Clinical efficacy and safety of mildronate in patients with ischemic heart disease and chronic heart failure

Aim. To compare clinical efficacy and safety of a fatty acids oxidation inhibitor mildronate with those of digoxin in a framework of a multicenter double blind randomized trial with parallel groups. Material. 120 patients with NYHA class II heart failure due to ischemic heart disease. Methods. Clinical symptoms, intracardiac hemodynamics and tolerance to physical exercise were studied before and after acute drug test and 6 weeks of treatment with mildronate. Results. Compared with placebo course treatment with mildronate (1-1,5 mg/day) was associated with increases in left ventricular contractile and pump function, improvement of physical working capacity and lowering of NYHA functional class in 63 (78%) of patients. Mildronate did not cause worsening of coronary blood flow and its clinical effect was comparable with that of digoxin. Conclusion. Thus mildronate can be considered a perspective drug to be used as a component of combination therapy of heart failure due to chronic ischemic heart disease.