The State Institution ‘S.I. Georgiyevskyi Memorial State Medical University of Crimea’, Simferopol, Ukraine
Key words: stable effort angina, Tivortin®
Cardiovascular disease is the leading cause of morbidity and mortality in Ukraine. According to official data, the fraction of cardiovascular mortality within the structure of overall mortality is 63%. More than 1000 persons per 100,000 of general population succumb to cardiovascular disease annually. In most cases, the immediate cause of death in patients with cardiovascular disease is ischaemic heart disease (IHD). In absolute numbers, there are approximately 8 million patients with chronic IHD in Ukraine . Reduced or lacking endogenous NO production in the setting of endothelial dysfunction is considered one of the key reasons behind atherosclerotic and ischaemic changes (primarily in the coronary arteries), leading to different variants of IHD. [5, 7].
Bearing this in mind, one of the most promising novel therapeutic approaches is using the natural precursor of NO, L-arginine. This is an essential amino acid and an active cellular regulator of multiple vital functions in the body. L-arginine is a substrate of NO-synthase, an enzyme catalysing NO production in endothelial cells. It penetrates from endothelial cells into the smooth muscle cells of the vascular wall and activates guanylate cyclase, which increases the levels of cGMP, which, in turn, results in relaxation of blood vessels [2, 3, 6].
The aim of our study was to evaluate the efficacy and safety of using L-arginine (Tivortin®, manufactured by Yuria-Pharm Ltd., Ukraine) as a part of multimodality therapy in patients with stable effort angina, Grade II-III.