Protective effect of trimetazidine on myocardial ischemia-reperfusion injury in patients with acute anterior myocardial infarction

BI Ying; LIU Xinlin; LIU Xiaowei; LIU Junxiang; GAO Bowen; ZHOU Xin; and ZHAO Jihong

PDF(674 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2017, Vol. 28 ›› Issue (10) : 988-991.

Protective effect of trimetazidine on myocardial ischemia-reperfusion injury in patients with acute anterior myocardial infarction

BI Ying¹, LIU Xinlin¹, LIU Xiaowei¹, LIU Junxiang¹, GAO Bowen², ZHOU Xin^{1, 3}, and ZHAO Jihong¹

Author information +

History +

Abstract

Objective To observe the protective effect of trimetazidine on myocardial ischemia reperfusion (I/R) injury in patients with acute anterior myocardial infarction treated with primary percutaneous coronary intervention(PCI).Methods 266 cases of newly diagnosed anterior acute ST segment elevation myocardial infarction were randomly divided into the trimetazidine group (132 cases) and the control group (134 cases). The treatment group received loading-dose trimetazidine of 60 mg before PCI and continued to take trimetazidine(20 mg tid) for three months after PCI. TIMI flow grade and TIMI myocardial perfusion grade(TMPG) of each group were recorded during PCI. The cardiac troponin Ic (cTNI) and creatine kinase-MB (CK-MB) levels of each group were measured 24 hours after operation. Left ventricular ejection fraction was also detected before PCI and at one month and three months after PCI by echocardiographic measurements.Results There were more cases of TIMI-3 blood flow and TMPG-3 myocardial perfusion in the trimetazidine group than in the control group. After PCI, the levels of cTNI[(17.04±1.71)ng/ml vs(14.39±1.42)ng/ml,P=0.001] and CK-MB[(90.32±9.26)U/L vs (82.55±8.04) U/L,P=0.001] in the trimetazidine group were significantly lower than those of the control group. Left ventricular ejection fraction of the trimetazidine group was also significantly higher than that of the control group[(54.81±3.27)% vs(52.26±2.55)%,P=0.001] at three months after PCI.Conclusions Early application of trimetazidine in patients with acute anterior myocardial infarction can reduce ischemia reperfusion (I/R) injury during PCI and long-term use of trimetazidine can improve heart function.

Key words

trimetazidine / acute anterior myocardial infarction / reperfusion therapy / ischemia-reperfusion injury

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

BI Ying, LIU Xinlin, LIU Xiaowei, LIU Junxiang, GAO Bowen, ZHOU Xin, and ZHAO Jihong. Protective effect of trimetazidine on myocardial ischemia-reperfusion injury in patients with acute anterior myocardial infarction[J]. Medical Journal of the Chinese People Armed Police Forces. 2017, 28(10): 988-991

References

[1] 赵季红,孙婧,赵鹏,等.经微导管注射不同药物对急诊经皮冠状动脉介入治疗术中无复流现象的疗效研究[J].生物医学工程与临床,2014,18(4):369-373.
[2] Arakawa K, Himeno H, Kirigaya J , et al . B-type natriuretic peptide as a predictor of ischemia/reperfusion injury immediately after myocardial reperfusion in patients with ST-segment elevation acute myocardial infarction[J]. Eur Heart J Acute Cardiovasc Care,2016,5(1):62-70.
[3] Neri M, Riezzo I, Pascale N, et al . Ischemia/Reperfusion Injury following Acute Myocardial Infarction: A Critical Issue for Clinicians and Forensic Pathologists[J]. Mediators Inflamm,2017,18:93.
[4] Eltzschig H K,Eckle T. Ischemia and reperfusion from mechanism to translation[J]. Nat Med,2011,17(11):1391-1401.
[5] Dai W, Hale S,Kloner R A. Delayed therapeutic hypothermia protects against the myocardial no-reflow phenomenon independently of myocardial infarct size in a rat ischemia/reperfusion model[J]. Int J Cardiol,2017,23 6400-6404.
[6] Ge L, Zhou X, Ji W J, et al . Neutrophil extracellular traps in ischemia-reperfusion injury-induced myocardial no-reflow: therapeutic potential of DNase-based reperfusion strategy[J]. Am J Physiol Heart Circ Physiol,2015,308(5):H500-509.
[7] Ito H. No-reflow phenomenon and prognosis in patients with acute myocardial infarction[J]. Nat Clin Pract Cardiovasc Med,2006,3(9):499-506.
[8] Bonello L, Sbragia P, Amabile N, et al . Protective effect of an acute oral loading dose of trimetazidine on myocardial injury following percutaneous coronary intervention[J]. Heart,2007,93(6):703-707.
[9] Chrusciel P, Rysz J,Banach M. Defining the role of trimetazidine in the treatment of cardiovascular disorders: some insights on its role in heart failure and peripheral artery disease[J]. Drugs,2014,74(9):971-980.
[10] Tsioufis K, Andrikopoulos G,Manolis A. Trimetazidine and cardioprotection: facts and perspectives[J]. Angiology,2015,66(3):204-210.
[11] Effect of 48-h intravenous trimetazidine on short- and long-term outcomes of patients with acute myocardial infarction, with and without thrombolytic therapy; A double-blind, placebo-controlled, randomized trial. The EMIP-FR Group. European Myocardial Infarction Project Free Radicals[J]. Eur Heart J,2000,21(18):1537-1546.
[12] Di Pasquale P, Lo Verso P, Bucca V, et al . Effects of trimetazidine administration before thrombolysis in patients with anterior myocardial infarction: short-term and long-term results[J]. Cardiovasc Drugs Ther,1999,13(5):423-428.