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Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary

Chang Wang1,2,3, Weiwei Chen1,2,4, Ming Yu1,3,4

  • 1Department of Cardiology, 74569China-Japan Union Hospital of Jilin University, Changchun, Jilin, P. R. China.

Angiology
|January 21, 2021
PubMed

Insights

Trimetazidine significantly reduced cardiac troponin I levels and improved left ventricular ejection fraction (LVEF) in patients undergoing percutaneous coronary intervention (PCI). However, it did not affect creatine kinase-myocardial band levels or anginal attacks.

Area of Science:

  • Cardiology
  • Pharmacology
  • Interventional Cardiology

Background:

  • Periprocedural myocardial injury is a complication of percutaneous coronary intervention (PCI).
  • Left ventricular ejection fraction (LVEF) is a key indicator of cardiac function.
  • Trimetazidine is an anti-anginal agent with potential cardioprotective effects.

Purpose of the Study:

  • To assess the efficacy of trimetazidine in reducing periprocedural myocardial injury.
  • To evaluate the impact of trimetazidine on postoperative left ventricular ejection fraction (LVEF).
  • To analyze the effect of trimetazidine in patients with coronary artery disease (CAD) undergoing PCI.

Main Methods:

  • Systematic literature search of multiple databases (PubMed, Ovid, Scopus, etc.).
  • Inclusion of 14 randomized controlled trials (RCTs).
  • Meta-analysis and meta-regression to evaluate efficacy and influencing factors.

Main Results:

  • Trimetazidine significantly reduced cardiac troponin I (cTnI) levels (P < .00001).
  • Significantly higher LVEF was observed with trimetazidine (P < .00001).
  • Reduced odds of ischemic ST-T segment changes were noted, but no significant difference in anginal attacks or creatine kinase-myocardial band levels.

Conclusions:

  • Preprocedure trimetazidine may reduce periprocedural myocardial injury in CAD patients undergoing PCI.
  • Postoperative trimetazidine may offer short-term improvement in LVEF.
  • Further high-quality RCTs are needed due to study heterogeneity and limitations.

Keywords:
cardiac troponincomplicationscoronary artery diseasemyocardial injurypercutaneous coronary intervention

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