The effect of quercetin on the C-reactive protein dynamics and the long-term prognosis in patients with myocardial infarction of the right ventricle on the background of the q-myocardial infarction of the left ventricle

Authors

DOI:

https://doi.org/10.15587/2519-4798.2017.109136

Keywords:

quercetin, myocardium infarction of the right ventricle, C-reactive protein, prognosis

Abstract

Aim of research: to estimate the influence of quercetin on the dynamic of C-reactive protein, course of myocardial infarction and long-term prognosis of patients with myocardial infarction of the right ventricle on the background of Q-MI of the left ventricle.

Materials and methods. There were examined 208 patients with myocardial infarction of the right ventricle: the 1st group - 155 patients on the background of the Q-MI of the posterior  wall of the left ventricle,  and the 2nd group – 53 patients with right ventricle MI on the  background of Q-MI of the left ventricle of the circular localization, aged 64.11±0.78 years. Quercetin was prescribed from the 1st day of myocardial infarction: in the 1st group – in 88 (55.5%) patients, in the 2nd  group – in 32 (60.4%) patients. The concentration of C-reactive protein in blood serum was determined on the 2nd day of myocardial infarction and in 6 months with enzyme immunoassay analysis using HS-CRP EIA (Vienna, Austria).

Follow-up was (30.6±4.5) months. Study endpoints were: cardiovascular death, unstable angina, recurrent myocardial infarction, heath failure hospitalizations  and stroke.

Results. The therapy by quercetin was accompanied by the reliable decrease of the risk of fatal arrhythmias, early post-infarction angina, manifestations of the acute and chronic heart failure in the acute period of myocardial infarction of the right ventricle. Quercetin prescription was associated with the reliable decrease of the C-reactive protein (р=0.006) levels in 6 months after myocardial  infarction. There was established the predictor role of C-reactive protein after 6 months after infarction in the development of recurrent myocardial infarction (11.4%), unstable angina (7.7%) during 30.6 months. The therapy by quercetin in the 1st group was associated with the decrease of the frequency of recurrent myocardial infarctions (р=0.012), heart failure hospitalizations (р=0.0056) and cases of the cardio-vascular death (р=0.039); in the 2nd group – with the decrease of cases of unstable angina (р=0.012) and cardio-vascular death (р=0.01) comparing with patients on the standard therapy.

Conclusion. Using of the  quercetin in addition to the standard therapy in patients with myocardium infarction of the right ventricle is associated with the reliable decrease of cardiovascular events, particularly cardiovascular death, hospitalizations because of unstable angina and heart failure during 30.6 months of observation and positive dynamics of the C-reactive protein in 6 months after myocardium infarction. The level of C-protein in 6 months after myocardium infarction is an additional risk factor of cardiovascular complications during 30.6 months after myocardium infarction of the right ventricle

Author Biographies

Vira Tseluyko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor

Department of Cardiology and Functional Diagnostics

Tetiana Lozova, Sumy City Clinical Hospital No. 1 20 rokiv Peremohy str., 13, Sumy, Ukraine, 40021

PhD, Cardiologist

Igor Martsovenko, PhD, Chief Doctor

Sumy Regional Cardiology Clinic

Kovpaka str., 30, Sumy, Ukraine, 40031

References

  1. Cohn, J. N., Guiha, N. H., Broder, M. I., Limas, C. J. (1974). Right ventricular infarction. The American Journal of Cardiology, 33 (2), 209–214. doi: 10.1016/0002-9149(74)90276-8
  2. Carter, T. K., Ellis, K. (2005). Right ventricular infarction. Critical Care Nurse, 25, 52–62.
  3. Makani, A., Sullivan, C., Sullivan, C., Josephson, R., Josephson, R. (2016). Isolated right ventricular infarction: Fatal dissection and shock requiring invasive therapies. Case Reports in Internal Medicine, 3 (4). Available at: http://www.sciedupress.com/journal/index.php/crim/article/view/9703/6081 doi: 10.5430/crim.v3n4p1
  4. Cabin, H. S., Clubb, K. S., Wackers, F. J. T., Zaret, B. L. (1987). Right ventricular myocardial infarction with anterior wall left ventricular infarction: An autopsy study. American Heart Journal, 113 (1), 16–23. doi: 10.1016/0002-8703(87)90004-4
  5. Ondrus, T., Kanovsky, J., Novotny, T. et. al. (2013). Right ventricular myocardial infarction: From pathophysiology to prognosis. Experimental & Clinical Cardiology, 18 (1), 27–30.
  6. Jensen, C. J., Jochims, M., Hunold, P., Sabin, G. V., Schlosser, T., Bruder, O. (2010). Right Ventricular Involvement in Acute Left Ventricular Myocardial Infarction: Prognostic Implications of MRI Findings. American Journal of Roentgenology, 194 (3), 592–598. doi: 10.2214/ajr.09.2829
  7. Frangogiannis, N. G., Smith, C. W., Entman, M. L. (2002). The inflammatory response in myocardial infarction. Cardiovascular Research, 53 (1), 31–47. doi: 10.1016/s0008-6363(01)00434-5
  8. Paoletti, R., Gotto, A. M., Hajjar, D. P. (2004). Inflammation in atherosclerosis and implications for therapy. Circulation, 109 (23), 20–26. doi: 10.1161/01.cir.0000131514.71167.2e
  9. Smit, J. J. J., Ottervanger, J. P., Slingerland, R. J., Kolkman, J. J. E., Suryapranata, H., Hoorntje, J. C. A. et. al. (2008). Comparison of Usefulness of C-reactive Protein Versus White Blood Cell Count to Predict Outcome After Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction. The American Journal of Cardiology, 101 (4), 446–451. doi: 10.1016/j.amjcard.2007.09.088
  10. Moybenko, A. A. (2011). Sistemnye i molekulyarno-geneticheskie mekhanizmy kardioprotektsii. Fzіologіchniy zhurnal, 57 (5), 51–54.
  11. Parhomenko, A. N., Kozhuhov, S. N. (2004). Kardioprotektsiya pri ostrom infarkte miokarda: teoreticheskie predposylki i vozmozhnye puti klinicheskogo resheniya problemy. Mezhdunarodnyi meditsinskyi zhurnal, 2, 6–11.
  12. Zupanets, I. A., Podpruzhnikov, Yu. V., Shalamay, A. S., Bezuglaya, N. P. (2011). Izuchenie farmakokіnetiki lekarstvennogo preparata «Korvitin». Ukrains'kiy medichniy al'manah, 14 (6), 81–83.
  13. Steg, G. P., James, S. K., Atar, D., Badano, L. P., Lundqvist, C. B., Borger, M. A. et. al. (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal, 33 (20), 2569–2619.
  14. Lutay, M. I., Golikova, I. P., Slobodskoy, V. A. (2007). Rol disfunktsii endoteliya, vospaleniya i dislipidemii v aterogeneze. Ukrains'kiy Kardіologіchniy Zhurnal, 5, 37–47.
  15. Bonvini, R. F., Hendiri, T., Camenzind, E. (2005). Inflammatory response post-myocardial infarction and reperfusion: a new therapeutic target? European Heart Journal Supplements, 7, 127–136. doi: 10.1093/eurheartj/sui077
  16. Scirica, B. M., Morrow, D. A., Cannon, C. P., de Lemos, J. A., Murphy, S. et. al. (2007). Clinical Application of C-Reactive Protein Across the Spectrum of Acute Coronary Syndromes. Clinical Chemistry, 53 (10), 1800–1807. doi: 10.1373/clinchem.2007.087957
  17. Moybenko, A. A., Parhomenko, A. N. (2015). Effektivnost' vodorastvorimoy formy kvertsetina (Korvitina) pri lechenii ostrogo koronarnogo sindroma s elevatsiey segmenta ST. Available at: http://health-ua.com/article/671.html
  18. Koval', E. A., Karavanskaya, I. L., Prog, R. V. (2006). Rezul'taty izucheniya kratko- i dolgo- vremennoy effektivnosti primeneniya korvitina v kompleksnoy terapii bol'nyh s Q-infarktom miokarda. Available at: http://www.bhfz.com.ua/site/page.php?lang=ru&page=papers&id_part=716&id_ppaper=124
  19. Parhomenko, A. N., Kozhuhov, S. N., Moybenko, A. A., Gavrilenko, T. I. (2008). Blokator 5-lipoksigenazy korvitin: vliyanie na markery vospaleniya i endotelial'noy disfunktsii u bol'nyh s ostrym infarktom miokarda. Ratsіonal'na farmakoterapіya, 2/1, 34–42.

Published

2017-08-31

How to Cite

Tseluyko, V., Lozova, T., & Martsovenko, I. (2017). The effect of quercetin on the C-reactive protein dynamics and the long-term prognosis in patients with myocardial infarction of the right ventricle on the background of the q-myocardial infarction of the left ventricle. ScienceRise: Medical Science, (8 (16), 27–31. https://doi.org/10.15587/2519-4798.2017.109136

Issue

Section

Medical Science