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Trimetazidine offers myocardial protection in elderly coronary artery disease patients undergoing non-cardiac surgery: a randomized, double-blind, placebo-controlled trial

Authors
  • Dai, Zhong-Liang1, 2
  • Song, Yi-Feng1, 2
  • Tian, Ya1, 2
  • Li, Yin1, 2
  • Lin, Miao1, 2
  • Lin, Juan1, 2
  • Wang, Qi1, 2
  • Wang, Ping1, 2
  • Gao, Wen-Li1, 2
  • 1 Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology),
  • 2 Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020 Guangdong China
Type
Published Article
Journal
BMC Cardiovascular Disorders
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 01, 2021
Volume
21
Identifiers
DOI: 10.1186/s12872-021-02287-w
PMID: 34598676
PMCID: PMC8485575
Source
PubMed Central
Keywords
Disciplines
  • Research
License
Unknown

Abstract

Background Trimetazidine (TMZ) pretreatment protects cardiomyocytes during cardiac surgery. TMZ may protect elderly patients with ischaemic heart disease (IHD) undergoing non-cardiac surgery. Methods This was a randomized, double-blind, placebo-controlled trial (registration #ChiCTR1900025018) of patients with IHD scheduled to undergo non-cardiac surgery at Shenzhen People’s Hospital (Shenzhen, Guangdong Province, China) between June 2014 and September 2015, randomized to 60 mg TMZ or placebo 12 h before surgery. The primary endpoint was the occurrence of in-hospital cardiovascular events. The secondary endpoints were myocardial ischaemia on five-lead electrocardiogram (cECG), cardiac troponin I (cTnI) elevation, cardiac death, acute coronary events, heart failure, and arrhythmia requiring treatments. Results Compared with the placebo group, the TMZ group showed a lower occurrence of in-hospital cardiovascular events (primary endpoint, 20.0% vs. 37.5%, P = 0.02), myocardial ischaemia (15.0% vs. 32.5%, P < 0.01), cTnI elevation (2.5% vs. 10%, P < 0.01), acute coronary events (10.0% vs. 20.0%, P < 0.05), heart failure (0% vs. 2.5%, P < 0.05), and arrhythmia requiring treatment (17.5% vs. 35.0%, P < 0.05). There was no acute myocardial infarction during the 30-day postoperative period. Conclusions In elderly patients with IHD undergoing non-cardiac surgery, TMZ pretreatment was associated with myocardial protective effects. Trial registration The trial was prospectively registered at http://www.chictr.org.cn/showproj.aspx?proj=41909 with registration number [ChiCTR1900025018] (7/8/2019).

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