Polyamine Treatment in Elderly Patients With Coronary Artery Disease

Inclusion Criteria: * Age ≥ 65 years * Chronic ischemic heart disease (previous revascularization or myocardial infarction) * Left ventricular ejection fraction of \> 40% And at least two of the following risk factors: * Type 2 diabetes, * Obesity (BMI ≥ 30 kg/m2), * Hypertension, * Previous LVEF \< 40%, * Left atrial volume index ≥ 30 mL/m2 * Left ventricular wall thickness ≥ 1.1 cm. Exclusion Criteria: * Unstable coronary syndrome * Significant and severe cardiac valve disease * Severe peripheral artery disease * Permanent atrial fibrillation * Pacemaker treatment * Chronic kidney disease with eGFR \<45 ml/min/1,73m2 * Severe comorbidity as judged by the investigator (such as severe pulmonary, neurological, or musculoskeletal disease) * Inability to give informed consent. Exclusion criteria for MRI: * Some metallic implants * Claustrophobia Exclusion criteria for muscle biopsy: * Treatment with either two antiplatelet drugs (aspirin and ADP-receptor antagonists) * Anticoagulants (warfarin, NOACs)