title: Chronic treatment with trimetazidine after discharge reduces the incidence of restenosis in patients who received coronary stent implantation: a 1-year prospective follow-up study.
abstract: BACKGROUND
  The incidence of stent restenosis (SR) has risen with as more patients are being treated with drug-eluting stents (DESs). Trimetazidine has multiple favorable effects on the cardiovascular system. Here, we aimed to evaluate whether chronic treatment with trimetazidine reduced the incidence of SR.
  
  
  METHODS
  From January 2009 to December 2011 at Chinese PLA General Hospital, 768 patients were enrolled and randomized into the trimetazidine treatment group (TG, n = 384) and control group (CG, n = 384). After DES implantation, all patients were treated with regular medication. In the TG, trimetazidine was administrated at 20mg tid for at least 30days. All patients received follow-up angiography 9-13 months after discharge. Major adverse cardiac and cerebrovascular events (MACCEs) were recorded.
  
  
  RESULTS
  Six hundred thirty-five patients were included in the final analysis (TG, n = 312; CG, n = 323). SR occurred in 49 (7.7%) patients. The TG had a lower incidence of SR compared to the CG (4.2% vs. 11.1%, p = 0.001). At the 30-day follow-up, the TG exhibited a higher left ventricular ejection fraction than the CG (65.4 ± 10.7 vs. 63.1 ± 10.4, p = 0.006). The incidence of MACCEs was also lower in the TG at the 1-year follow-up (6.1% vs. 10.8%, p = 0.032). Further multivariate analysis revealed that trimetazidine treatment was a predictor for SR (OR: 0.376; 95% CI: 0.196-0.721; p = 0.003).
  
  
  CONCLUSIONS
  Trimetazidine treatment effectively reduced the incidence of SR and MACCEs after DES implantation at the 1-year follow-up.
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Tian
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Han
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Cardiology, Chinese PLA General Hospital, Beijing 100853, China. Electronic address: cyundai@medmail.com.cn.
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014292:Trimetazidine / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine
keywords: Drug-eluting stents; Endothelial dysfunction; Stent restenosis; Trimetazidine; Vascular smooth muscle cell