Evaluation of the efficiency of metabolic therapy in elderly patients with carbohydrate metabolism disorders after ischemic stroke

DOI: https://doi.org/10.29296/25877305-2020-03-15
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Issue: 
3
Year: 
2020

V. Shishkova(1, 2), Candidate of Medical Sciences; A. Remennik(1), Candidate of Medical Sciences; E. Kerimova(1); E. Sayutina(3), Candidate of Medical Sciences; L. Kapustina(4), Candidate of Medical Sciences (1)Center for Speech Pathology and Neurorehabilitation, Moscow Healthcare Department (2)A.I. Evdokimov Moscow State University of Medicine and Dentistry (3)N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University) (4)City Polyclinic Sixty-Nine, Moscow Healthcare Department

The objective of this open-label randomized controlled study was to investigate the time course of changes in the parameters of carbohydrate and lipid metabolisms and in the concentration of N-terminal pro b-type natriuretic peptide (NT-proBNP), a marker for heart failure, in elderly patients who had experienced primary or secondary ischemic stroke treated with Mildronate 1000 mg/day added to the standard therapy cycle. Subjects and methods. The investigation enrolled 60 patients aged 60 to 90 years who had experienced a primary or secondary ischemic stroke in 2019. All the patients selected for this investigation were randomized into two groups. In Group 1 (n=30), the standard therapy was added by Mildronate as 500-mg capsules twice daily for 12 weeks; in Group 2 (n=30) Mildronate was not used. All the included patients underwent a double study of blood biochemical parameters: glucose, cholesterol, LDL-cholesterol, HLD-cholesterol, triglycerides, ALT, AST, creatinine, high-sensitivity C-reactive protein (hs-CRP), NT-proBNP, glycated hemoglobin (HbA1c) at the beginning and completion of the treatment cycle. The follow-up period was 12 weeks. All the patients included in the study received therapy that included secondary prevention of stroke and correction using antihypertensive, lipid-lowering, antiplatelet, anticoagulant, and hypoglycemic therapies for all currently existing concomitant diseases. Results. Group 1, in which Mildronate 1000 mg per day was added to the therapy for 12 weeks, showed a significant decrease in the parameters: glucose, glycated hemoglobin, triglycerides, ALT, AST and brain natriuretic peptide. The levels of cholesterol, LDL-cholesterol, atherogenic index, CRP, and creatinine decreased in Group 1, and, on the contrary, the concentration of HDL-cholesterol increased; however, these changes did not reach statistical significance at the end of the follow-up. In the control group, no significant changes were found in the biochemical parameters under study. Conclusion. This open-label randomized controlled study has led to the conclusion that Mildronate can have a positive effect on the parameters of carbohydrate and lipid metabolisms and improve myocardial and hepatic functions in elderly patients after a primary or secondary ischemic stroke.
Keywords: 
carbohydrate and lipid disorders
Mildronate
ischemic stroke
rehabilitation

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