Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.
We systematically searched the literature to assess the efficacy of trimetazidine in reducing periprocedural myocardial injury and improving postoperative left ventricular ejection fraction (LVEF) in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). An electronic search was conducted based on the PubMed, Ovid, Scopus, Springer, CENTRAL, and Google Scholar databases; 14 randomized controlled trials (RCTs) were included. Our meta-analysis showed a significant reduction in cardiac troponin I (cTnI) levels with trimetazidine compared with controls (P < .00001) but not in serum creatine kinase-myocardial band levels (P = .49). There were significantly reduced odds of ischemic ST-T segment changes with trimetazidine (P = .0.03) but lack of significant difference in the incidence of anginal attacks between the 2 groups (P = .10). Results also suggest significantly higher LVEF with trimetazidine compared with controls (P < .00001). Meta-regression analysis indicated no influence of duration of trimetazidine therapy on cTnI levels. The administration of preprocedure trimetazidine may have a role in reducing periprocedural myocardial injury in patients with CAD undergoing PCI. Evidence also suggests that postoperative trimetazidine may improve LVEF in the short term. Lack of high-quality trials and the heterogeneity of studies limit the ability of our analysis to draw strong conclusions. Further well-designed RCTs are required to supplement current evidence.
['Wang|Chang|C|', 'Chen|Weiwei|W|', 'Yu|Ming|M|', 'Yang|Ping|P|0000-0002-6494-2377']
D015415:Biomarkers D002317:Cardiovascular Agents D003324:Coronary Artery Disease D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D015428:Myocardial Reperfusion Injury D009206:Myocardium D062645:Percutaneous Coronary Intervention D016032:Randomized Controlled Trials as Topic D020127:Recovery of Function D012307:Risk Factors D013318:Stroke Volume D016896:Treatment Outcome D014292:Trimetazidine D019210:Troponin I D016277:Ventricular Function, Left
myocardial injury percutaneous coronary intervention coronary artery disease cardiac troponin complications