Comparison of therapeutic effects of coronary drugs in the USSR

T he prevalence of coronary artery disease in urban Union of Soviet Socialist Republics (USSR) population appears to be similar to that in Western European countries and the United States and, therefore, is a problem of major concern. Numerous articles, proceedings of conferences, and monographs on coronary heart disease appeared during the past decade. Naturally, drug therapy plays a substantial part, as demonstrated in the articles by Goldberg,’ Doshitsyn and co-workers2 and in the monographs of Kissin and VotchaL4 However, there does not seem to be a project in the USSR comparable in scale to the National Institutes of Health supported “Coronary Drug Project.” In the United States a massive double-blind therapeutic trial of lipid lowering drugs in coronary disease is in progress. This study known as the Coronary Drug Project has 8,341 male myocardial infarction patients enrolled in 55 centers throughout the country. At the time of enrollment they were between the ages of 30 and 64 years. The drugs under study are: nicotinic acid, clofibrate (Atromid S), estrogen, D-thyroxine (Coloxin), and placebo. The duration of follow-up is set at five years. Events studied include recurrent myocardial infarction, acute coronary insufficiency, angina, and other manifestations of arteriosclerosis, such as electrocardiographic changes, serum lipids, and mortality rates. The study will have completed five years for all patients by 1974 and should answer the question whether such drugs are useful in the therapy of arteriosclerosis, particularly coronary arteriosclerosis. The large control group of patients will provide invaluable information on the natural history of male coronary patients, a necessary yardstick for comparison with coronary patients treated by any means. One of the best controlled recent studies is the comparison of the therapeutic effect of several drugs used in the USSR for treatment of coronary heart disease by Votchal and Goldberg5 of the Central Institute of Postgraduate Medical Education in Moscow. In double-blind technique, the therapeutic effect of preparations-Papaverin, Nospa,* Segontin,t Ustimon,$ Intensain,§