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Сильденафила цитрат может применяться больными с ИБС
Исследования, в т.ч. с применением ЭКГ-методов показывают, что применение сильденафила (основного компонента ВИАГРЫ) не оказывает влияния на нагрузку у больных с коронарной недостаточностью. "Данное исследование показало хорошую переносимость тестов при введении сильденафила", утверждают исследователи из клиники Мэйо, Рочестер, Миннесота
"Cardiovascular Effects of Sildenafil During Exercise in Men With Known or Probable Coronary Artery Disease A Randomized Crossover Trial"
Journal of the American Medical Association (JAMA)
02/13/2002
By Elda Hauschildt
Electrocardiography indicates sildenafil does not affect exercise in men with stable coronary artery disease (CAD).
Patients with CAD and erectile dysfunction should be assessed individually, however, before being prescribed sildenafil, United States researchers say.
"In this prospective, randomised study in men with erectile dysfunction and known or probable CAD, sildenafil administered one hour before maximal, symptom-limited exercise testing was well tolerated," say investigators from the Mayo Clinic and the Mayo Foundation in Rochester, Minnesota.
They point out sildenafil use "did not change the onset, extent or severity of ischemia, as assessed by exercise electrocardiography or echocardiography."
The researchers state: "Patients with known or suspected CAD and erectile dysfunction should have an individualized assessment before sildenafil prescriptions are issued.
"Exercise testing can be performed after sildenafil administration and may be indicated for risk stratification of some patients.
"Patients with stable coronary artery disease who are able to exercise to 4.5 METs (metabolic equivalent tasks) without angina or hypotension and with a negative or mildly positive stress test result can probably safely take sildenafil."
They add further research would "clarify what levels of functional capacity and severity of ischemia can be considered truly safe for men with coronary disease who wish to use sildenafil."
Investigators followed 105 men in a double-blind, crossover trial conducted from March to October 2000. Mean age of participants was 66 years.
Patients underwent two symptom-limited supine bicycle cardiograms separated by an interval of one to three days. All received a single dose of sildenafil or placebo one hour before each exercise test.
"Mean resting ejection fraction was 56 percent," the researchers say.
"After sildenafil use, resting systolic blood pressure was reduced from 135 mmHg to 128 mmHg, for a mean change of minus 7 mmHg. After placebo use, the mean change was from 135 mmHg to 133 mmHg, a difference of minus 2 mmHg.
"Resting heart rate, diastolic blood pressure and wall motion score index did not change significantly in either group.
"Exercise capacity was similar with sildenafil use and placebo use. Exercise blood pressure and heart rate increments were similar."
They note dyspnea or angina developed in 69 patients who took sildenafil and 70 patients who took placebo. Exercise electrocardiography was positive in 12 patients who took sildenafil and 17 patients who took placebo.
Investigators say risk factors for erectile dysfunction and CAD are similar. They include age, diabetes mellitus, hypertension and smoking.
"Coexistence of CAD and sexual dysfunction in middle-aged and older men is common."
JAMA, 2002; 287: 719-725. "Cardiovascular Effects of Sildenafil During Exercise in Men With Known or Probable Coronary Artery Disease A Randomized Crossover Trial"
DocGuide 20.02.2002
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