cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-938Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESТриметазидин: механизм действия и результаты контролируемых исследований у больных ишемической болезнью сердцаTrimetazidine in coronary heart disease patients: mechanism of action and controlled trials’ resultsКремневаЛ. В.KremnevaL. V.ois@cardio.tmn.ruАбатуроваО. В.AbaturovaO. V.ois@cardio.tmn.ruШалаевС. В.ShalaevS. V.ois@cardio.tmn.ruФилиал ГУ НИИ кардиологии Томского научного центра СО РАМН «Тюменский кардиологический центр», ТюменьTumen Cardiology Center, Cardiology Research Institute of Tomsk Scientific Center, Siberian Branch of the Russian Academy of Medical Science, Tumen2005200420054299107Copyright © Кремнева Л.В., Абатурова О.В., Шалаев С.В., 20052005Кремнева Л.В., Абатурова О.В., Шалаев С.В.Kremneva L.V., Abaturova O.V., Shalaev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/938

Метаболическая кардиопротекция – важное направление в лечении больных ишемической болезнью сердца (ИБС). Среди препаратов этой группы наиболее широко используется триметазидин, механизм действия которого основан на ингибировании метаболизма жирных кислот, активировании окисления глюкозы и предупреждении внутриклеточного дефицита энергии аденозинтрифосфата. В многочисленных, рандомизированных, контролируемых исследованиях продемонстрирована антиишемическая эффективность триметазидина, сопоставимая с действием β-адреноблокаторов, антагонистов кальция. Триметазидин улучшает сократительную способность миокарда и уменьшает клинические проявления сердечной недостаточности. Обнаружено положительное влияние препарата на ассоциированные с ишемией формы миокардиальной дисфункции: оглушение, гибернацию, прекондиционирование. Триметазидин рекомендован для лечения больных стабильной стенокардией и ишемической дисфункцией левого желудочка в сочетании с другими средствами. Целесообразность применения триметазидина при реваскуляризации миокарда у больных ИБС, а также при остром инфаркте миокарда требует дальнейшего изучения.

Metabolic cardioprotection is an important part of treating patients with coronary heart disease (CHD). The most widely used drug in this group is trimetazidine. Its mechanism of action is based on fatty acids metabolism inhibition, glucose oxidation activation, intracellular ATP deficit prevention. Numerous randomized, controlled clinical studies demonstrated trimetazidine antiischemic efficacy, similar to that for beta-adrenoblockers or calcium antagonists. Trimetazidine improves myocardial contractility, reduces clinical manifestations of heart failure. The medication beneficially influences ischemia-associated myocardial dysfunction: stunning, hybernation, preconditioning. Trimetazidine is recommended for treating patients with stable angina and ischemic left ventricular dysfunction, in combination with other drugs. Perspectives of trimetazidine therapy in myocardial revascularization and acute myocardial infarction should be examined in future trials.

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The authors declare that there are no conflicts of interest present.