EVALUATION OF THE EFFICIENCY OF METABOLIC THERAPY IN ELDERLY PATIENTS WITH CARBOHYDRATE METABOLISM DISORDERS AFTER ISCHEMIC STROKE

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.

carbohydrate and lipid disorders, Mildronate, ischemic stroke, rehabilitation