Improving the quality of life of patients with stable angina pectoris using combined therapy
AbstractTreatment of chronic ischemic heart disease includes the use of non-drug methods (anti-hypodynamia, smoking cessation, etc.), as well as drug therapy, the main tasks of which are to reduce the risk of complications such as stroke, myocardial infarction, sudden cardiac death, and to gain an increase in life expectancy. An important aspect of treatment is also a decrease in the frequency and intensity of angina attacks, the need for short-acting nitrates, to gain an increase in physical activity, that is, an overall, improvement in the quality of life of patients. The article presents the results of studying the quality of life indicators of patients with stable angina pectoris with the use of omega-3 polyunsaturated fatty acids and magnetotherapy. 85 patients with stable angina pectoris were examined, divided into three groups according to the method of therapy. 28 patients of the I (control) group received a drug complex corresponding to the national protocol for the treatment of patients with angina pectoris: nitrates, beta-blockers, ACE inhibitors, antiplatelet drugs, statins (atorvastatin at a daily dose of 20 mg). 29 patients of the II group, together with protocol therapy, received the drug omega-3 polyunsaturated fatty acids in a daily dosage of 2000 mg, divided into 2 doses. In connection with the known hypolipidemic action of omega-3 PUFA, the daily dose of atorvastatin in this and the next group was reduced to 10 mg. Group III consisted of 28 patients who were prescribed omega-3 polyunsaturated fatty acids and a course of magnetotherapy according to a special method against the background of the protocol medication complex. It was revealed that, initially in patients with angina, the quality of life indicators according to the Seattle questionnaire and the visual analogue scale were reduced. It was shown that with the use of the protocol medication complex, all the parameters of the quality of life improved reliably, with a significant reduction in the angina pain scales and less significant improvement on the scales of physical activity, assessments of health and the perception of the disease . Upon adherence to the therapy of omega-3 polyunsaturated fatty acids, there was a positive but very weak tendency to improve the quality of life indicators, which did not differ significantly from the control. The use of combined therapy with simultaneous inclusion of omega-3 polyunsaturated fatty acids and magnetotherapy led to significant and reliable improvement in the quality of life indicators, not only on the scales reflecting the pain component, but also on the indicators that characterize the psychological contribution to the quality of life (treatment satisfaction and quality of life (disease perception)). The significant improvement in the quality of life in patients receiving magnetotherapy in contrast to the absence of such influence in patients receiving omega-3 polyunsaturated fatty acids without magnetotherapy was due to the strong antianginal effect of MT, its sedative and emotionally relaxing action, and the ability to enhance the effects of medications.
De Caterina, R. (2011). N-3 fatty acids in cardiovascular diseases. The New England Journal of Medicine, 364(9), 2439–2450.
Dougherty, C. M., Dewhurst, T., Nichol, W. P., & Spertus, J. (1998). Comparison of three quality of life instruments in stable angina pectoris. Journal of Clinical Epidemiology, 51(7), 569–575.
Kovalenko, V. M., Lutai, M. Y., Syrenko, I. M., & Sychov, O. S. (2016). Sertsevo-sudynni zakhvoriuvannia. Klasyfikatsiia, standarty diagnostyky ta likuvannia [Cardiovascular diseases. Classification, standards of diagnosis and treatment]. Morion, Kyiv (in Ukrainian).
Lizohub, V. H., Zavalska, T. V., Horna, O. O., Pliskevych, D. A., & Savchenko, O. V. (2010). Metabolizm polinenasychenykh zhyrnykh kyslot ta yoho znachennia dlia orhanizmu liudyny [Metabolism of polyunsaturated fatty acids and its significance for the human body]. Likarska Sprava, 7–8, 21–28 (in Ukrainian).
Marcevich, S. Y., Kutishenko, N. P., & Deev, A. D. (2016). Izuchenie vlijanija nikorandila na kachestvo zhizni patsientov so stabil’noj stenokardiej v ramkah issledovanija “KVAZAR” [The assessment of Nicorandil effect on the quality of life in patients with stable angina in the “KVAZAR” study]. Racional’naja Farmakoterapija v Kardiologii, 12(6), 654–660 (in Russian).
Mihin, V. P., & Mal’ceva, L. S. (2013). Vlijanie omakora na variabel’nost’ serdechnogo ritma i ishemicheskie izmenenija v miokarde u bol’nyh hronicheskoj ishemicheskoj bolezn’ju serdca v sochetanii s saharnym diabetom 2 tipa. [Influence of omacor on of heart rate variability and ischemic changes in the myocardium in patients with chronic ischemic heart disease in conjunction with diabetes mellitus type 2]. Arhiv Vnutrennej Mediciny, 9, 25–32 (in Russian).
Müller-Nordhorn, J., Binting, S., Roll, S., & Willich, S. N. (2008). An update on regional variation in cardiovascular mortality within Europe. European Heart Journal, 29(10), 1316–1326.
Osipov, D. A., Rozhdestvenskaja, T. V., Krom, I. L., & Rebrov, A. P. (2011). Sootnoshenie prediktorov prognoza kachestva zhizni bol’nyh ishemicheskoj bolezn’ju serdca [Correlation of predictors of life quality prognosis of patients with coronary heart disease]. Saratovskij nauchno-medicinskij zhurnal, 7(2), 426–429 (in Russian).
Rector, T., & Cohn, J. (1992). Assessment of patient outcome with the Minnesota living with heart failure questionnaire: Reliability and validity during a randomized, double-mind, placebo-controlled trial of pimobendan. American Heart Journal, 124(4), 1017–1025.
Saravanan, P., Davidson, N. C., Schmidt, E. B., & Calder, P. C. (2010). Cardiovascular effects of marine omega-3 fatty acids. The Lancet, 376(9740), 540–550.
Serdiuk, V. V. (2004). Magnitoterapiya – proshloe, nystoiashchee, budushchee [Magnetotherapy – past, present, future]. Azymut – Ukraina, Kyiv (in Russian).
Sin’kova, M. N., Pepelyaeva, T. V., Isakov, L. K., Tarasov, N. I., & Teplyakov, A. T. (2014). Otdalennye effekty vlijanija omega-3 polinenasyshhennyh zhirnyh kislot na techenie ishemicheskoj bolezni serdca u bol’nyh, perenesshih infarkt miokarda s podjemom segmenta ST na fone mnogososudistogo stenozirujushhego ateroskleroza koronarnyh arterij [Long-term effects of omega-3 polyunsaturated fatty acids on the course of ischemic heart disease in patients after ST-elevation myocardial infarction at the background of multiple-vessel lesion coronary atherosclerosis]. Kardiovaskulyarnaja Terapija i Profilaktika, 13(6), 32–37 (in Russian).
Sizova, Z. M., Zaharova, V. L., Kozlova, N. V., & Kuchkina, T. S. (2016). Vlijanie aktivatora kalievyh kanalov nikorandila na kachestvo zhizni bol’nyh ishemicheskoj bolezn’ju serdca so stabil’noj stenokardiej naprjazhenija [Influence of the potassium channels activator nicorandil to the quality of life in patients with ishemic heart disease and stable angina pectoris]. Kardiologija, 56(6), 26–31 (in Russian).
Soboleva, M. S., & Slobodenjuk, E. V. (2013). Ocenka vlijanija priverzhennosti k lecheniju, kachestva zhizni i zatrat pacientov na effektivnost’ antigipertenzivnoj terapii [Estimating effects of medical treatment adherence, life quality and patients’ expenditures for efficiency of antihypertensive therapy]. Tihookeanskij Medicinskij Zhurnal, 2, 9–13 (in Russian).
Spertus, J. A., Jones, P., McDonell, M., Fan, V., & Fihn, S. (2002). Health status predicts long-term outcome in outpatients with coronary disease. Circulation, 106(1), 43–49.
Spertus, J. A., Winder, J. A., Dewhurst, T. A., Deyo, R. A., Prodzinski, J., McDonnell, M., & Fihn, S. D. (1995). Development and evaluation of the Seattle Angina Questionnaire: A new functional status measure for coronary artery disease. Journal of the American College of Cardiology, 25(2), 333–341.
Sysoeva, I. V. (2005). Sovremennoe predstavlenie o biologicheskom dejstvii magnitnyh polej i ih primenenie v medicine [Modern understanding of the biological effect of magnetic fields and their application in medicine]. Medicinskie Novosti, 4, 21–28 (in Russian).
Tavazzi, L., Maggioni, A. P., & Marchioli, R. (2008). Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): A randomized, double-blind, placebo-controlled trial. The Lancet, 372(9645), 1223–1230.
Tendera, M., Chassany, O., Ferrari, R., Ford, I., Steg, P. G., Tardif, J. C., & Fox, K. (2016). Quality of life with ivabradine in patients with angina pectoris. Circulation: Cardiovascular Quality and Outcomes, 9, 31–38.
Ulashik, V. S. (2001). Sovremennye napravlenija razvitija magnitoterapii [Modern directions of the development of the magnetotherapy]. Vestnik Fizioterapii i Kurortologii, 7(3), 9–15 (in Russian).
Ulashik, V. S., Pletnev, A. S., Vojchenko, N. V., & Pletnev, S. V. (2015). Magnitoterapija: Teoreticheskie osnovy i prakticheskoe primenenie [Magnetotherapy: Theoretical basis and practical application]. Belarusskaja nauka, Minsk (in Russian).
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short form health survey (SF-36): Conceptual framework and item selection. Medical Care, 30, 473–483.
Zholdasbekova, A. S., Kalmatayeva, Z. A., Nurbakyt, A. N., & Absatarova, K. S. (2016). Izuchenie kachestva zhizni pacientov ishemicheskoj bolezn’ju serdca, perenesshih operacii po revaskuliarizacii miokarda [The study of quality of life in patients with coronary artery disease after operations of myocardial revascularization]. Vestnik Kazahskogo Nacional’nogo Medicinskogo Universiteta, 1, 654–656 (in Russian).
Zolotarova, N. A., & Panigrahi, P. K. (2008). Sostojanie sistemy gemostaza u bol’nyh posle trombolizisa i kursa geparinoterapii i metody ego korrekcii s ispol’zovaniem magnitoterapii [The state of the hemostatic system in patients after thrombolysis and the course of heparin therapy and methods of its correction with the use of magnetotherapy]. Ukrainskyi Terapevtychnyi Zhurnal, 2, 37–41 (in Russian).
Zolotarova, N. A., & Petrosjan, A. P. (2004). Biologicheskie effekty razlichnyh vidov magnitnyh polej i ih ispol’zovanie v lechenii IBS i degenerativnyh zabolevanij sustavov [Biological effects of different types of magnetic fields and their use in the treatment of IHD and degenerative joint diseases]. Medicinskaja Reabilitacia, Kurortologija i Fizioterapija, 39, 41–43 (in Russian).
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons «Attribution» 4.0 License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.