Trimetazidine reduces oxidative stress in cardiac surgery.
BACKGROUND
Trimetazidine is an anti-ischemic agent that is used to treat angina and it has cardioprotective effects without inducing any significant hemodynamic changes. It inhibits the long-chain mitochondrial 3-ketoacyl coenzyme A thiolase enzyme in the myocyte and can improve cardiac mitochondrial metabolism, as well as scavenge free radicals. The aim of this double-blind prospective randomized study was to investigate the effect of preoperative use of trimetazidine on the reduction of oxidative stress during coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).


RESULTS
The study group (group T) and the control group (group C) each comprised 12 patients. Pretreatment began 2 weeks before CABG with trimetazidine (60 mg/day po); the control group did not receive any medication. Serial blood samples were collected before and after CPB for measurement of the serum concentrations of these major endogenous antioxidant enzyme systems, which are markers for oxidative degradation of the cellular membranes; postoperative levels were significantly different between the groups (p<0.05). There were no significant difference in hemodynamic values.


CONCLUSIONS
The findings suggest that pretreatment with trimetazidine alleviates malondialdehyde production and preserves endogenous antioxidant capacity during CABG with CPB and cardioplegic arrest.
Iskesen
Ihsan
I
Department of Cardiovascular Surgery, Celal Bayar University School of Medicine, Turkey. iskesen@yahoo.com
Saribulbul
Osman
O
Cerrahoglu
Mustafa
M
Var
Ahmet
A
Nazli
Yunus
Y
Sirin
Hayrettin
H
D000368:Aged; D000975:Antioxidants / Q000032:analysis; D001026:Coronary Artery Bypass; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D014292:Trimetazidine / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage*
D000975:Antioxidants; D014665:Vasodilator Agents; D008315:Malondialdehyde; D014292:Trimetazidine