Title : The effect of a polypeptide angioprotector on the effectiveness of rehabilitation of patients with atherosclerosis of the lower extremities who have suffered acute myocardial infarction and have type 2 diabetes mellitus: A prospective controlled study
Abstract:
Introduction: Cardiovascular diseases remain the leading cause of mortality in the Russian Federation, with acute myocardial infarction (AMI) holding a particular place in the structure of population disability. The presence of type 2 diabetes mellitus (T2DM) in patients after AMI occurs in 30-45% of cases and is associated with a worse prognosis.
Aim: To provide a scientific rationale and evaluate the efficacy of a polypeptide angioprotector in improving the outcomes of medical rehabilitation in patients with T2DM and diabetic angiopathy of the lower extremities who have suffered an AIM.
Material and Methods: A prospective, open-label, controlled study was conducted in two parallel groups at the Federal State Budgetary Institution "National Medical Research Center for Rehabilitation and Balneology" of the Ministry of Health of Russia. The study included 58 patients with T2DM and instrumentally confirmed diabetic angiopathy of the lower extremities at 2.5 [2.0; 3.0] months after AMI. For statistical data analysis, patients were divided into 2 groups: the main group (n=29, standard rehabilitation course + polypeptide angioprotector 5 mg IM twice a week, 10 injections) and the comparison group (n=29, standard rehabilitation course only). Efficacy was assessed using laboratory, functional, and instrumental methods at baseline, after 15 days, and after 50 days.
Results: The main group achieved significant improvements in the lipid profile (LDL reduction, p=0.04), NT-proBNP (p=0.004), and IL-6 (p=0.01). Pain-free walking distance increased (p<0.001), and the WIQ score improved (p<0.001). An increase in tibial nerve conduction velocity by 6% (p=0.008) and peak calf muscle strength by 14% (p<0.001) was recorded. According to cardiopulmonary exercise testing, maximum workload increased by 24% (p<0.001), and peak oxygen consumption increased by 12% (p=0.002). In the control group, the changes were minimal or absent.
Discussion: The obtained results demonstrate that the inclusion of a polypeptide angioprotector in the rehabilitation program provides a multisystem positive effect: correction of dyslipidemia, endothelial dysfunction, and systemic inflammation. This creates a foundation for improving peripheral circulation and increasing exercise tolerance.
Conclusion: Incorporating a polypeptide angioprotector into the comprehensive phase II medical rehabilitation program for patients with T2DM and diabetic angiopathy of the lower extremities after AMI significantly improves the effectiveness of restorative treatment. This is achieved by correcting metabolic disorders, improving peripheral hemodynamics and neuromuscular conduction, and increasing aerobic reserves, which is accompanied by a meaningful improvement in quality of life.
