Potential of Trimetazidine in Protecting the Myocardium on Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis

Abstract

Aims: Increased biochemicals such as Troponin T, CKMB, and CK from myocardial injury are side effects of CABG. Trimetazidine is an anti-ischemic agent that can also have a cardioprotective. We conducted a systematic review and meta-analysis to analyse the role of trimetazidine therapy on postoperative myocardial preservation in CABG. Methods: The research instrument used was RCT test articles that have been published in the PubMed, Cochrane, and Google Scholar databases in 2013 and 2023. We were classified into two group analyses based on sampling time (at least ≤12 or >12 hours after CABG). Results: Five RCTs were finally included in the meta-analysis. Significant differences in TnT, CK-MB, and CK were found between trimetazidine-treated CABG patients and control CABG patients (p < 00001) in the subgroup examinations conducted ≤12 and >12 post-CABG, indicating significantly lower postoperative TnT, CK-MB, and CK levels in trimetazidine-treated CABG patients compared with control CABG patients. Conclusion: Myocardial preservation of CABG by comparing the effects of trimetazidine and placebo by assessing several levels of myocardial damage such as TnT, CK-MB, and CK was significantly lower in CABG patients treated with trimetazidine compared with control CABG patients.