The metabolic and cytoprotective orientation of meldonium in multimorbidity

The paper discusses the vaso-, neuro- and cardioprotective effects of a cytoprotective drug from a class of partial inhibitors of fatty acid β-oxidation (meldonium) and the possibility of its use in patients with multimorbidity. Meldonium is currently recommended for use as part of combination therapy for a number of cardiovascular diseases as a cytoprotector that affects cellular energy metabolism during ischemia and improves the use of oxygen by cells, including cardiomyocytes. Meldonium has a good safety and tolerability profile, increases exercise tolerance, performance in patients with coronary heart disease, stable exertional angina, heart failure, and improves quality of life. The additional immunomodulatory effects of meldonium allow the use of this drug to be expanded in clinical practice. The authors present their own observation of a middle-aged female patient with concomitant diseases who has taken meldonium as part of combination pathogenetic therapy. The paper discusses the possibilities of using meldonium that affects the neurometabolic processes in order to enhance the efficiency of therapy, to reduce the manifestations of asthenic syndrome, and to improve quality of life in the patients.