The Effects of Postoperative Trimetazidine Treatment on Ischemia-Reperfusion Injury after Isolated Surgical Myocardial Revascularization
Abstract
Background
Surgical revascularization is the gold standard in the management of patients with multi-vessel coronary artery disease (CAD). It is well known that increased oxidative stress during ischemia-reperfusion and post-revascularization procedures leads to the release of free radical in the circulation. This process can cause reversible or irreversible myocardial damage.
Aim
The aim of this study was to assess the effect of trimetazidine on decreasing postoperative ischemia-reperfusion myocardial damage.
Material and methods
This prospective single-blind randomized controlled trial included 90 patients with elective surgery, operated between March 2018 and October 2018. The patients were divided into two equal groups, a study group and a control group; those in the study group received trimetazidine 35 mg b.d., immediately after tracheal extubation, in addition to their regular therapy. Pre- and postoperative levels of specific blood biomarkers such as high-sensitivity troponin T (hs-TnT), creatine kinase-MB (CK-MB), and malondialdehyde (MDA) were evaluated. Patients were followed for a period of 6 months after surgery.
Results
MDA levels were lower in patients who received trimetazidine, leading to a reduction in oxidative stress and improved cardiomyocyte protection by augmentation of the antioxidant status. The quality-of-life assessment with the Minnesota Living with Heart Failure Questionnaire yielded excellent results.
Conclusions
Improvement of myocardial cell metabolism and decreasing the level of postoperative ischemiareperfusion damage is alleviated by postoperative regular trimetazidine therapy.
© 2024 Stanev Kamen, Dobreva-Yatseva Bistra, Gonovski Todor, Ivanov Asen, Nachev Gencho, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
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