Protective effect of an acute oral loading dose of Trimetazidine on myocardial injury following percutaneous coronary intervention.

Abstract

Objective: To evaluate the effect of pre-procedural acute oral administration of Trimetazidine (TMZ) on PCI-induced myocardial injury.

Design: Single-center, prospective, randomized evaluation study.

Setting: Patients with stable angina pectoris and single vessel disease undergoing percutaneous coronary angioplasty (PCI).

Patients: 582 were prospectively randomized. Patients who underwent more than one inflation during PCI were excluded, resulting in 266 patients randomly assign to two groups.

Interventions: Patients were randomly assigned to receive an acute loading dose of 60 mg of Trimetazidine or not prior to intervention.

Main outcome: The frequency and the level of troponin Ic (cTnI) elevation following successful PCI. cTnI levels were measured before and 6, 12, 18 and 24 hours after PCI.

Results: 136 patients were assigned to the TMZ group and 130 to the control group. Although there was no statistically significant difference in the frequency of cTnI elevation between the two groups, post procedural cTnI levels were significantly reduced in the TMZ group at all time points (6 hours: 4.2 ±0.8 vs 1.7 ±0.2, p<0.0001; 12 hours: 5.5 ±1.5 vs 2.3 ±0.4, p<0.0001; 18 hours: 9 ±2.3 vs 3 ±0.5, p<0.0001) and 24 hours: 3.2 ±1.2 vs 1 ±0.5, p<0.0001). Moreover, the total amount of cTnI released after PCI, as assessed by the area under the curve of serial measurement, was significantly reduced in the TMZ group (p<0.05).

Conclusion: Pre-procedural acute oral Trimetazidine administration significantly reduces PCI-induced myocardial infarction.