EFFICACY OF MELDONIUM IN ACUTE PERIOD OF ISCHEMIC STROKE

Cover Page


Cite item

Full Text

Abstract

Background: As long as systemic thrombolysis is indicated to not more than 10% of patients with ischemic stroke, the search for medical agents for basic treatment of stroke is an important problem of today’s neurology.

Aim: To evaluate efficacy of meldonium in patients with acute ischemic stroke.

Materials and methods: One hundred and fourteen patients were assessed in the acute period of strokes in the internal carotid artery system. The main group included 70 patients who were given meldonium (Mildronate) in addition to their basic treatment regimen. The drug was administered intravenously in daily drop infusions at dose of 10 ml of 10% solution for 10 days, thereafter they were switched to oral treatment at 250 mg daily for 2 to 3 weeks. The control group consisted of 40 patients who received only basic treatment regimen. Both groups were compatible for their age, gender distribution, severity of stroke and degree of neurologic dysfunction.

Results: In the patients who were given meldonium in addition to basic treatment of ischemic stroke, neurological deficiency, assessed by NIHSS, scored significantly better than in those from the control group (3.1 ± 0.1 vs. 2.6 ± 0.17, p < 0.05). Also, they had significantly less disability on modified Rankin scale (1.3 ± 0.03 vs. 1.07 ± 0.07, p < 0.01) and more improvement in mobility as per Rivermead mobility index (3.6 ± 0.17 vs. 2.9 ± 0.25, p < 0.05).

Conclusion: The addition of meldonium to the set of medical treatment in ischemic stroke patients gives positive results reflecting a decreased neurological deficiency, increased levels of mobility and daily activities.

About the authors

S. V. Kotov

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: kotovsv@yandex.ru

MD, PhD, Professor; Head of Department of Neurology; Head of Chair of Neurology, Postgraduate Training Faculty

Russian Federation

E. V. Isakova

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor; Senior Research Fellow, Department of Neurology; Chair of Neurology, Postgraduate Training Faculty

Russian Federation

T. V. Volchenkova

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

PhD, Head of Department of Neurology (Healthcare Unit)

Russian Federation

L. V. Smetana

Lyubertsy District Hospital No. 2;

Email: fake@neicon.ru

PhD, Head of Department of Neurology for Stroke Patients

Russian Federation

S. N. Belkina

Lyubertsy District Hospital No. 2;

Email: fake@neicon.ru

Neurologist, Department of Neurology for Stroke Patients

Russian Federation

References

  1. Стаховская ЛВ, Котов СВ, ред. Инсульт: руководство для врачей. М.: МИА; 2014. 400 с. Stakhovskaya LV, Kotov SV, editors. Insul't: rukovodstvo dlya vrachey [Stroke: Manual for doctors]. Moscow: MIA; 2014. 400 p. (in Russian).
  2. Elkins JS, Johnston SC. Thirty-year projections for deaths from ischemic stroke in the United States. Stroke. 2003;34(9):2109–12.
  3. Kruyt ND, Nederkoorn PJ, Dennis M, Leys D, Ringleb PA, Rudd AG, Vermeulen M, Stam J, Hacke W, Roos YB. Door-to-needle time and the proportion of patients receiving intravenous thrombolysis in acute ischemic stroke: uniform interpretation and reporting. Stroke. 2013;44(11):3249–53.
  4. Хасанова ДР, Гильманов АА, Прокофьева ЮВ, Гаврилов ИА. Результаты внедрения многоуровневой системы оказания медицинской помощи больным с инсультом в Республике Татарстан. Журнал неврологии и психиатрии им. С.С. Корсакова. 2013;113(7, 2):86–9. Khasanova DR, Gil'manov AA, Prokof'eva YuV, Gavrilov IA. Rezul'taty vnedreniya mnogourovnevoy sistemy okazaniya meditsinskoy pomoshchi bol'nym s insul'tom v Respublike Tatarstan [Results of introduction multilevel system of medical care to the patient with a stroke in the Tatarstan Republic]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2013;113(7, 2):86–9 (in Russian).
  5. Dirnagl U. Bench to bedside: the quest for quality in experimental stroke research. J Cereb Blood Flow Metab. 2006;26(12):1465–78.
  6. Kleinschnitz C, Grund H, Wingler K, Armitage ME, Jones E, Mittal M, Barit D, Schwarz T, Geis C, Kraft P, Barthel K, Schuhmann MK, Herrmann AM, Meuth SG, Stoll G, Meurer S, Schrewe A, Becker L, Gailus-Durner V, Fuchs H, Klopstock T, de Angelis MH, Jandeleit-Dahm K, Shah AM, Weissmann N, Schmidt HH. Poststroke inhibition of induced NADPH oxidase type 4 prevents oxidative stress and neurodegeneration. PLoS Biol. 2010;8(9).pii: e1000479.
  7. Dambrova M, Liepinsh E, Kalvinsh I. Mildronate: cardioprotective action through carnitinelowering effect. Trends Cardiovasc Med. 2002;12(6):275–9.
  8. Jaudzems K, Kuka J, Gutsaits A, Zinovjevs K, Kalvinsh I, Liepinsh E, Liepinsh E, Dambrova M. Inhibition of carnitine acetyltransferase by mildronate, a regulator of energy metabolism. J Enzyme Inhib Med Chem. 2009;24(6):1269–75.
  9. Стаценко МЕ, Беленкова СВ, Спорова ОЕ, Шилина НН. Применение милдроната в комбинированной терапии хронической сердечной недостаточности в постинфарктном периоде у больных сахарным диабетом 2-го типа. Клиническая медицина. 2007;85(7):39–42. Statsenko ME, Belenkova SV, Sporova OE, Shilina NN. Primenenie mildronata v kombinirovannoy terapii khronicheskoy serdechnoy nedostatochnosti v postinfarktnom periode u bol'nykh sakharnym diabetom 2-go tipa [The use of mildronate in combined therapy of postinfarction chronic heart failure in patients with type 2 diabetes mellitus]. Klinicheskaya meditsina. 2007;85(7):39–42 (in Russian).
  10. Суслина З, Максимова М, Федорова Т. Хронические цереброваскулярные заболевания: клиническая и антиоксидантная эффективность Милдроната. Врач. 2007;(4):40–5. Suslina Z, Maksimova M, Fedorova T. Khronicheskie tserebrovaskulyarnye zabolevaniya: klinicheskaya i antioksidantnaya effektivnost' Mildronata [Chronic cerebrovascular disorders: clinical and antioxidant efficacy of Mildronate]. Vrach. 2007;(4):40–5 (in Russian). 11. Максимова МЮ, Федорова ТН, Шарыпова ТН. Применение Милдроната в лечении больных с нарушениями мозгового кровообращения. Фарматека. 2013;(9):84–94. Maksimova MYu, Fedorova TN, Sharypova TN. Primenenie Mildronata v lechenii bol'nykh s narusheniyami mozgovogo krovoobrashcheniya [The use of Mildronate in patients with cerebrovascular disease]. Pharmateca. 2013;(9):84–94 (in Russian).
  11. Волченкова ТВ, Колчу ИГ, Исакова ЕВ, Котов СВ. Углеводный обмен у больных с церебральным инсультом. Бюллетень сибирской медицины. 2010;(4):35–7. Volchenkova TV, Kolchu IG, Isakova EV, Kotov SV. Uglevodnyy obmen u bol'nykh s tserebral'nym insul'tom [Carbohydrate metabolism in cerebral stroke patients]. Bulletin of Siberian Medicine. 2010;(4):35–7 (in Russian).
  12. Суслина ЗА, Максимова МЮ, Кистенев БА, Федорова ТН, Ким ЕК. Антиоксидантная терапия у больных дисциркуляторной энцефалопатией, отягощенной сахарным диабетом типа 2. Фарматека. 2005;(12):68–71. Suslina ZA, Maksimova MYu, Kistenev BA, Fedorova TN, Kim EK. Antioksidantnaya terapiya u bol'nykh distsirkulyatornoy entsefalopatiey, otyagoshchennoy sakharnym diabetom tipa 2 [Antioxidant therapy in patients with discirculatory encephalopathy complicated by type 2 diabetes mellitus]. Pharmateca. 2005;(12): 68–71 (in Russian).
  13. Лобанова МВ, Полетаева ЛВ, Романюк СС. Влияние Милдроната на уровень глюкозы крови и гликированного гемоглобина у больных сахарным диабетом типа 2. Вестник РГМУ. 2008;2(61):37. Lobanova MV, Poletaeva LV, Romanyuk SS. Vliyanie Mildronata na uroven' glyukozy krovi i glikirovannogo gemoglobina u bol'nykh sakharnym diabetom tipa 2 [The effect of Mildronate on blood glucose and glycated haemoglobin levels in type 2 diabetic patients]. Vestnik RGMU. 2008;2(61):37 (in Russian).

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2015 Kotov S.V., Isakova E.V., Volchenkova T.V., Smetana L.V., Belkina S.N.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies