Protective effect of an acute oral loading dose of trimetazidine on myocardial injury following percutaneous coronary intervention.
OBJECTIVE
To evaluate the effect of pre-procedural acute oral administration of trimetazidine (TMZ) on percutaneous coronary intervention (PCI)-induced myocardial injury.


METHODS
Single-centre, prospective, randomised evaluation study.


METHODS
Patients with stable angina pectoris and single-vessel disease undergoing PCI.


METHODS
582 patients were prospectively randomised. Patients who underwent more than one inflation during PCI were excluded, resulting in 266 patients randomly assigned to 2 groups.


METHODS
Patients were randomly assigned to receive or not an acute loading dose of 60 mg of TMZ prior to intervention.


RESULTS
The frequency and the increase in the level of cardiac troponin Ic (cTnI) after successful PCI. cTnI levels were measured before and 6, 12, 18 and 24 h after PCI.


RESULTS
136 patients were assigned to the TMZ group and 130 to the control group. Although no statistically significant difference was observed in the frequency of cTnI increase between the two groups, post-procedural cTnI levels were significantly reduced in the TMZ group at all time points (6 h: mean (SD) 4.2 (0.8) vs 1.7 (0.2), p<0.001; 12 h: 5.5 (1.5) vs 2.3 (0.4), p<0.001; 18 h: 9 (2.3) vs 3 (0.5), p<0.001; and 24 h: 3.2 (1.2) vs 1 (0.5), p<0.001). 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).


CONCLUSIONS
Pre-procedural acute oral TMZ administration significantly reduces PCI-induced myocardial infarction.
Bonello
Laurent
L
Division of Cardiology, Hospital Nord, University of Marseille, School of Medicine, Marseille, France.
Sbragia
Pascal
P
Amabile
Nicolas
N
Com
Olivier
O
Pierre
Sandrine V
SV
Levy
Samuel
S
Paganelli
Franck
F
D000284:Administration, Oral; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D006335:Heart Injuries / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D015607:Stents; D014292:Trimetazidine / Q000627:therapeutic use*; D019210:Troponin I / Q000097:blood; D014665:Vasodilator Agents / Q000627:therapeutic use*
D003287:Contrast Media; D019210:Troponin I; D014665:Vasodilator Agents; D014292:Trimetazidine