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2015 ; 94
(33
): e1161
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Role of Trimetazidine in Ischemic Preconditioning in Patients With Symptomatic
Coronary Artery Disease
#MMPMID26287407
Costa LMA
; Rezende PC
; Garcia RMR
; Uchida AH
; Seguro LFBC
; Scudeler TL
; Bocchi EA
; Krieger JE
; Hueb W
; Ramires JAF
; Filho RK
Medicine (Baltimore)
2015[Aug]; 94
(33
): e1161
PMID26287407
show ga
Ischemic preconditioning (IP) is a powerful cardioprotective cellular mechanism
that has been related to the "warm-up phenomenon" or "walk-through" angina, and
has been documented through the use of sequential exercise tests (ETs). It is
known that several drugs, for example, cromokalim, pinacidil, adenosine, and
nicorandil, can interfere with the cellular pathways of IP. The purpose of this
article is to report the effect of the anti-ischemic agent trimetazidine (TMZ) on
IP in symptomatic coronary artery disease (CAD) patients.We conducted a
prospective study evaluating IP by the analysis of ischemic parameters in 2
sequential ETs. In phase I, without TMZ, patients underwent ET1 and ET2 with a
30-minute interval between them. In phase II, after 1 week of TMZ 35?mg twice
daily, all patients underwent 2 consecutive ETs (ET3 and ET4). IP was considered
present when the time to 1.0-mm segment ST on electrocardiogram deviation
(T-1.0?mm) and rate pressure product (RPP) were greater in the second of 2 tests.
The improvement in T-1.0?mm and RPP were compared in the 2 phases: without TMZ
and after 1-week TMZ to assess the action of such drug in myocardial protective
mechanisms. ETs were analyzed by 2 independent cardiologists.From 135 CAD
patients screened, 96 met inclusion criteria and 62 completed the study protocol.
Forty patients manifested IP by demonstrating an improvement in T-1.0?mm in ET2
compared with ET1, without the use of any drugs (phase I). In phase II, after
1-week TMZ, 26 patients (65%) did not show any incremental result in ischemic
parameters in ET4 compared with ET3. Furthermore, of these patients, 8 (20%) had
IP blockage.In this study, TMZ did not add any benefit to IP in patients with
stable symptomatic CAD.
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