs 2000; 60: 955–74.
22. Sekiya M, Sato M, Funada J et al. Effects of the long-term administration of nicorandil on vascular endothelial function and the progression of arteriosclerosis. J Cardiovasc Pharmacol 2005; 46 (1): 63–7.
23. Kasama S, Toyama T, Sumino H et al. Long-term nicorandil therapy improves cardiac sympathetic nerve activity after reperfusion therapy in patients with first acute myocardial infarction. J Nucl Med 2007; 48 (10): 1676–82.
24. Kasama S, Toyama T, Hatori T et al. Comparative effects of nicorandil with isosorbide mononitrate on cardiac sympathetic nerve activity and left ventricular function in patients with ischemic cardiomyopathy. Am Heart J 2005; 150 (3): 477.e1–477.e8.
25. The IONA Study Group. Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomised trial. Lancet 2002; 359: 1269–75.
26. VNOK. Ratsional'naia farmakoterapiia bol'nykh SSZ. Rossiiskie rekomendatsii. Kardiovask. terapiia i profilaktika. 2009; 8 (6; Pril. 4): 12. [in Russian]
27. The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 2013 ESC guidelines on the management of stable coronary artery disease. Eur Heart J 2013; 34: 2949–3003.
28. Rezvanova Iu.A., Adamchik A.S. Otsenka antiishemicheskoi i kardioprotektivnoi effektivnosti nikorandila u patsientov so stabil'noi stenokardiei. Kardiologiia. 2015; 8 (55): 21–5. [in Russian]
29. Bulakhova E.Iu. i dr. Klinicheskie preimushchestva terapii nikorandilom v sravnenii s izosorbid-5-mononitratom u bol'nykh IBS. Serdtse. 2013; 12 (2): 83–7. [in Russian]
30. Riabikhin E.A., Mozheiko M.E., Krasil'nikova Iu.A. i dr. Dopolnitel'nye vozmozhnosti v lechenii ishemicheskoi bolezni serdtsa, oslozhnennoi khronicheskoi serdechnoi nedostatochnost'iu s nizkoi fraktsiei vybrosa levogo zheludochka. Serdechnaia nedostatochnost'. 2016; 17 (1): 3–9. [in Russian]
31. Sakata Ia. i dr. Snizhenie smertnosti u bol'nykh posle ostrogo infarkta miokarda, sviazannoe s peroral'noi terapiei nikorandilom pri vypiske iz statsionara. Ros. kardiol. zhurn. 2012; 5 (97): 90–7. [in Russian]
32. Hausenloy DJ, Yellon DM. Preconditioning and postconditioning: united at reperfusion. Pharmacol Ther 2007; 116 (2): 173–91.
33. Granfeld A, Lefer DJ, Vinten-Johansen J. Protective ischemia in patients: preconditioning and postconditioning. Cadiovasc Res 2009; 83 (2): 234–46.
34. Van Vunren D, Lochner A. Ischemic preconditioning: from bench to bedside… Cardiovasc J Afr 2008; 19 (6): 311-20.
35. Natsional'nye klinicheskie rekomendatsii «Ostryi infarkt miokarda s pod"emom segmenta ST elektrokardiogrammy: reabilitatsiia i vtorichnaia profilaktika». Cardiosomatics. 2014; 5 (Suppl. 1). [in Russian]
Авторы
А.Л.Верткин*, Г.Ю.Кнорринг
ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1 *kafedrakf@mail.ru
________________________________________________
A.L.Vertkin*, G.Yu.Knorring
A.I.Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1 *kafedrakf@mail.ru