曲美他嗪治疗对经皮冠状动脉介入术后左心室功能的影响

[Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention].

作者信息

Xu Xiao-han, Zhang Wei-jun, Zhou Yu-jie, Zhou Zhi-ming, Ma Han-ying, Hu Bin, Kang Yun-peng, Luo Fang-fang

机构信息

Department of Cardiology, Affiliated Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing 100029, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Mar;41(3):205-9.

PMID:23879944

Abstract

OBJECTIVE

To explore the effects of trimetazidine therapy on left ventricular (LV) function after percutaneous coronary intervention (PCI).

METHODS

A total of 106 patients with unstable angina pectoris underwent successful elective PCI were randomly assigned to standard therapy group (control, n = 55) or trimetazidine group (n = 51, 60 mg trimetazidine loading dose prior to PCI followed by 20 mg Tid after PCI on top of standard therapy). cTnI level was measured before and at 16-18 hours after PCI. LV function was evaluated by echocardiography and major adverse cardiac events (MACE, including death, re-infarction and target vessel revascularization) at 12 months after PCI was compared between the two groups.

RESULTS

Post procedural cTnI level increased from [0.02 (0.01, 0.03)] µg/L at baseline to [0.11 (0.07, 0.13)] µg/L (P < 0.05) at 16-18 hours in the trimetazidine group, while [0.02(0.01, 0.03)] µg/L to [1.31(0.44, 2.31)] µg/L in the control group (P < 0.05). Post procedural cTnI level was significantly reduced in the trimetazidine group compared to the control group (P < 0.05). At 12 months follow-up, left ventricular ejection fraction in the trimetazidine group was significantly higher than in control group [(65.65 ± 3.94)% vs. (62.29 ± 3.06)%, P < 0.01] while incidence of MACE was similar between the two groups.

CONCLUSION

Trimetazidine can reduce the post-PCI cTnI release and improve left ventricular function after PCI in patients with unstable angina pectoris.

摘要

目的

探讨曲美他嗪治疗对经皮冠状动脉介入治疗（PCI）后左心室（LV）功能的影响。

方法

将106例成功接受择期PCI的不稳定型心绞痛患者随机分为标准治疗组（对照组，n = 55）或曲美他嗪组（n = 51，PCI术前给予60 mg曲美他嗪负荷剂量，PCI术后在标准治疗基础上给予20 mg每日三次）。在PCI术前及术后16 - 18小时测量肌钙蛋白I（cTnI）水平。通过超声心动图评估LV功能，并比较两组在PCI术后12个月时的主要不良心脏事件（MACE，包括死亡、再梗死和靶血管血运重建）。

结果

曲美他嗪组术后16 - 18小时cTnI水平从基线时的[0.02（0.01，0.03）]μg/L升高至[0.11（0.07，0.13）]μg/L（P < 0.05），而对照组从[0.02（0.01，0.03）]μg/L升高至[1.31（0.44，2.31）]μg/L（P < 0.05）。与对照组相比，曲美他嗪组术后cTnI水平显著降低（P < 0.05）。在12个月随访时，曲美他嗪组左心室射血分数显著高于对照组[（65.65 ± 3.9）% vs.（62.29 ± 3.06）%，P < 0.01]，而两组间MACE发生率相似。