Role of metabolic manipulator trimetazidine in limiting percutaneous coronary intervention–induced myocardial injury

Trimetazidine (TMZ) is a metabolic modulator that shifts substrate utilization from fatty acid to carbohydrates, thereby, increasing myocardial glucose oxidation and improving myocardial ischemia. We evaluated whether TMZ is effective in reducing myocardial injury after percutaneous coronary interve...

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Bibliographic Details
Published in:Indian heart journal 2018-12, Vol.70 (Suppl 3), p.S365-S371
Main Authors: Kazmi, Danish H., Kapoor, Aditya, Sinha, Archana, Ambesh, Paurush, Kashyap, Shiridhar, Khanna, Roopali, Kumar, Sudeep, Garg, Naveen, Tewari, Satyendra, Goel, Pravin K.
Format: Article
Language:English
Subjects:
Biomarkers - blood
Coronary Angiography
Coronary Stenosis - surgery
Creatine Kinase, MB Form - blood
Female
Follow-Up Studies
Humans
Interventional Cardiology
Male
Metabolic modulation
Middle Aged
Myocardial Reperfusion Injury - diagnosis
Myocardial Reperfusion Injury - metabolism
Myocardial Reperfusion Injury - prevention & control
PCI
Percutaneous Coronary Intervention - adverse effects
Peri-procedural myocardial injury
Postoperative Complications - blood
Postoperative Complications - prevention & control
Prognosis
TIMI flow
Trimetazidine
Trimetazidine - therapeutic use
Troponin
Troponin I - blood
Vasodilator Agents - therapeutic use
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Summary:Trimetazidine (TMZ) is a metabolic modulator that shifts substrate utilization from fatty acid to carbohydrates, thereby, increasing myocardial glucose oxidation and improving myocardial ischemia. We evaluated whether TMZ is effective in reducing myocardial injury after percutaneous coronary intervention (PCI). Patients with stable angina undergoing elective PCI were divided into two groups, one who received oral TMZ (35 mg BD) started 7 days before PCI (n = 48) and second who did not receive any TMZ (in addition to the standard therapy (n = 52)). Troponin-I (cTnI) and creatine kinase–MB (CK-MB) were measured before, 8, and 24 h after PCI. The primary end point was a difference in post-PCI cTnI and CK-MB levels (vs baseline). Frequency of cTnI release in the two groups, total amount of cTnI release, and difference in TIMI flow grade before and after the procedure were also assessed. Baseline demographics in the groups were comparable. Despite similar baseline levels, post-procedural cTnI was lower at 8 h (0.13 vs 0.56 ng/ml, p = 0.03) and 24 h (0.2 vs 1.13 ng/ml, p = 0.004) in the TMZ group. Decline or no change in cTnI was significantly more common in the TMZ group (26% vs 2%, p 
ISSN:0019-4832
DOI:10.1016/j.ihj.2018.10.415