MOLSIDOMINE AND THE BRAIN: IMPACT ON COGNITIVE FUNCTIONS

Abstract

Molsidomine is a widely used drug in the symptomatic treatment of patients with ischemic heart disease with proven benefits, and in many respects superior to other drugs with a similar pharmacodynamic profile such as nitroglycerin-containing drugs. In addition, recent preclinical studies in animal models have focused on potential extracardiac effects, with emphasis on its action on the nervous system and the brain. Objective: The aim of the present study is to investigate the effects of molsidomine, prescribed to patients with angina pectoris, on brain activity, especially on cognition. Materials and methods: In a group of 75 patients with CAD, hospitalized in the cardiology clinic in the period from 13th March 2025 to 07th November 2025, we initiated molsidomine therapy. We conducted four basic screening tests (MMSE, Isaac’s test, Clock Drawing test, Luria’s test) aiming at identyfing patients with cognitive deficits. We planned to perform the tests on the first and sixth month of treatment. As for now 11 patients have been tested on the sixth month, and a follow-up test for the rest of the group is to be scheduled. Results: Among the patients that have been tested for a second time, six are showing improvement in their results from the MMSE (55%), four are having worse results (36%), and one patient’s results have not changed (9%) When analysing the results from the second Isaac’s test, we noted that 7 patients scored a higher result (64%), while four of them presented with worsening (36%). On the second Clock Drawing test conduction all the patients fulfilled their task, as three of them (27%) have not managed to do it during their first try. While analysing the memory curves created on the basis of Luria’s test, we found out that 6 patients (55%) who presented with a low score from the first test, had the same result on the second one. Five of the patients (45%) showed a normal memory curve on the first and second month. All the results depend on the age and educational status of the patients. Conclusion: This own, locally conducted study reveals new potential benefits of the application of nitric oxide donors, namely molsidomine, beyond its traditional use as an anti-ischaemic drug and sets an initial direction of thinking in another direction. The described data cannot currently establish a definite positive effect on cognition, but at the same time no deterioration of the same is reported. A trend towards improvement is observed in some of the parameters studied, especially in younger patients.