Introduction of alpha-li poic acid i nto therapy of patients with coronary artery disease and associated type 2 diabetes mel litus or without it

Abstract

The purpose — to evaluate the index of arterial stiffness and the common carotid artery in patients with coronary artery disease (CAD), depending on the presence of type 2 diabetes mellitus (T2DM), lesions of the coronary arteries (CA) prior to therapy and in the process of standard and combined therapy with the addition of alpha-lipoic acid (ALA). Materials and Methods. 131 patients with CAD and control group (n=20) were examined. Depending on the presence of T2DM patients with CAD were divided into 2 groups: 1st group (n=70) — patients with concomitant T2DM, 2nd group (n=61) — patients with CAD and without T2DM All patients depending on the nature of the therapy were divided into 2 subgroups — subgroup IA (standard therapy) and the subgroup IB (combination therapy). Also were assessed cfPWV and TIM CCA before treatment and after 12 weeks of treatment. Results. The study demonstrated that in patients with CAD, the values of cfPWV were significantly increased in comparison with the control group. In the 1st group patients, in comparison with the 2nd group, the values of cfPWV (12.29±2.10 m/s vs 11.02±2.15 m/s, p12=0.0009) were significantly increased. In the 1st group of patients TIM CCA was significantly higher in comparison with the control (1.22±0.10 mm vs 0.89±0.06 mm, p=0.00001), in the 2nd group patients also TIM CCA was significantly higher in comparison with the control group (1.11±0.15 mm vs 0.89±0.06 mm, p=0.00001). In addition, in the 1st group patients TIM CCA was significantly higher in comparison with patients of the 2nd group (1.22±0.10 mm vs 1.11±0.15 mm, p=0.00001). In the 1st group patients of standard therapy, after 12 weeks of treatment, an unreliable decrease cfPWV (10,60±2,26 m/s vs 10,23±2,16 m/s, p>0.05) and TIM CCA (1.11±0.07 mm vs 1.07±0.07 mm, p>0.05). In the 2nd group patients of standard therapy, after 12 weeks of treatment, there was a slight decrease cfPWV (9.85±2.10 m/s 9.49±2.10 m/s), TIM CCA (1.07±0.10 mm vs 1.05±0.10 mm, p>0.05), but there was no significant difference (p>0.05). In the 1st group patients of combined therapy, after 12 weeks of treatment, an unreliable decrease in the value of cfPWV was noted (12.64±1.87 m/s vs 12.12±1.88 m/s, p>0.05), a significant decrease TIM CCA (1.24±0.08 mm vs 1.21±0.09 mm, p=0.0302). In the 2nd group patients of combined therapy, after 12 weeks of treatment, an unreliable decrease cfPWV was noted (11.37±2.10 m/s vs 10.83±2.07 m/s, p>0.05), and TIM CCA (1.11± 0.14 mm vs 1.08±0.14 mm, p>0.05). Conclusions. Introduction of ALA into the standard therapy helps to improve the elasticity of the vascular wall, slow down the development of the atherosclerotic process in patients with CAD including T2DM. However, further clinical studies with a longer follow-up period are needed to clarify the role of ALA in reducing residual cardiovascular risk.