Abstract
Effect of trimetazidine in patients with acute coronary syndrome, undergoing primary percutaneous coronary intervention. Systematic review and meta-analysis Aims: The aim of our study is to review and meta-analytically analyze data from studies published comparing patients with acute coronary syndrome who have undergone primary PCI and received trimetazidin additionally to the optimal medical therapy or placebo during the reperfusion procedure. Methods and results: Our meta-analysis follows the points of PRISMA protocol and meets all of their criteria. We managed a search in three scientific database using the following keyword combination (coronar* OR heart disease ORacs) AND (trimetazidine). 917 publications were collected and a statistical analysis was performed on nine randomized-controlled trials (RCT). Three outcomes was analyzed by mean difference calculation, changes in left ventricle ejection fraction (LVEF), cardiac troponin I (cTnI) and high-sensitivity C-reactive protein (hs-CRP) levels. For the LVEF a significant increase was observed in the trimetazidin group (MD: 3.4%, CI: 1.393–5.408, P=0.001). There was significant improvement in the level of cTnI compared pre- and post-procedurally. (MD: 0.426, CI: 0.060–0.791, P=0.022). Non-significant improvement was measured in the hs-CRP level (MD: 1,214, CI: –0.122–2.549, P=0.075). Conclusions: Based on the results of our meta-analysis it can be suggested that the trimetazidine administered as adjunctive therapy in the treatment of primary PCI in patients with ACS yielded significant results in two of the three parameters we studied, which were improvement in LVEF and change in cTnI, while the third parameter, in the case of hs-CRP not-significant change was measurable. In evaluating our results, we took into account whether the participants did or did not fully receive optimal medical therapy (OMT) and numerous limitating factors.
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