Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease.
OBJECTIVE
Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value for arrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects of trimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease.


METHODS
One hundred patients (23 females, mean age 55.6±9.2 years) with stable ischemic heart disease were included in the study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patients were stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for a minimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWA values were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography.


RESULTS
After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63±8 μV vs. 53±7 μV, p<0.001). Abnormal MTWA was present in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001).


CONCLUSIONS
Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parameters related with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmic complications and improve myocardial functions in patients with stable coronary artery disease.
Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey .
Mehmet
M
Yaman
Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey .
Uğur
U
Arslan
Department of Cardiology,Van 100. Yıl University, Van, Turkey .
Hasan Ali
HA
Gümrükçüoğlu
Department of Cardiology,Van 100. Yıl University, Van, Turkey .
Musa
M
Şahin
Department of Cardiology,Van 100. Yıl University, Van, Turkey .
Hakkı
H
Şimşek
Department of Cardiology,Van 100. Yıl University, Van, Turkey .
Serkan
S
Akdağ
Echocardiography; Electrocardiography; Ischemic heart disease; Trimetazidine