Tkachenko O. Metabolic and clinical effects of statins and angiotensin converting enzyme inhibitors is ishaemic heart disease

Subject of investigation: patients with stable and unstable angina. Objective of the work: to increase the ischaemic heart disease treatment efficiency by means of endothelium functional state, coagulation haemostasis and lipid exchange correction with ACE inhibitors and statins. Theoretical novelty: On the basis of study of effects of the course therapy with statins, ACE inhibitors and their combination, on the clinical course and endothelial function, lipid exchange and coagulograms parameters in patients with stable and unstable angina, for the first time: - the relationship between ET-1, sICAM-1 and fibrinogen (FG) levels and dislipidemia type was revealed; - it was established, that even 4 weeks of statins treatment promotes fibrinogen reduction in patients with stable angina as well as reduces the ET-1 and sICAM-1 levels in patients with stable and unstable angina; - criteria for application of statins, ACE inhibitors and their combination in patients with stable and unstable are substantiated.Practical novelty: It was shown that for adequate assessment of disease severity and clinical activity of IHD, complex evaluation of serum ET-1 and sICAM-1 levels and coagulogram parameters was advisable. Approaches to administration of statins, ACE inhibitors and their combination for treatment of stable and unstable angina are worked out. It is shown that course therapy with both ACE inhibitors and statins increases effectiveness of IHD treatment, at that, for patients with stable angina of effort and hyperfibrinogenemia, administration of statins is preferable. In patients with unstable angina, concomitant administration of these preparations has the maximal effectiveness. Degree of introduction: Recommendations, worked out with regard to optimisation of treatment of patients with stable and unstable angina with ACE inhibitors and statins, were introduced in the practice of appropriate clinical departments of Kharkov and Ukraine. As a result of introduction, number of angina attacks and nitrite medications'consumption in patients with IHD have been reduced, that enables to shorten hospitalisation terms. Field of application: The work relates to cardiology, its results may be introduced on all the medical care levels - rural, regional, urban health care institutions for the IHD patients' antianginal therapy effectiveness increase, as well as for scientific researches.