Can we better protect patients who undergo revascularization? Beneficial effects of short- and long-term trimetazidine MR therapy in patients undergoing CABG and PCI.
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Can we better protect patients who undergo revascularization? Beneficial effects of short- and long-term trimetazidine MR therapy in patients undergoing CABG and PCI Revascularization may cause irreversible myocardial injuries About one-third of all elective PCI procedures are associated with significant myocardial injury, which has been linked to increased subsequent mortality. Beneficial effects of trimetazidine MR therapy in revascularization procedures Study involving patients undergoing CABG Study involving patients undergoing PCI • 306 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • 214 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • Trimetazidine MR started 2 weeks prior to CABG and continued for the next 3 years • Trimetazidine MR started 2 weeks prior to PCI and continued for the next 3 years Beneficial effects of trimetazidine MR therapy in revascularization procedures Study involving patients undergoing CABG Study involving patients undergoing PCI • 306 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • 214 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • Trimetazidine MR started 2 weeks prior to CABG and continued for the next 3 years • Trimetazidine MR started 2 weeks prior to PCI and continued for the next 3 years Lopatin YM, Dronova EP. Eur Heart J. 2010;31(abstract suppl):58. Beneficial effect of trimetazidine MR in patients undergoing CABG • Left ventricular ejection fraction *p< 0.05 vs baseline Administration of trimetazidine MR for 3 years after the procedure leads to a significantly increased left ventricular ejection fraction. Beneficial effect of trimetazidine MR in patients undergoing CABG • Serum CK and CK-MB levels in the early postoperative period Adding trimetazidine MR for 2 weeks prior to the procedures lowers levels of creatine kinase-MB isoenzyme (CK-MB) in the early postoperative period. Beneficial effects of trimetazidine MR therapy in revascularization procedures Study involving patients undergoing CABG Study involving patients undergoing PCI • 306 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • 214 Patients with stable angina and heart failure, split in 2 groups: trimetazidine MR group and control group without trimetazidine MR • Trimetazidine MR started 2 weeks prior to CABG and continued for the next 3 years • Trimetazidine MR started 2 weeks prior to PCI and continued for the next 3 years Lopatin YM, Dronova EP. Eur Heart J. 2011;32(abstract suppl):569. Beneficial effects of trimetazidine MR in patients undergoing PCI • Rate of hospitalization for acute coronary syndrome (3 years of follow-up) 7.5 4.7 Administration of trimetazidine MR for 3 years after the procedure significantly reduces the rate of hospitalization for acute coronary syndromes. Beneficial effects of trimetazidine MR in patients undergoing PCI • Arrhythmias during the first 30 minutes after intervention 7.5 P<0.05 5.6 P<0.005 3.7 0.9 Adding trimetazidine MR for 2 weeks prior to the procedures lowers frequency of arrhythmias in the early postoperative period. Beneficial effect of trimetazidine MR in post-MI patients with stable angina and heart failure • 6-Year mortality N=120 Long-term prescription of trimetazidine MR may improve prognosis. Lopatin YM, et al. Presented at ESC Congress 2012; August 2012; Munich, Germany. Abstract 2052. Conclusions • Treatment with trimetazidine MR prior to CABG or PCI protects the myocardium and decreases myocardial damage. • Combining treatment with trimetazidine MR prior to CABG or PCI and continued treatment for the following 3 years provides an improvement in left ventricular function with an increase in exercise tolerance and can improve prognosis. • Trimetazidine MR confirms its 6-year cardioprotective benefit in post–myocardial infarction patients, showing the importance of maintaining treatment in the long term.