Mildronate and Acute Ischemic Stroke, the period of early rehabilitation

Evaluating the effectiveness of treatment of patients with ischemic stroke Mildronate it was carried out by Professor SM Vinichukom back in 1991 year.

The treatment regimen consisted of:

- Mildronate 500 mg / day intravenously for 10 days, then orally (duration of treatment is 2-3 weeks) jet (Group 1);

- Control group (Group 2) - Cavinton 10 mg, 100 mg of Pentoxifylline.

The results showed that the effect of a course of Mildronate treatment on total cerebral blood flow (OOMK) depended on the initial state of the regional hemodynamics. When brain tissue hypoperfusion and indicators rheoencephalography OOMK amplitude increases, hyperperfusion - decreased. Advancing stabilization tone resistant vessels of the brain, as evidenced by normalization of cerebral peripheral vascular resistance. Positive therapeutic effect Mildronate can be recommended in complex treatment of patients with acute cerebral blood flow by ischemic type. Efficacy of Mildronate on hemodynamics is due not only to a positive inotropic effect on the myocardium, but also the property of the normalization of cerebral vascular reactivity of the microvasculature, which improves cerebral hemodynamics in the post-ischemic brain gipo-perfuzione zone.

The study of clinical efficacy in patients Mildronate lacunar strokes were the spent ZA Suslina et al. in 2005 and a number of the authors, the purpose of which was to evaluate the effect of the drug on the dynamics of neurological deficit, the state of lipid peroxidation and cerebral hypoperfusion.

The treatment regimen consisted of:

- Mildronate 500 mg / day intravenously (Group 1) within 21 days (if necessary - anti-hypertensive and cardiac drugs, but excludes nootropic therapy, psychotropic drugs, antiplatelet agents and anticoagulants).

Results of the study was significantly (p <0.01) showed that treatment with Mildronate a significant proportion of patients with lacunar stroke in the acute phase of the disease there is a positive dynamics of subjective disorders and focal neurological deficits, improved cognitive function, reduction in lipid peroxidation intensity and an increase in activity endogenous antioxidants. Neuropsychological study showed a significant shortening of the execution time of the serial accounts (the study of intellectual activity) and improved memory (reproduction numerical series in reverse order). It was concluded that the inclusion of Mildronate in the course of therapy lacunar stroke, thanks to its antioxidant and neuroprotective properties, is appropriate and pathogenetically justified.

Evaluation of Mildronate application in the treatment of patients with ischemic stroke was conducted by a research team led by Professor GB Kabdrakhmanov (2005). The aim of the study was to investigate the efficacy of Mildronate in complex treatment of patients with ischemic stroke in the carotid or vertebrobasilar basin evaluation, not only the dynamics of neurological status, and level indicators of lipid peroxidation and antioxidant defense system.

The treatment regimen consisted of:

- Mildronate 1000 mg / day intravenously (Group 1) within 10 days against the background of basic therapy;

- Control group (Group 2) - only basic therapy.

The results of the study showed that in the group using Mildronate proved that recovery of neurological deficit in a shorter time with regression cerebral symptoms of vestibular and speech disorders; according to a study of mnemonic functions: a rapid increase in retained material (learning curve); According to laboratory tests showed a significant reduction in lipid peroxidation indices in comparison with the control group. Regression of neurological symptoms, a positive effect on cellular metabolism that underlies one of the most important parts of the pathogenetic mechanisms of acute cerebrovascular events, have shown the feasibility of incorporating Mildronate in combination therapy of neurological patients.

Given that stroke risk factors contribute to more frequent and rapid development of cerebral accident, work was carried out in 2006 (BA Duschanova, Abbasov GA, et al., 2006) to study the efficiency of use of clopidogrel in combination with at Mildronate patients in the recovery period of ischemic stroke.

The treatment regimen consisted of:

- Clopidogrel 75 mg po and Mildronate 1000 mg / day intravenously for 10 days followed by administration of clopidogrel 75 mg and 1000 mg Mildronate orally for 1 year.

The results showed that the rate of combined treatment with clopidogrel and Mildronate (Meldonium) has a stronger influence on the processes of lipid peroxidation and antiradical activity in patients in rehabilitation period of ischemic stroke.