The aim of the study was to assess lipid and carbohydrate metabolism parameters and pleiotropic effects of statins in patients with coronary heart disease (CHD) associated with type 2 diabetes mellitus after coronary myocardial revascularization. This study included 44 CHD patients (mean age of 59.7±6.5) who had sub#compensated type 2 diabetes mellitus. The patients were randomized into two groups. Exercise tolerance, systemic hemodynamics, lipid and carbohydrate metabolism parameters, and microcirculation status were assessed. During the follow up period, patients of the first group (n=24) were taking ACE inhibitors, beta blockers, anticoagulants, and simvastatin (average dose of 16.7±1.4 mg/day); patients of the second group (n=20) were taking ACE inhibitors, beta blockers, anticoagulants, and atorvastatin (average dose of 10.8±0.8 mg/day). After the treatment, patients of the first and second groups showed increment in exercise tolerance by 24.6% and by 24.7%, respectively. The diastolic function improved in both groups, while the systolic function did not change. The basal blood flow increased by 16.1% in the first group and by 13.8% in the second group. After eight weeks of simvastatin therapy, the first group showed significant decrease in total cholesterol (TC) by 21.1%, low#density lipoproteins (LDL) by 28.7%, atherogenic index (AI) by 32.9%, triglycerides (TG) by 16.5%, glucose basal level by 6.3%, and postprandial glycemia by 23.5% (p=0.001). In the second group after atorvastatin therapy, we observed TC decrease by 15.1%, LDL decrease by 23.1%, AI decrease by 35.7%, glucose basal level decrease by 9.8%, and postprandial glycemia decrease by 18.2%. The study showed that eight#week simvastatin therapy at the average dose of 16.7±1.4 mg/day and atorvastatin therapy at the average dose of 10.8±0.8 mg/day in type 2 diabetes mellitus patients resulted in exercise tolerance increase, microcirculation improvement, and positive impact on lipid and carbohydrate metabolism.

Clinical-hemodynamic and anti-ischemic activity of combined therapy of cardioselective ?1-blocker of the third generation nebivolol (Berlin-Chemie/Menarini Pharma GmbH) having NO-modulating activity with neutral diuretics indapamid (Firm ?Makiz-Pharma?, Moscow) and influence of carbohydrate and lipid exchange were assessed in 38 CAD patients associated with the diabetes mellitus of the 2-nd type. Significant hypertensive and anti-ischemic effects of the combined drugs were noted 12 weeks after. Decreased level of postprandial glycemia and atherogenous dislipidaemia was observed. Marked cardiac-and vasoprotective effects were noted. In the setting of improved microcirculation indices and myocardial mass index regress, left ventricular diastolic function was improved.

Anti-ischemic, cardioprotective, hemodynamic and metabolic affects as well as influence on regress of insulin resistance microcirculation injuries of valtarsan which was used in combination with tiasid diuretics hydrochlortiasid were studied in the secondary prevention of chronic heart failure in patients with left ventricular postinfarction remodeling, ischemic cardiac dysfunction aggravated with the diabetes mellitus of the 2-nd type. The study included 25 patients aged 59,2±5,8 years. Results of 3-months treatment with these drugs revealed their high anti-ischemic and cardioprotective efficacy. The study results showed markedly increased physical tolerance and quality of life of such patients.

The aim of the study was to assess influence of 3-months treatment using selective в1-blocker with additional NO-modulating peculiarities nebivolol, cytoprotector mildronate and their combination on clinical course, intracardiac hemodynamics and quality of life of coronary artery disease patients having chronic heart failure of the II-III functional NYHA class associated with the 2-nd type diabetes mellitus. Improved left ventricular diastolic function was revealed in all patients. The results obtained ground the expediency of including these drugs and their combination in the treatment of patients having ischemic heart disease associated the 2-nd type diabetes mellitus.

Results of the study of antiischemic, cardioprotective, hemodynamic and metabolic effects as well as influence on disturbed microcirculation regress of the blocker AT1-receptors of angiotensin II candesartan cylecsitil combined with b1-adrenoblocker nebivolol in the secondary prevention of chronic heart failure in patients having ischemic heat failure associated with the 2-nd type diabetes mellitus are given in the article. The study included 20 patients aged 57,6±3,1 years. The study results showed high anti-ichemic and anti-hypertensive efficacy of combined therapy of AT1receptors A II candesartan in a dose of 8-16 mg/day combined with b1-adrenoblocker nebivolol in a dose of 2,5-5 mg/day during 4-week therapy course and revealed significantly increased endothelium-dependent vasodilation in response to maximum blood flow during the test with regional hyperemia which points to improved endothelial function.