Issue 25-2, 2026

Original article

https://doi.org/10.38025/2078-1962-2026-25-2-8-22

The Effect of a Polypeptide Angioprotector on the Rehabilitation of Patients with Type 2 Diabetes Mellitus and Atherosclerosis of the Arteries of the Lower Extremities Who Have Suffered Myocardial Infarction:A Prospective Controlled Trial

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ORCIDMariam A. Simonyan, ORCIDLarisa A. Marchenkova, ORCIDValeriia A. Vasileva*

National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia


ABSTRACT

INTRODUCTION.  Cardiovascular diseases remain the leading cause of mortality in the Russian Federation, with acute myocardial infarction (AMI) accounting for a significant proportion of population disability. The presence of type 2 diabetes mellitus (T2DM) in patients after AMI occurs in 30–45 % of cases and is associated with a worse prognosis.

AIM.  To provide a scientific rationale and evaluate the efficacy of a polypeptide angioprotector in improving the outcomes of medical rehabilitation in patients with T2DM and diabetic angiopathy of the lower extremities who have suffered an AMI.

MATERIAL AND METHODS.   A prospective, open-label, controlled study was conducted in two parallel groups at the National Medical Research Center for Rehabilitation and Balneology in 2025. The study included 58 patients with T2DM and instrumentally confirmed diabetic angiopathy of the lower extremities 2.5 [2.0; 3.0] months after AMI. For statistical data analysis, patients were divided into 2 groups: the main group (n = 29; standard rehabilitation course + polypeptide angioprotector 5 mg intramuscularly twice a week; 10 injections) and the comparison group (n = 29, standard rehabilitation course only). The efficacy was assessed using laboratory, functional, and instrumental methods at baseline, after 15 days, and after 50 days.

RESULTS.   The main group achieved significant improvements in the lipid profile (LDL reduction; p = 0.04), NT-proBNP (p = 0.004), and IL-6 (p = 0.01). Pain-free walking distance increased (p < 0.001), and the Walking Impairment Questionnaire (WIQ) score improved (p < 0.001). There was also an increase in n. tibial conduction velocity of 6 % (p = 0.008) and in peak calf muscle strength of 14 % (p < 0.001). According to cardiopulmonary exercise testing, maximum workload increased by 24 % (p < 0.001), and peak oxygen consumption increased by 12 % (p = 0.002). In the control group, the changes were minimal or absent.

DISCUSSION.   The findings show that incorporation of a polypeptide angioprotector in the rehabilitation program provides a multisystem positive effect: correction of dyslipidemia, endothelial dysfunction, and systemic inflammation. This lays the groundwork for improving peripheral circulation and increasing exercise tolerance.

CONCLUSION.  Incorporating a polypeptide angioprotector into the comprehensive phase II medical rehabilitation program for patients with T2DM and diabetic angiopathy of the lower extremities after AMI significantly improves the effectiveness of restorative treatment. This is achieved by correcting metabolic disorders, improving peripheral hemodynamics and neuromuscular conduction, and increasing aerobic capacity, resulting in a notable improvement in quality of life.


KEYWORDS: medical rehabilitation, acute myocardial infarction, type 2 diabetes mellitus, diabetic angiopathy, bovine vascularpolypeptides, angioprotector, cardiopulmonary exercise testing, quality of life, exercise tolerance

FOR CITATION: Simonyan M.A., Marchenkova L.A., Vasileva V.A. The Effect of a Polypeptide Angioprotector on the Rehabilitation of Patients with Type 2 Diabetes Mellitus and Atherosclerosis of the Arteries of the Lower Extremities Who Have Suffered Myocardial Infarction:A Prospective Controlled Trial. Bulletin of Rehabilitation Medicine. 2026; 25(2):8–22. https://doi.org/10.38025/2078-1962-2026-25-2-8-22 (In Russ.).

FOR CORRESPONDENCE:

Valeriia A. Vasileva, Е-mail:  valeri08.00@bk.ru,  vasilevava@nmicrk.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.