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The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study)
Myocardial ischemia is caused by epicardial coronary artery stenosis or atherosclerotic disease affecting microcirculation. Trimetazidine (TMZ), promotes glucose oxidation which optimizes cellular energy processes in ischemic conditions. Small studies demonstrated protective effects of TMZ in terms...
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| Published in: | Frontiers in cardiovascular medicine 2023-06, Vol.10, p.1112198-1112198 |
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| description | Myocardial ischemia is caused by epicardial coronary artery stenosis or atherosclerotic disease affecting microcirculation. Trimetazidine (TMZ), promotes glucose oxidation which optimizes cellular energy processes in ischemic conditions. Small studies demonstrated protective effects of TMZ in terms of reducing myocardial injury after percutaneous coronary intervention (PCI), its effect on microcirculation using contemporary investigative methods has not been studied. The aim of the study was to examine effects of trimetazidine, given before elective PCI, on microcirculation using invasively measured index of microcirculatory resistance (IMR).
This was prospective, single blinded, randomized study performed in a single university hospital. It included consecutive patients with an indication for PCI of a single,
, native coronary artery lesion. Patients were randomly assigned to receive either TMZ plus standard therapy (TMZ group) or just standard therapy. Coronary physiology indices fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were measured before and after PCI using coronary pressure wire.
We randomized 71 patients with similar clinical characteristics and risk profile, previous medications and coronary angiograms. Patientshad similar values of Pd/Pa, FFR and CFR prior to PCI procedure. After PCI, FFR values were higher in TMZ group, while IMR values were lower in this group respectively (FFR TMZ + 0.89 ± 0.05 vs. TMZ - 0.85 ± 0.06,
= 0.007; CFR TMZ + 2.1 ± 0.8 vs. TMZ- 2.3 ± 1.3,
= 0.469; IMR TMZ + 18 ± 9 vs. TMZ- 24 ± 12,
= 0.028). In two-way repeated measures ANOVA PCI was associated with change in FFR values (TMZ
= 0.050; PCI
|
| doi_str_mv | 10.3389/fcvm.2023.1112198 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_8a9d99fcb872438f920ad0652931976b</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_8a9d99fcb872438f920ad0652931976b</doaj_id><sourcerecordid>2838645685</sourcerecordid><originalsourceid>FETCH-LOGICAL-c466t-89c12e4067ef5b630dfe96cec1aec6a1713a290db75dd8ddcea46ec305d983f73</originalsourceid><addsrcrecordid>eNpVkU9PGzEQxVdVUUHAB-il8pEekvrPrtc-VRGCFgkUJFKpN8trj4PR7jq1vUjh09dpUgS-eDR-85tnvar6TPCcMSG_OfM8zCmmbE4IoUSKD9UJpbKd4ab5_fFNfVydp_SEMSZNLRouPlXHrK1LQclJtVk9AvLD_cJkFBxaRT9A1i_e-hFQGNGdN3FpfDRTr7MvDe0yRPSQYcx-XCMXIkpZdz0gE2IYddwiHYtki6xPoBOgi_vF6m75UGST3X49q46c7hOcH-7T6tf11ery5-x2-ePmcnE7MzXneSakIRRqzFtwTccZtg4kN2CIBsM1aQnTVGLbtY21wloDuuZgGG6sFMy17LS62XNt0E9qU_5VrKmgvfrXCHGtik9velBCSyulM51oac2EkxRri3lDJSOy5V1hfd-zNlM3QNk15qj7d9D3L6N_VOvwrAhmtSinEC4OhBj-TJCyGnwy0Pd6hDAlRQUTfJdJU6RkLzUxpBTBve4hWO2SV7vk1S55dUi-zHx5a_B14n_O7C8iFKxT</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2838645685</pqid></control><display><type>article</type><title>The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study)</title><source>PubMed Central(OpenAccess)</source><creator>Ilic, Ivan ; Timcic, Stefan ; Milosevic, Maja ; Boskovic, Srdjan ; Odanovic, Natalija ; Furtula, Matija ; Dobric, Milan ; Aleksandric, Srdjan ; Otasevic, Petar</creator><creatorcontrib>Ilic, Ivan ; Timcic, Stefan ; Milosevic, Maja ; Boskovic, Srdjan ; Odanovic, Natalija ; Furtula, Matija ; Dobric, Milan ; Aleksandric, Srdjan ; Otasevic, Petar</creatorcontrib><description>Myocardial ischemia is caused by epicardial coronary artery stenosis or atherosclerotic disease affecting microcirculation. Trimetazidine (TMZ), promotes glucose oxidation which optimizes cellular energy processes in ischemic conditions. Small studies demonstrated protective effects of TMZ in terms of reducing myocardial injury after percutaneous coronary intervention (PCI), its effect on microcirculation using contemporary investigative methods has not been studied. The aim of the study was to examine effects of trimetazidine, given before elective PCI, on microcirculation using invasively measured index of microcirculatory resistance (IMR).
This was prospective, single blinded, randomized study performed in a single university hospital. It included consecutive patients with an indication for PCI of a single,
, native coronary artery lesion. Patients were randomly assigned to receive either TMZ plus standard therapy (TMZ group) or just standard therapy. Coronary physiology indices fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were measured before and after PCI using coronary pressure wire.
We randomized 71 patients with similar clinical characteristics and risk profile, previous medications and coronary angiograms. Patientshad similar values of Pd/Pa, FFR and CFR prior to PCI procedure. After PCI, FFR values were higher in TMZ group, while IMR values were lower in this group respectively (FFR TMZ + 0.89 ± 0.05 vs. TMZ - 0.85 ± 0.06,
= 0.007; CFR TMZ + 2.1 ± 0.8 vs. TMZ- 2.3 ± 1.3,
= 0.469; IMR TMZ + 18 ± 9 vs. TMZ- 24 ± 12,
= 0.028). In two-way repeated measures ANOVA PCI was associated with change in FFR values (TMZ
= 0.050; PCI
< 0.001;
for interaction 0.577) and TMZ with change in IMR values (TMZ
= 0.034, PCI
= 0.129,
for interaction 0.344).
Adding trimetazidine on top of medical treatment prior to elective PCI reduces microvascular dysfunction by lowering postprocedural IMR values when compared to standard therapy alone.</description><identifier>ISSN: 2297-055X</identifier><identifier>EISSN: 2297-055X</identifier><identifier>DOI: 10.3389/fcvm.2023.1112198</identifier><identifier>PMID: 37456821</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>Cardiovascular Medicine ; chronic coronary artery disease ; coronary flow ; index of microcirculatory resistance (IMR) ; PCI-percutaneous coronary intervention ; Trimetazidine (TMZ)</subject><ispartof>Frontiers in cardiovascular medicine, 2023-06, Vol.10, p.1112198-1112198</ispartof><rights>2023 Ilic, Timcic, Milosevic, Boskovic, Odanovic, Furtula, Dobric, Aleksandric and Otasevic.</rights><rights>2023 Ilic, Timcic, Milosevic, Boskovic, Odanovic, Furtula, Dobric, Aleksandric and Otasevic. 2023 Ilic, Timcic, Milosevic, Boskovic, Odanovic, Furtula, Dobric, Aleksandric and Otasevic</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-89c12e4067ef5b630dfe96cec1aec6a1713a290db75dd8ddcea46ec305d983f73</citedby><cites>FETCH-LOGICAL-c466t-89c12e4067ef5b630dfe96cec1aec6a1713a290db75dd8ddcea46ec305d983f73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348888/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348888/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37456821$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ilic, Ivan</creatorcontrib><creatorcontrib>Timcic, Stefan</creatorcontrib><creatorcontrib>Milosevic, Maja</creatorcontrib><creatorcontrib>Boskovic, Srdjan</creatorcontrib><creatorcontrib>Odanovic, Natalija</creatorcontrib><creatorcontrib>Furtula, Matija</creatorcontrib><creatorcontrib>Dobric, Milan</creatorcontrib><creatorcontrib>Aleksandric, Srdjan</creatorcontrib><creatorcontrib>Otasevic, Petar</creatorcontrib><title>The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study)</title><title>Frontiers in cardiovascular medicine</title><addtitle>Front Cardiovasc Med</addtitle><description>Myocardial ischemia is caused by epicardial coronary artery stenosis or atherosclerotic disease affecting microcirculation. Trimetazidine (TMZ), promotes glucose oxidation which optimizes cellular energy processes in ischemic conditions. Small studies demonstrated protective effects of TMZ in terms of reducing myocardial injury after percutaneous coronary intervention (PCI), its effect on microcirculation using contemporary investigative methods has not been studied. The aim of the study was to examine effects of trimetazidine, given before elective PCI, on microcirculation using invasively measured index of microcirculatory resistance (IMR).
This was prospective, single blinded, randomized study performed in a single university hospital. It included consecutive patients with an indication for PCI of a single,
, native coronary artery lesion. Patients were randomly assigned to receive either TMZ plus standard therapy (TMZ group) or just standard therapy. Coronary physiology indices fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were measured before and after PCI using coronary pressure wire.
We randomized 71 patients with similar clinical characteristics and risk profile, previous medications and coronary angiograms. Patientshad similar values of Pd/Pa, FFR and CFR prior to PCI procedure. After PCI, FFR values were higher in TMZ group, while IMR values were lower in this group respectively (FFR TMZ + 0.89 ± 0.05 vs. TMZ - 0.85 ± 0.06,
= 0.007; CFR TMZ + 2.1 ± 0.8 vs. TMZ- 2.3 ± 1.3,
= 0.469; IMR TMZ + 18 ± 9 vs. TMZ- 24 ± 12,
= 0.028). In two-way repeated measures ANOVA PCI was associated with change in FFR values (TMZ
= 0.050; PCI
< 0.001;
for interaction 0.577) and TMZ with change in IMR values (TMZ
= 0.034, PCI
= 0.129,
for interaction 0.344).
Adding trimetazidine on top of medical treatment prior to elective PCI reduces microvascular dysfunction by lowering postprocedural IMR values when compared to standard therapy alone.</description><subject>Cardiovascular Medicine</subject><subject>chronic coronary artery disease</subject><subject>coronary flow</subject><subject>index of microcirculatory resistance (IMR)</subject><subject>PCI-percutaneous coronary intervention</subject><subject>Trimetazidine (TMZ)</subject><issn>2297-055X</issn><issn>2297-055X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkU9PGzEQxVdVUUHAB-il8pEekvrPrtc-VRGCFgkUJFKpN8trj4PR7jq1vUjh09dpUgS-eDR-85tnvar6TPCcMSG_OfM8zCmmbE4IoUSKD9UJpbKd4ab5_fFNfVydp_SEMSZNLRouPlXHrK1LQclJtVk9AvLD_cJkFBxaRT9A1i_e-hFQGNGdN3FpfDRTr7MvDe0yRPSQYcx-XCMXIkpZdz0gE2IYddwiHYtki6xPoBOgi_vF6m75UGST3X49q46c7hOcH-7T6tf11ery5-x2-ePmcnE7MzXneSakIRRqzFtwTccZtg4kN2CIBsM1aQnTVGLbtY21wloDuuZgGG6sFMy17LS62XNt0E9qU_5VrKmgvfrXCHGtik9velBCSyulM51oac2EkxRri3lDJSOy5V1hfd-zNlM3QNk15qj7d9D3L6N_VOvwrAhmtSinEC4OhBj-TJCyGnwy0Pd6hDAlRQUTfJdJU6RkLzUxpBTBve4hWO2SV7vk1S55dUi-zHx5a_B14n_O7C8iFKxT</recordid><startdate>20230630</startdate><enddate>20230630</enddate><creator>Ilic, Ivan</creator><creator>Timcic, Stefan</creator><creator>Milosevic, Maja</creator><creator>Boskovic, Srdjan</creator><creator>Odanovic, Natalija</creator><creator>Furtula, Matija</creator><creator>Dobric, Milan</creator><creator>Aleksandric, Srdjan</creator><creator>Otasevic, Petar</creator><general>Frontiers Media S.A</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20230630</creationdate><title>The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study)</title><author>Ilic, Ivan ; Timcic, Stefan ; Milosevic, Maja ; Boskovic, Srdjan ; Odanovic, Natalija ; Furtula, Matija ; Dobric, Milan ; Aleksandric, Srdjan ; Otasevic, Petar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-89c12e4067ef5b630dfe96cec1aec6a1713a290db75dd8ddcea46ec305d983f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiovascular Medicine</topic><topic>chronic coronary artery disease</topic><topic>coronary flow</topic><topic>index of microcirculatory resistance (IMR)</topic><topic>PCI-percutaneous coronary intervention</topic><topic>Trimetazidine (TMZ)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ilic, Ivan</creatorcontrib><creatorcontrib>Timcic, Stefan</creatorcontrib><creatorcontrib>Milosevic, Maja</creatorcontrib><creatorcontrib>Boskovic, Srdjan</creatorcontrib><creatorcontrib>Odanovic, Natalija</creatorcontrib><creatorcontrib>Furtula, Matija</creatorcontrib><creatorcontrib>Dobric, Milan</creatorcontrib><creatorcontrib>Aleksandric, Srdjan</creatorcontrib><creatorcontrib>Otasevic, Petar</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in cardiovascular medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ilic, Ivan</au><au>Timcic, Stefan</au><au>Milosevic, Maja</au><au>Boskovic, Srdjan</au><au>Odanovic, Natalija</au><au>Furtula, Matija</au><au>Dobric, Milan</au><au>Aleksandric, Srdjan</au><au>Otasevic, Petar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study)</atitle><jtitle>Frontiers in cardiovascular medicine</jtitle><addtitle>Front Cardiovasc Med</addtitle><date>2023-06-30</date><risdate>2023</risdate><volume>10</volume><spage>1112198</spage><epage>1112198</epage><pages>1112198-1112198</pages><issn>2297-055X</issn><eissn>2297-055X</eissn><abstract>Myocardial ischemia is caused by epicardial coronary artery stenosis or atherosclerotic disease affecting microcirculation. Trimetazidine (TMZ), promotes glucose oxidation which optimizes cellular energy processes in ischemic conditions. Small studies demonstrated protective effects of TMZ in terms of reducing myocardial injury after percutaneous coronary intervention (PCI), its effect on microcirculation using contemporary investigative methods has not been studied. The aim of the study was to examine effects of trimetazidine, given before elective PCI, on microcirculation using invasively measured index of microcirculatory resistance (IMR).
This was prospective, single blinded, randomized study performed in a single university hospital. It included consecutive patients with an indication for PCI of a single,
, native coronary artery lesion. Patients were randomly assigned to receive either TMZ plus standard therapy (TMZ group) or just standard therapy. Coronary physiology indices fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were measured before and after PCI using coronary pressure wire.
We randomized 71 patients with similar clinical characteristics and risk profile, previous medications and coronary angiograms. Patientshad similar values of Pd/Pa, FFR and CFR prior to PCI procedure. After PCI, FFR values were higher in TMZ group, while IMR values were lower in this group respectively (FFR TMZ + 0.89 ± 0.05 vs. TMZ - 0.85 ± 0.06,
= 0.007; CFR TMZ + 2.1 ± 0.8 vs. TMZ- 2.3 ± 1.3,
= 0.469; IMR TMZ + 18 ± 9 vs. TMZ- 24 ± 12,
= 0.028). In two-way repeated measures ANOVA PCI was associated with change in FFR values (TMZ
= 0.050; PCI
< 0.001;
for interaction 0.577) and TMZ with change in IMR values (TMZ
= 0.034, PCI
= 0.129,
for interaction 0.344).
Adding trimetazidine on top of medical treatment prior to elective PCI reduces microvascular dysfunction by lowering postprocedural IMR values when compared to standard therapy alone.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>37456821</pmid><doi>10.3389/fcvm.2023.1112198</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central(OpenAccess) |
| subjects | Cardiovascular Medicine chronic coronary artery disease coronary flow index of microcirculatory resistance (IMR) PCI-percutaneous coronary intervention Trimetazidine (TMZ) |
| title | The imPAct of Trimetazidine on MicrOcirculation after Stenting for stable coronary artery disease (PATMOS study) |
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