Transcript the slide set

Can we better protect patients who
undergo revascularization?
Beneficial effects of
short- and long-term trimetazidine MR therapy
in patients undergoing CABG and PCI
Revascularization may cause irreversible
myocardial injuries
About one-third of all elective PCI procedures are
associated with significant myocardial injury, which has
been linked to increased subsequent mortality.
Beneficial effects of trimetazidine MR therapy
in revascularization procedures
Study involving patients
undergoing CABG
Study involving patients
undergoing PCI
• 306 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• 214 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• Trimetazidine MR started 2
weeks prior to CABG and
continued for the next 3
years
• Trimetazidine MR started 2
weeks prior to PCI and
continued for the next 3
years
Beneficial effects of trimetazidine MR
therapy in revascularization procedures
Study involving patients
undergoing CABG
Study involving patients
undergoing PCI
• 306 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• 214 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• Trimetazidine MR started 2
weeks prior to CABG and
continued for the next 3
years
• Trimetazidine MR started 2
weeks prior to PCI and
continued for the next 3
years
Lopatin YM, Dronova EP. Eur Heart J. 2010;31(abstract suppl):58.
Beneficial effect of trimetazidine MR in
patients undergoing CABG
• Left ventricular ejection fraction
*p< 0.05 vs baseline
Administration of trimetazidine MR for 3 years after the procedure
leads to a significantly increased left ventricular ejection fraction.
Beneficial effect of trimetazidine MR in
patients undergoing CABG
• Serum CK and CK-MB levels in the early postoperative period
Adding trimetazidine MR for 2 weeks prior to the procedures lowers
levels of creatine kinase-MB isoenzyme (CK-MB) in the early
postoperative period.
Beneficial effects of trimetazidine MR
therapy in revascularization procedures
Study involving patients
undergoing CABG
Study involving patients
undergoing PCI
• 306 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• 214 Patients with stable
angina and heart failure, split
in 2 groups: trimetazidine
MR group and control group
without trimetazidine MR
• Trimetazidine MR started 2
weeks prior to CABG and
continued for the next 3
years
• Trimetazidine MR started 2
weeks prior to PCI and
continued for the next 3
years
Lopatin YM, Dronova EP. Eur Heart J. 2011;32(abstract suppl):569.
Beneficial effects of trimetazidine MR in
patients undergoing PCI
• Rate of hospitalization for acute coronary syndrome (3 years of follow-up)
7.5
4.7
Administration of trimetazidine MR for 3 years after the procedure
significantly reduces the rate of hospitalization for acute coronary
syndromes.
Beneficial effects of trimetazidine MR in
patients undergoing PCI
• Arrhythmias during the first 30 minutes after intervention
7.5
P<0.05
5.6
P<0.005
3.7
0.9
Adding trimetazidine MR for 2 weeks prior to the procedures lowers
frequency of arrhythmias in the early postoperative period.
Beneficial effect of trimetazidine MR in post-MI
patients with stable angina and heart failure
• 6-Year mortality
N=120
Long-term prescription of trimetazidine MR may improve prognosis.
Lopatin YM, et al. Presented at ESC Congress 2012; August 2012; Munich, Germany. Abstract 2052.
Conclusions
• Treatment with trimetazidine MR prior to CABG or PCI protects
the myocardium and decreases myocardial damage.
• Combining treatment with trimetazidine MR prior to CABG or
PCI and continued treatment for the following 3 years provides
an improvement in left ventricular function with an increase in
exercise tolerance and can improve prognosis.
• Trimetazidine MR confirms its 6-year cardioprotective benefit in
post–myocardial infarction patients, showing the importance of
maintaining treatment in the long term.