Trimetazidine Group Research Articles

Effect of trimetazidine pretreatment on myocardial injury induced by propofol in rats

Objective To evaluate the effect of trimetazidine pretreatment on myocardial injury induced by propofol in rats.Methods Forty healthy Sprague-Dawley rats,weighing 240-250 g,aged 2.5 months,were randomly divided into 4 groups (n =10 each):fat emulsion group (group L),propofol group (group P),and different doses of trimetazidine groups (TL and TH groups).In group L,10％ fat emulsion was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In group P,1％ propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In TL and TH groups,trimetazidine 2 and 5 mg/kg were injected intravenously,respectively,and 1.5 h later propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.At 6 and 12 h after beginning of administration,blood samples from the internal jugular vein were taken for determination of the levels of serum creatine kinase (CK),creatine kinase isoenzyme-MB (CK-MB),lactate dehydrogenase (LDH),α-hydroxybutyric acid dehydrogenase (α-HBDH),cardiac troponin Ⅰ (cTnⅠ),triglycerides (TG),low-density lipoprotein (LDL) and high-density lipoprotein (HDL).After blood sampling at 12 h after beginning of administration,myocardial specimens were obtained for microscopic examination of the pathological changes with light and electron microscope.Results Compared with group L,the serum CK,CK-MB,LDH,α-HBDH,cTnⅠ and TG levels were significantly increased,HDL was decreased,and no significant changes were found in LDL concentrations in P and TL groups,and the serum TG,HDL and LDL were increased,and no significant changes were found in the other parameters in group TH.Compared with group P,the serum CK,CK-MB,LDH,α-HBDH,and cTnⅠ levels were significantly decreased in TL and TH groups,the serum TG level was increased in TL group,and the serum TG,HDL and LDL levels were increased in TH group.Compared with group TL,the serum CK,CK-MB,LDH,α-HBDH and cTnⅠ levels were significantly decreased,and the serum TG,HDL and LDL levels were increased in group TH.Conclusion Trimetazidine pretreatment can attenuate myocardial injury induced by propofol,but it induces increase in blood lipids. Key words: Trimetazidine; Propofol; Myocardial

Trimetazidine significantly reduces cerulein-induced pancreatic apoptosis

Acute pancreatitis continues to be associated with significant rates of mortality and morbidity, and therapeutic options are still very limited. We aimed to investigate the efficacy of trimetazidine on cerulein-induced pancreatic apoptosis and histopathological and biochemistrical consequences of acute pancreatitis. Thirty-two Wistar albino rats were randomized into four groups (group 1: control group; group 2: acute pancreatitis group; group 3: acute pancreatitis and trimetazidine treatment group; group 4: placebo group). Acute edematous pancreatitis was induced by subcutaneous cerulein injection (20 μg/kg) four times at one-hour intervals. Trimetazidine was prepared in suspension form. In group 3, after gas anesthesia, trimetazidine was administrated to rats via a catheter. Serum interleukin (IL)-1β, tumor necrosis factor (TNF)-α, amylase, lipase and leukocyte levels, pancreatic apoptotic status and pancreatic Schoenberg scores were determined for all groups. Results are given as the mean ± SD. A value of P<0.05 was accepted as statistically significant. SPSS for Windows v15.0 was used for statistical analyses. In the acute pancreatitis group IL-1β, amylase, lipase and leukocyte levels were elevated and pancreatic histopathological evaluation revealed a diagnosis of acute pancreatitis IL-1β amylase and lipase levels and pancreatic inflammation were decreased significantly in the trimetazidine group (P<0.01). White blood cell counts and TNF-α concentrations for the trimetazidine group and the acute pancreatitis group were not significantly different. Trimetazidine significantly reduced apoptosis in pancreatic tissues and Schoenberg scores were also significantly reduced (P<0.05). In this study, we showed that trimetazidine treatment significantly decreases the levels of IL-1β, amylase and lipase reduces pancreatic apoptosis and ameliorates the histopathological findings of cerulein-induced acute pancreatitis. Trimetazidine could be a new therapeutic option in the early treatment of acute pancreatitis.

Impact of Trimetazidine on Incidence of Myocardial Injury and Contrast-Induced Nephropathy in Diabetic Patients With Renal Dysfunction Undergoing Elective Percutaneous Coronary Intervention

Trimetazidine is an anti-ischemic agent with antioxidant activity. This study evaluated the effect of periprocedural administration of trimetazidine on the incidence of percutaneous coronary intervention (PCI)-induced myocardial injury and contrast-induced nephropathy (CIN) in diabetic patients with mild-to-moderate renal dysfunction. One hundred patients with a mean glomerular filtration rate of 48 ± 16 (ml/min/1.73m(2)) were prospectively enrolled, then randomly assigned to receive (50 patients; trimetazidine group) or not receive (50 patients; control group) periprocedural trimetazidine (70mg/day) for 72hours. The serum creatinine level was measured pre-PCI, 72hours, and 10days thereafter. An increase in the serum creatinine level by >0.5mg/dl or 0.25% of the baseline value is considered as CIN. Cardiac troponin I levels were measured before and 6, 12, and 24hours after PCI. Mean age of the study cohort was 59 ± 6years (men 68%). The serum creatinine level in the control group increased significantly 3days after PCI and decreased on the tenth day. However, it showed no significant change in the trimetazidine group. Incidence of CIN was 12% in the trimetazidine group and 28% in the control group (p <0.05). Cardiac troponin I levels were significantly reduced in the trimetazidine group (6hours: 8 ± 0.3 vs 16 ± 0.2 pg/ml, 12hours: 13 ± 0.9 vs 24 ± 0.8 pg/ml, 24hours: 7 ± 0.7 vs 14 ± 0.3 pg/ml, p <0.001). Inconclusion, trimetazidine intake before elective PCI in diabetic patients with mild-to-moderate renal dysfunction is associated with decreased incidence of CIN and myocardial injury.

Effect of trimetazidine on renal function in patients with shock

To investigate the effects of trimetazidine on renal function in patients with shock. A prospective randomized controlled double-blind study was conducted. 128 patients with shock admitted to intensive care unit (ICU) of Guangzhou Red Cross Hospital from April 2011 to April 2013 were enrolled and randomly divided into control group and trimetazidine treatment group, each n=64. All patients received anti-shock treatment, while the patients in trimetazidine group received trimetazidine treatment (20 mg orally, tid) for 7 days, and patients in control group received placebo (10 mL of sterile water for injection, tid) for 7 days. The urinary output, serum creatinine (SCr), blood urea nitrogen (BUN), cystatin C, and creatinine clearance (CCr) reflecting renal function were recorded in both groups, and the values were compared before treatment, 48 hours after treatment, and 1 week after the treatment. At the same time, dynamic mean arterial pressure (MAP) was monitored, and 48-hour and 1-week mortality rates were recorded. There was no significant difference in results in all the renal function parameters before the treatment between two groups. The levels of SCr, BUN, cystatin C were gradually decreased after treatment in both groups, but CCr and MAP were gradually increased. Compared with the control group, cystatin C at 48 hours after treatment was significantly decreased, while CCr was significantly increased in treatment group (cystatin C: 0.85±0.81 mg/L vs. 1.01±0.91 mg/L, t=2.562, P=0.017; CCr: 0.93±0.64 mL/s vs. 0.69±0.40 mL/s, t=2.155, P=0.033). SCr and BUN at 1 week after treatment were significantly decreased in treatment group (SCr: 94.23±88.31 μmol/L vs. 104.99±98.37 μmol/L, t=2.921, P=0.003; BUN: 9.46±8.24 mmol/L vs. 11.87±8.65 mmol/L, t=2.611, P=0.010). Urine output per hour and MAP was improved after treatment in both groups, and no significant difference was found between treatment group and control group (urine output: 48 hours after treatment 55.67±31.43 mL vs. 45.34±11.79 mL, t=0.934, P=0.323; 1 week after treatment 71.67±37.23 mL vs. 75.35±22.88 mL, t=1.280, P=0.210; MAP: 48 hours after treatment 72.13±33.24 mmHg vs. 69.28±39.98 mmHg, t=1.408, P=0.179; 1 week after treatment 71.44±21.98 mmHg vs. 72.32±31.11 mmHg, t=1.184, P=0.252]. Mortality rate in treatment group was lowered compared with control group, however no statistical significance was found [48 hours after treatment: 31.2% (20/64) vs. 32.8% (21/64), χ2=0.084, P=0.785; 1 week after treatment: 32.8% (21/64) vs. 35.9% (23/64), χ2=2.084, P=0.173]. Trimetazidine can improve renal function in patients with shock.

Protective effect of trimetazidine on amikacin-induced ototoxicity in rats

ObjectiveAminoglycoside antibiotics are known to have ototoxic effects and may induce sensorineural hearing loss. This study investigated the protective effect of trimetazidine, which has antioxidant and cytoprotective properties, against amikacin ototoxicity. MethodsThirty-two male rats were divided into four groups – amikacin, amikacin+trimetazidine, trimetazidine, and control groups. Trimetazidine, 10mg/kg per day, was given for 14 days by oral gavage. Amikacin, 600mg/kg per day, was also given for 14 days, by the intramuscular route. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) tests were applied to the rats for hearing assessment. At the termination of the study, the biochemical parameters were calculated to evaluate the oxidative status. ResultsThe DPOAE values of the amikacin group were significantly lower on the 7th and 14th days than those of the trimetazidine+amikacin group and there was an increase in the ABR thresholds. The ABR thresholds for the amikacin group on the 7th and 14th days were significantly higher than the levels on the first day of the study, while there was no significant increase in those values in the trimetazidine+amikacin group. The total oxidant status (TOS) and oxidant status index (OSI) values of the amikacin group were significantly higher than those of the trimetazidine+amikacin group. The total antioxidant status (TAS) values of the amikacin group were lower than those of the trimetazidine+amikacin group. ConclusionsThe audiologic tests and biochemical parameters investigated in this study both point to the protective effect of trimetazidine against amikacin-induced ototoxicity.

The first histopathological evidence of trimetazidine for the prevention of contrast-induced nephropathy

Aim: We aimed to investigate the prophylactic effects of trimetazidine (TMZ) against contrast-induced nephropathy (CIN) in rat kidneys. Methods and results: 28 Wistar rats were divided into 4 groups of 7 rats each (control (C), contrast media (CM) TMZ, trimetazidin + contrast media groups (TMZ + CM). The administration of TMZ solution was done on d2, d3 and d4. Fifth day, contrast media was administered at a single dose. On d6 scarification was performed. The oxidant/antioxidant parameters were measured and histopathological scores were performed in kidney tissues. Most of the histopathological scores were significantly higher in the CM group as compared to other groups. Moreover, the scores of the TMZ + CM and C groups were not statistically different. CM group, had significantly higher levels of MDA compared to the C and CM + TMZ groups (562.82 ± 38.15 vs. 419.15 ± 49.01 and 507.34 ± 14.16 01 nmol/mg protein respectively) (p < 0.001). CM group had significantly lower levels of SOD as compared to C, CM + TMZ and TMZ groups (p < 0.05). Conclusion: To the best of our knowledge, this study for the first time, histopathologically demonstrated the effectiveness of TMZ for the prevention of CIN.

Effect of Trimetazidine on Recurrent Angina Pectoris and Left Ventricular Structure in Elderly Multivessel Coronary Heart Disease Patients with Diabetes Mellitus After Drug-Eluting Stent Implantation: A Single-Centre, Prospective, Randomized, Double-Blind Study at 2-Year Follow-Up

Trimetazidine has been shown to improve angina pectoris and left ventricular (LV) function in diabetic patients with ischaemic cardiomyopathy. The objective of this study was to evaluate the effects of trimetazidine on recurrent angina pectoris and LV structure after drug-eluting stent (DES) implantation in elderly multivessel coronary heart disease (CHD) patients with diabetes mellitus (DM) and a left ventricular ejection fraction (LVEF) of ≥ 50 %. This was a single-centre, prospective, randomized, double-blind evaluation study. Between January 2010 and September 2010, 700 CHD patients with DM who were aged ≥ 65 years and undergoing coronary angiography at An Zhen Hospital (Beijing, China) were recruited and prospectively randomized to receive trimetazidine (20 mg three times daily) or placebo after DES implantation as an addition to conventional CHD treatment. The primary end points were the incidence of recurrent angina pectoris and measures of various echocardiographic parameters, which included LVEF. At 2-year follow-up, patients in the trimetazidine group (n = 255) showed significant improvements in the incidence (P = 0.024) and severity of angina pectoris, compared with the control group, as well as silent myocardial ischaemia (P = 0.009) and angina pectoris-free survival (P = 0.011). LV function and structure in trimetazidine-treated patients were relatively stable at 2-year follow-up, while they deteriorated in the control group (n = 255) with a significant difference between groups (all P < 0.01). The E peak to A peak (E/A) ratio in trimetazidine-treated patients and in the control group decreased after 2 years; the E/A ratio in trimetazidine-treated patients was slightly better than that in the control group, without a significant difference (P = 0.170). There was no significant difference in event-free survival for the composite end point including death, myocardial infarction, cerebrovascular accident (P = 0.422) and subsequent revascularization (P = 0.073). Adjunctive therapy with trimetazidine after DES implantation can have a beneficial effect on recurrent angina pectoris as well as LV function and structure in elderly multivessel CHD patients with DM.

Cardioprotective Effects of Oral Trimetazidine in Diabetic Patients With Anterior Wall Myocardial Infarction Treated with Thrombolysis.

BackgroundTrimetazidine is an anti-ischemic agent with anti-oxidant activity. This study sought to evaluate the impact of oral trimetazidine on extent of myocardial damage in diabetic patients who were presented with anterior wall ST-segment elevation myocardial infarction (STEMI).MethodsOne hundred patients were prospectively enrolled, and then randomly assigned to receive oral trimetazidine (70 mg then 35mg bid) (group A, 50 patients) or placebo (group B, 50 patients), starting before thrombolysis. Serum creatine kinase-T and MB (CK-T and CK-MB) were measured serially. Degree of ST-segment resolution was recorded after 90 minutes. Left ventricle ejection fraction (LVEF) was assessed at baseline and after 6 months. Adverse events were recorded after thrombolysis and 6 months later.ResultsMean age of the study cohort was 59.05 ± 3.8 years (males: 60%). After 24 hours, 45 (90%) patients in group A vs. 10 (20%) patients in group B showed peaking of CK-T and CK-MB levels (P < 0.05). Both biomarkers’ levels were significantly higher in the placebo group at different sampling times. Complete resolution of ST-segment elevation was recorded in 35 (70%) patients in group A vs. 18 (36%) patients in group B (P < 0.05). Six months later, group A showed higher LVEF and fewer cardiac adverse events (P < 0.05).ConclusionIn diabetic patients receiving thrombolytic therapy for anterior wall STEMI, oral trimetazidine dosing was associated with less myocardial damage, earlier successful reperfusion, improvement of LVEF and less cardiac adverse events.

Effect of Shuangshen Ningxin formula on energy metabolism of myocardial ischemia/reperfusion rats

To investigate the effect of Shuangshen Ningxin (SSNX) formula on energy metabolism of myocardial ischemia/reperfusion rats. The myocardial ischemia/reperfusion model of Wistar rats was established through the ligation of left anterior descending branch of coronary artery of for 40 min and the reperfusion for 2 h. The Wistar rats were randomly divided into six groups: the sham operation group, the model group, the Trimetazidine group (10 mg x kg(-1)) and SSNX groups (22.5, 45, 90 mg x kg(-1)). Preventive administration was conducted for 5 d. The operation was performed at 1 h on the day of the last administration. CK-MB assay kit was adopted to detect the activity of serum CK-MB. HPLC was used to determine ATP, ADP and AMP contents in myocardial tissues and calculate TAN and EC. The preventive administration with SSNX could reduce the activity of serum CK-MB and increase ATP content and EC level in myocardial tissues (P < 0.01 or P < 0.05 vs. the model group). SSNX formula can maintain energy charge in cardiomyocytes and relieve ischemia/reperfusion injury by preserving ischemic myocardium ATP.

Effects of trimetazidine in patients with acute myocardial infarction: data from the Korean Acute Myocardial Infarction Registry

Excess myocardial fatty acid oxidation can cause a range of deleterious myocardial effects. Trimetazidine (TMZ) is a clinically effective antianginal agent that selectively inhibits long-chain 3-ketoacyl CoA thiolase, reducing fatty acid oxidation and stimulating glucose oxidation. The role of TMZ in acute myocardial infarction (AMI), however, remains unclear. Our retrospective analysis explores the effect on clinical outcomes of adding TMZ to standard treatment in patients with AMI. All 13,733 AMI patients registered in the Korean Acute Myocardial Infarction Registry from 2005 to 2008 were retrospectively enrolled. Patients were divided into two groups: those treated with TMZ during their in-hospital management period and those who were not. Primary endpoints were all-cause death combined in-hospital and 12-month death and major adverse cardiac events (MACE), which included all-cause death, recurrent myocardial infarction (MI), repeated percutaneous coronary intervention (PCI) for target lesion revascularization (TLR), and coronary artery bypass graft. Propensity-matched patients were analyzed using an adjusted Cox proportional hazards model. Baseline clinical and angiographic characteristics in the TMZ and no-TMZ groups were generally similar, with the exceptions of pre-PCI thrombolysis in myocardial infarction flow grade, stent type, and stent length. Over 12 months, the relative risk of all-cause death fell by 59 % (event rate 2.3 vs. 6.4 %; hazard ratio 0.41, 95 % CI 0.18-0.97, P = 0.042) and the relative risk of MACE fell by 76 % (event rate 2.3 vs. 9.5 %; hazard ratio 0.24, 95 % CI 0.10-0.56, P = 0.001) in the TMZ group compared with those in the no-TMZ group. Trimetazidine appeared to improve clinical outcomes in AMI patients by significantly reducing all-cause mortality and MACE over 12 months.

Trimetazidine may be a new additional therapy to improve symptoms and cardiac function for patients after proceeding with surgical valve replacement

Background: After successful surgery for valvular heart disease, symptoms and cardiac function are in general greatly improve. Nevertheless, left ventricle dysfunction and heart failure symptoms may persist and worsen postoperatively. We hypothesized that the metabolically acting agent trimetazidine would help improve symptoms and cardiac function after valve replacement. Methods: In a randomized, open-label, case-control 1-year study, trimetazidine (35 mg twice daily) was added to optimal standard therapy (vitamin K antagonists, ACEIs/ARBs, beta-blockers, diuretics, statins, and digoxin) 2–4 weeks after conventional aortic/mitral valve replacement. Efficacy endpoints included changes from preoperative baseline in 6-min walk distance (6-MWD), New York Heart Association (NYHA) functional class, hemodynamic parameters, heart failure hospitalizations, and all-cause mortality. Results: 120 patients [mean (SE) age 53.2 (2.1) years, 72 males (60%), 48 females (40%)] with mechanical prosthesis of aortic (n=64) and mitral (n=56) valve [48 due to degenerative (40%), 42 rheumatic (35%), 12 myxomatous (10%), 10 congenital valve diseases (8.3%) and 8 infectious endocarditis (6.7%); 65% NYHA class III, 35% NYHA class II; 20% concomitant CABG; median (IQR) 6-MWD 329 (162–420) m; mean (SE) left ventricular ejection fraction (LVEF) 59.6 (2.8)%] were randomized. There were no significant differences between trimetazidine and control group at baseline. At month 12, patients receiving trimetazidine (n=60) had a mean increase in 6-MWD of 156 m (p<0.0001); control patients (n=60) had a mean 6-MWD increase of 121 m (p=0.0005), with a control-adjusted difference of +35 m (p=0.041). NYHA status improved by two classes in 40% of trimetazidine versus 21.7% of controls (p=0.035), by one class in 60% versus 78.3% (p=0.035). Trimetazidine delayed the time to clinical worsening (p=0.0202) and reduced the heart failure admissions (p=0.0045). Improvements were noted in control-adjusted changes in postoperative heart remodelling, e.g. in mean LVEF (+3.8%; p=0.003), left ventricular end-diastolic diameter (–5.6 mm; p=0.001), and end-systolic diameter (–3.7 mm; p=0.004). Combination therapy with trimetazidine was well tolerated. No a patient died in the trimetazidine group, as compared with one patient in the control group (p=0.89). Conclusions: Long-term trimetazidine therapy for patients with mechanical aortic/mitral valve prostheses improves symptom status and cardiac function. This study supports the hypothesis of clinical benefits from continued metabolic trimetazidine in surgically corrected valvular heart disease.

Effect of trimetazidine on recurrent angina and left ventricular function in elderly multivessel coronary heart disease patients with diabetes mellitus after elective percutaneous coronary interventio

Objective: To evaluate the effect of trimetazidine (TMZ) on recurrent angina and left ventricular function in elderly multivessel coronary heart disease (CHD) patients with diabetes mellitus (DM) after elective percutaneous coronary intervention (PCI). Methods: In this single-center, prospective, randomized evaluation study, 400 patients with DM aged 65 and over undergoing coronary angiography were recruited to randomly receive or not TMZ (20 mg three times daily orally) as an addition to the conventional treatment of CHD at admission before angiography. Recurrent angina and echocardiogram were followed at 2 years after PCI. Results: Two hundred and fifty-one patients who successfully underwent elective PCI were finally enrolled, 125 in the TMZ group and 126 in the control group. At 2-year follow up, patients in the TMZ group showed a significant improvement in the proportion of angina patients (40 (31.2%) vs 58 (46.0%), P=0.023) and angina-free survival (P=0.003). The independent predictors of 2-year recurrent angina included no TMZ treatment, current smoking, hypercholesterolemia and BMI. TMZ-treated patients showed a significant greater left ventricular function and smaller left ventricular diastolic and systolic diameters compared with patients in the control group (LVEF: 65.65±3.870% vs 62.34±3.008%; LVEDD: 47.6±4.637 mm vs 50.86±3.597 mm; LVESD: 31.00±4.255 vs 33.06±3.371 mm, all P<0.01). E:A ratio in TMZ-treated patients was better than that in the control group without significant difference (0.849±0.256 vs 0.808±0.313, P=0.464). Although there was a trend towards a decrease in cumulative cardiovascular events in TMZ-treated patients, there was no significant difference in event–free survival for composite major adverse cardiac events including death, MI, TVR and hospitalization for cardiac causes (P=0.163). Conclusion: Adjunctive therapy of TMZ (20 mg tid) after PCI reduces the occurrence of recurrent angina, improve left ventricular function and inhibit left ventricular remodeling in elderly multivessel CHD patients with DM.

Effect of trimetazidine on contrast induced nephropthy in rats

Purpose: We aimed to investigate the prophylactic effects of trimetazidine against contrast induced nephropathy (CIN) in rat kidney tissues. Methods: 28 wistar rats were divided into 4 groups of 7 rats each (control (C), contrast media (CM), trimetazidine (TMZ), trimetazidin + contrast media groups (TMZ+CM).Second day,contrast media (Omnipaque 300 mg I/ml) was administered at a single dose of 10 ml/kg into the tail vein. The administration of TMZ solution (10 mg/kg/day) was done on the second, third, and fourth days. After sacrification, the left kidney was dissected for measuring the SOD, CAT, GSH and MDA levels. The histopathological evaluation of the right kidney was performed by a pathologist using a semiquantitative scale of 0 to 3. Results: All histopathological scores were significantly higher in the CM group as compared to other groups.Moreover the scores of the CM+TMZ and C groups were not statistically different (Table 1).CM group, had significantly higher levels of MDA compared to the C group (562,82±38,15 versus 419,15±49,01 nmol/mg protein) (p 0.05).CM group had significantly lower levels of SOD as compared to C,CM+TMZ and TMZ groups (2,54±0,26 versus 3,73±0,42, 3,72±0,37 and 3,87±0,20 U/mg protein respectively) (p<0.05). View this table: Table 1 Conclusion: To the best of our knowledge, this study, for the first time,histopathologically demonstrated the effectiveness of TMZ for the prevention of CIN.Antioxidant properties of TMZ might have contributed to these findings.

Trimetazidine improves health-related quality of life in operated valvular heart disease

Purpose: Successful surgical intervention in valvular heart disease has been shown to prolong and improve quality of life. We aimed to evaluate postoperative health-related quality of life (HRQoL) in patients following trimetazidine therapy. Methods: 120 patients [aged 53.2±2.1 years, 60% males] 2–4 weeks after conventional aortic (n=64) and mitral (n=56) valve replacement by mechanical prostheses (40% due to degenerative, 35% rheumatic, 10% myxomatous, 8.3% congenital valve diseases and 6.7% infectious endocarditis) were randomized 1:1 to receive either conventional therapy or trimetazidine (35 mg twice daily) added to standard treatment. HRQoL was assessed at baseline and 12 months using the Short Form (SF-36 v.1) Health Survey. Results: There were no significant differences between trimetazidine and control group at baseline. Patients reported poor postoperative HRQoL. In both groups, SF-36 scores substantially rose after follow-up. Trimetazidine patients had significant higher improvements in HRQoL over time compared to controls. One patient died in the control group (p=0.89). View this table: Health-related quality of life Conclusions: Mechanical valves patients commonly suffer from severe HRQoL impairment. Long-term trimetazidine, added to conventional treatment, greatly improves HRQoL. The results provide support for trimetazidine as a promising therapy for patients with heart valve prostheses.

GW24-e1192 The Effect of Trimetazidine on endothelial function of Patient with Chronic Heart Failure

ObjectivesTo observe the effect of the Trimetazidine on endothelial function of patient with chronic heart failure, in order to provide a theretical basis for clinical medicine.Methods68 patients with chronic heart...

An efficacy comparison of betahistin, trimetazidine and ginkgo biloba extract in patients with tinnitus

This study aims to investigate the efficacy of trimetazidine, betahistine and ginkgo biloba extract in the treatment of tinnitus. Complete clinical data of 90 patients (48 males, 42 females; mean age 52.3±15.1 years; range 20 to 61 years) who received betahistine, trimetazidine and ginkgo biloba extract for three months were retrospectively analyzed. The patients were divided into three groups including 30 in each group according to treatments received. Pre-treatment and post-treatment scores of tinnitus disability questionnaire were compared statistically. There was no statistically significant difference between pre-treatment scores of tinnitus disability questionnaire among all three groups (p>0.05), while there was a statistically significant difference among the groups following treatment (p=0.019, p<0.05). After a-three-month treatment, a decrease of 19.7±15.5 units in trimetazidine group, 12.2±12.7 units in betahistine group, and 3.80±5.9 units in ginkgo biloba extract group were found to be statistically significant, compared to the mean pretreatment tinnitus disability questionnaire scores (p=0.002, p<0.01). Our study results suggest that trimetazidine, betahistin and ginkgo biloba extract reduce tinnitus symptoms. However, symptomatic relief can be mostly achieved with trimetazidine treatment.

Abstract 9643: Effect of Partial Fatty Acids Oxidation Inhibition With Trimetazidine on Survival in Heart Failure: Results From an International Multicentre Retrospective Cohort Study

Background: Trimetazidine (TMZ) shifts myocardial energy production from free fatty acids to glucose oxidation, a more efficient metabolic pathway. Previous small studies in patients with chronic heart failure (CHF) have shown that TMZ can improve contractile left ventricular function, exercise capacity and NYHA class compared to placebo. However, no data on the effects of TMZ on survival in patients with CHF have ever been produced. Methods: In this international multicentre retrospective cohort study 669 patients (521 post-ischaemic) from the CHF clinics of our institutions were recruited. 362 patients (288 post-ischaemic) were on TMZ (20 mg tid or 35 mg bid) due to symptoms persistence (dyspnoea on exertion, fatigue, orthopnoea, oedema, alone or in combination) despite up titration of optimal CHF medical therapy, while the remaining patients continued conventional CHF therapy alone. Effects of TMZ administration were evaluated by Kaplan-Meier survival analysis and Cox-Regression survival analysis. Obtained results were corrected with propensity score (PS) in order to minimize selection bias. The protocol has been registered in the Italian Pharmaceutical Agency (AIFA) - Italian Ministry of Health, on the observational studies registry, ID number 458. Results: Kaplan-Meier analysis for global mortality showed 11•3% improved global survival (p=0•015) and 8•5% improved survival for death from cardiovascular disease (CVD) causes (p=0•050) in the TMZ group. Cox regression analysis for global mortality showed a significant risk reduction for TMZ treated patients with a PS-corrected hazard ratio (HR)= 0•189 (confidence interval - CI 95%: 0•079-0•454; p=0•0002). TMZ also showed a good risk reduction profile for CVD death causes (PS-adjusted HR=0•072, CI 95%: 0•019-0•268, p=0•0001). The rate of hospitalization for cardiovascular causes was reduced by 10.4% at 5 years (p &lt; 0•0005) with increased hospitalization-free survival of •8 months. Conclusions: TMZ is effective in reducing both global and cardiovascular mortality and event-free survival in patients with CHF. The addition of TMZ on top of optimal medical therapy improves long-term survival in CHF patients.

Effect of partial fatty acid oxidation inhibition with trimetazidine on mortality and morbidity in heart failure: Results from an international multicentre retrospective cohort study

ObjectivesThe aim of this cohort study was to retrospectively evaluate, in patients with chronic heart failure (CHF), the long term effect of trimetazidine (TMZ) on morbidity and mortality. BackgroundPrevious small studies in patients with CHF have shown that TMZ can improve left ventricular function, exercise capacity and NYHA class compared to placebo. However, no data on the effects of TMZ on survival in patients with CHF have ever been produced. MethodsIn this international multicentre retrospective cohort study data from 669 patients were analyzed. 362 patients were on TMZ due to symptom persistence despite up-titration of optimal CHF therapy, while the remaining patients continued conventional CHF therapy alone. Propensity score analysis was performed in order to minimize selection bias between the two groups. ResultsKaplan–Meier analysis for global mortality showed 11.3% improved global survival (p=0.015) and 8.5% improved survival for cardiovascular (CVD) death (p=0.050) in the TMZ group. Cox regression analysis for global mortality showed a significant risk reduction for TMZ treated patients with a hazard ratio (HR)=0.189 (confidence interval — CI 95%: 0.017–0.454; p=0.0002). TMZ also showed a good risk reduction profile for CVD death causes (HR=0.072, CI 95%: 0.019–0.268, p=0.0001). The rate of hospitalization for cardiovascular causes was reduced by 10.4% at 5years (p<0.0005) with increased hospitalization-free survival of 7.8months. ConclusionTMZ is effective in reducing mortality and event-free survival in patients with CHF. The addition of TMZ on top of optimal medical therapy improves long term survival in CHF patients.

PROTECTIVE EFFECT OF TRIMETAZIDINE ON MYOCARDIAL INJURY AND RECURRENT ANGINA AFTER PERCUTANEOUS CORONARY INTERVENTION

ObjectivesTo explore the effect of trimetazidine (TMZ) on the myocardial injury related to percutaneous coronary intervention (PCI) and left heart function after PCI.Methods132 patients with unstable angina pectoris admitted for...

TRIMETAZIDINE ON CARDIAC FUNCTION OF ISCHAEMIC CARDIOMYOPATHY CLINICAL OBSERVATION

Objectives1. to investigate trimetazidine' effect on cardiac function in patients with ischaemic cardiomyopathy;2. to investigate trimetazidine' effect on exercise tolerance in patients with chronic heart failure;Methods1. Analyse data of patients...