Key result
Trimetazidine before elective PCI reduces postprocedural IMR by ~25% versus standard therapy.
Why the study?
Although small studies demonstrated protective effects of trimetazidine on myocardial injury after PCI, its effect on microcirculation using contemporary investigative methods has not been studied.
Does trimetazidine given before elective PCI improve microcirculation (IMR, FFR, CFR) in patients with stable coronary artery disease?
Population
71 consecutive patients with an indication for PCI of a single de novo native coronary lesion
Comparison
Trimetazidine plus standard therapy vs standard therapy alone
Design
Single-blind randomized trial at a single university hospital
Authors
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TMZ pretreatment may lower post-PCI IMR; leaves open whether microvascular benefits translate to clinical outcomes in randomized trials.
RCT (n=71)
Single-blind
Computer based algorithm
No
Does trimetazidine given before elective PCI improve microcirculation (IMR, FFR, CFR) in patients with stable coronary artery disease?
Absolute Event Rate: 18% vs 24%
p-value: p=0.028
Adding trimetazidine prior to elective PCI for stable coronary artery disease significantly improves postprocedural fractional flow reserve and reduces the index of microcirculatory resistance, suggesting a protective effect against PCI-induced microvascular dysfunction.
Ilić et al. (2023) conducted an RCT in Stable coronary artery disease (n=71). Trimetazidine vs. Standard therapy was evaluated on Postprocedural index of microcirculatory resistance (IMR) (p=0.028). Trimetazidine administered before elective percutaneous coronary intervention significantly reduced postprocedural index of microcirculatory resistance compared to standard therapy alone (18 vs 24, p=0.028).
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