对于稳定的冠状动脉疾病 (PATMOS研究) 进行支架后Trimetazidine对微循环的影响
Ivan Ilic1,2, Stefan Timcic1, Maja Milosevic1
1Cardiology Clinic, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia.
Frontiers in cardiovascular medicine
|July 17, 2023
概括
在穿皮冠状动脉干预 (PCI) 之前给出的三甲 (TMZ) 通过降低微循环阻力指数 (IMR) 来改善微循环. 这项研究表明,与单独的标准治疗相比,TMZ在PCI后有利于微血管功能.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心肌缺血源于冠状动脉狭窄或微循环问题.
- 三甲素 (TMZ) 通过促进葡萄糖氧化,优化了缺血期间的细胞能量代谢.
- 之前的研究表明TMZ在皮肤穿刺冠状动脉干预 (PCI) 后具有保护作用,但其对微循环的影响需要调查.
研究的目的:
- 在选择性PCI之前,评估三甲 (TMZ) 对微循环的影响.
- 使用侵入性测量评估微循环阻力指数 (IMR) 的变化.
主要方法:
- 一项前性,单盲,随机化研究,涉及71名接受选择性PCI的患者.
- 患者接受TMZ加标准治疗或单独接受标准治疗.
- 冠状动脉生理指数,包括分数流量储备 (FFR),冠状动脉流量储备 (CFR) 和微循环阻力指数 (IMR),在PCI前后使用压力线测量.
主要成果:
- 在PCI后,TMZ组与对照组相比显示出明显更高的FFR值 (0.89±0.05对比0.85±0.06,p=0.007) 和较低的IMR值 (18±9对比24±12,p=0.028).
- 虽然CFR值没有显著差异 (2.1 ± 0.8与2.3 ± 1.3,p=0.469),但ANOVA显示TMZ显著影响了IMR的变化 (p=0.034).
- PCI程序本身与FFR的变化有关 (p<0.001).
结论:
- 预先用三甲 (TMZ) 与标准药物治疗一起进行治疗,可以有效地减少选择性皮肤冠状动脉干预 (PCI) 后的微血管功能障碍.
- 这种改善的证据是微循环电阻 (IMR) 值的术后指数显著降低.
- 在接受PCI的患者中,TMZ与单独的标准治疗相比,对微循环阻力产生有益影响.
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