T. Motsak¹*, V. Lyzogub¹, O. Kupchynska^1,2, Y. Bielikova¹

¹Bogomolets National Medical University, Kyiv, Ukraine;
²SI “National Scientific Center “Institute of Cardiology, Clinical
and Regenerative Medicine named after Academician M.D. Strazhesko”
National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine;
*e-mail: tetianamihalovna@gmail.com

Received: 12 February 2025; Revised: 08 April 2025;
Accepted: 11 June 2025; Available on-line: 07 July 2025

Multifocal atherosclerosis (MAS) is associated with the development of ischemia in many organs and a significant deterioration in the prognosis for patients. An important role in this disease is played by the imbalance of neurotransmitters and increased content of matrix metalloproteinases (MMP) caused by ischemia. The aim of the study was to develop approaches to drug optimization of blood levels of dopamine, histamine and MMP in patients with multifocal atherosclerosis. The study included: 66 men with MAS aged 67.2 ± 2.9 years, who were divided into two groups: group 1 – patients with ischemic stroke, group 2 – patients with myocardial infarction, common to patients in both groups were atherosclerotic encephalopathy, ischemic heart disease and intermittent claudication syndrome; the control group consisted of 18 practically healthy men aged 63.4 ± 5.1 years. In addition to the basic treatment, patients received cilostazol (50 mg twice a day), GABA – aminalon (250 mg twice a day), atenolol (25 mg once a day) and catechins – Green T-Max (1 capsule per day) for 16 weeks. The examination included: determination of volumetric blood flow (FV) in the coronary, cerebral and femoral vascular territories, walking distance, daily ECG monitoring, estimation of dopamine and histamine levels in serum and MMP-2,-9 level in blood plasma by ELISA. Cognitive function was determined using the Montreal scale. Significantly lower FV in the studied vascular areas and extremely high histamine and dopamine levels were found in both MAS groups compared with the control group. The levels of MMP-2 and MMP-9 in both groups notably exceeded the indices in control group. After additional treatment with the studied medications, the drop in excessively high levels of histamine, dopamine, MMP-2 and MMP-9l was observed, the clinical condition, FV, cognitive functions and walking distance in patients of both MAS groups were improved. Thus, the use of the combination of cilostazol, aminalon, atenolol and catechins, in addition to standard therapy, allowed us to optimize the levels of neurotransmitters dopamine and histamine, which may reduce the risk of recurrent cardiovascular events in patients with MAS.

Keywords: dopamine, histamine, metalloproteinases-2, metalloproteinases-9, multifocal atherosclerosis