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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">russjcardiol</journal-id><journal-title-group><journal-title xml:lang="ru">Российский кардиологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Cardiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-4071</issn><issn pub-type="epub">2618-7620</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">russjcardiol-1127</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИКА И ФАРМАКОТЕРАПИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR THE PRACTITIONER</subject></subj-group></article-categories><title-group><article-title>МЕТАБОЛИЧЕСКАЯ ТЕРАПИЯ L-КАРНИТИНОМ ПРИ ПЕРЕДНЕМ ОСТРОМ ИНФАРКТЕ МИОКАРДА С ПОДЪЕМОМ СЕГМЕНТА ST: РАНДОМИЗИРОВАННОЕ КЛИНИЧЕСКОЕ ИССЛЕДОВАНИЕ</article-title><trans-title-group xml:lang="en"><trans-title>METABOLIC TREATMENT WITH L-CARNITINE IN ACUTE ANTERIOR ST SEGMENT ELEVATION MYOCARDIAL INFARCTION: A RANDOMISED CONTROLLED TRIAL</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарантини</surname><given-names>Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarantini</surname><given-names>G.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Scrutinio</surname><given-names>D.</given-names></name><name name-style="western" xml:lang="en"><surname>Scrutinio</surname><given-names>D.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Bruzzi</surname><given-names>P.</given-names></name><name name-style="western" xml:lang="en"><surname>Bruzzi</surname><given-names>P.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Boni</surname><given-names>L.</given-names></name><name name-style="western" xml:lang="en"><surname>Boni</surname><given-names>L.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Rizzon</surname><given-names>P.</given-names></name><name name-style="western" xml:lang="en"><surname>Rizzon</surname><given-names>P.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Iliceto</surname><given-names>S.</given-names></name><name name-style="western" xml:lang="en"><surname>Iliceto</surname><given-names>S.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>Кардиологическое отделение Торакальных и Сосудистых исследований, Университет Падуи, Падуя</institution><country>Italy</country></aff><aff xml:lang="ru" id="aff-2"><institution>Кардиологическое отделение “S. Maugeri Foundation”, IRCCS, Бари</institution><country>Italy</country></aff><aff xml:lang="ru" id="aff-3"><institution>Отделение клинической эпидемиологии и клинических исследований, Национальный институт исследования опухолей, Генуя</institution><country>Italy</country></aff><aff xml:lang="ru" id="aff-4"><institution>Кардиологический институт Бари, Италия</institution><country>Italy</country></aff><aff xml:lang="ru" id="aff-5"><institution>Кардиологическое отделение Торакальных и Сосудистых исследований, Университет Падуи1, Падуя</institution><country>Italy</country></aff><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>28</day><month>08</month><year>2011</year></pub-date><volume>0</volume><issue>4</issue><fpage>77</fpage><lpage>84</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тарантини Г., Scrutinio D., Bruzzi P., Boni L., Rizzon P., Iliceto S., 2011</copyright-statement><copyright-year>2011</copyright-year><copyright-holder xml:lang="ru">Тарантини Г., Scrutinio D., Bruzzi P., Boni L., Rizzon P., Iliceto S.</copyright-holder><copyright-holder xml:lang="en">Tarantini G., Scrutinio D., Bruzzi P., Boni L., Rizzon P., Iliceto S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://russjcardiol.elpub.ru/jour/article/view/1127">https://russjcardiol.elpub.ru/jour/article/view/1127</self-uri><abstract><p>Известно, что терапия L-карнитином у пациентов с передним острым инфарктом миокарда (ОИМ) обладает протективным действием в отношении ремоделирования левого желудочка. Целью данного исследования была оценка влияния терапии L-карнитином на показатели смертности и частоты развития сердечной недостаточности у больных с передним ОИМ. Исследование CEDIM 2 являлось многоцентровым рандомизированным, двойным слепым, плацебо-контролируемым клиническим испытанием, выполненным у больных с передним ОИМ. Запланированное число участников составляло 4000. Исследование было прекращено досрочно вследствие меньшей, чем ожидалось, скорости набора пациентов. В целом, в исследование были включены 2330 больных. Основной комбинированной конечной точкой являлась частота развития сердечной недостаточности либо летального исхода в течение 6 месяцев. Дополнительной конечной точкой являлась смертность в течение 5 дней. В течение 6 месяцев наблюдения частота основной конечной точки в группах L-карнитина и плацебо достоверно не различалась (9,2% против 10,5% соответственно; р=0,27). Среди больных, принимавших L-карнитин, наблюдалось снижение смертности в течение 5 дней (отношение рисков (ОР) = 0,61; 95% доверительный интервал (ДИ) 0,37-0,98; р=0,041). В исследовании CEDIM 2 терапия L-карнитином приводила к снижению показателей ранней смертности (дополнительная конечная точка) у больных с передним ОИМ. Через 6 месяцев от момента рандомизации в группе L-карнитина не наблюдалось достоверного снижения риска смерти либо сердечной недостаточности (основная конечная точка).</p><sec><title> </title><p> </p></sec><sec><title> </title><p> </p></sec></abstract><trans-abstract xml:lang="en"><p>Administration of L-carnitine in patients with anterior acute myocardial infarction (AMI) prevents left ventricular remodelling. Current study was aimed to assess the effect of L-carnitine administration on mortality and heart failure in patients with anterior AMI. CEDIM 2 trial was a randomized, double-blind, multicentre, placebo-controlled trial planned to enrol 4,000 patients with acute anterior AMI. The trial was interrupted after the enrolment of 2,330 patients because of the lower than expected enrolment rate. The primary end point was a composite of death and heart failure at 6 months; 5-day mortality was the secondary end point. During the 6-month follow-up, the primary endpoint was not significantly different between the L-carnitine and placebo group (9,2 vs. 10,5%, p=0,27). A reduction in mortality was seen in the L-carnitine arm on day 5 (secondary end-point) from randomization (HR=0,61, 95% CI 0,37–0,98, p=0,041). In CEDIM 2 trial L-carnitine therapy led to a reduction in early mortality (secondary end-point) without affecting the risk of death and heart failure at 6 months in patients with anterior AMI, leading to a non-significant finding with respect to the primary end-point.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>oстрый инфаркт миокарда</kwd><kwd>инфаркт миокарда</kwd><kwd>фармакотерапия</kwd><kwd>метаболическая протекция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Acute myocardial infarction</kwd><kwd>myocardial infarction</kwd><kwd>pharmacotherapy</kwd><kwd>metabolic protection</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Armstrong PW, Collen D: Fibrinolysis for acute myocardial infarction. Current status and new horizons for pharmacological reperfusion.Part I. 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