What question did this study set out to answer?

To evaluate the efficacy of trimetazidine in reducing periprocedural myocardial injury and improving postoperative left ventricular ejection fraction in patients with coronary artery disease undergoing percutaneous coronary intervention.

January 21, 2021Angiology

Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

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Why the study?

To assess the efficacy of trimetazidine in reducing periprocedural myocardial injury and improving postoperative LVEF in patients with CAD undergoing PCI.

Does trimetazidine reduce periprocedural myocardial injury and improve postoperative LVEF in patients with CAD undergoing PCI?

Key Points

To evaluate the efficacy of trimetazidine in reducing periprocedural myocardial injury and improving postoperative left ventricular ejection fraction in patients with coronary artery disease undergoing percutaneous coronary intervention.
Systematic search conducted across PubMed, Ovid, Scopus, Springer, CENTRAL, and Google Scholar databases.
Identified and included 14 randomized controlled trials evaluating perioperative trimetazidine versus control in percutaneous coronary intervention.
Trimetazidine significantly reduced cardiac troponin I levels (P < .00001) and odds of ischemic ST-T segment changes (P = .03), though serum creatine kinase-myocardial band levels did not differ significantly (P = .49).
Postoperative left ventricular ejection fraction was significantly higher in the trimetazidine group compared with controls (P < .00001), with no significant difference observed in anginal attacks (P = .10).
Meta-regression analysis indicated that the duration of trimetazidine therapy had no significant influence on cardiac troponin I reductions.

Structured PICO

Does trimetazidine reduce periprocedural myocardial injury and improve postoperative LVEF in patients with CAD undergoing PCI?

Population

Patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) (pooled from 14 RCTs)

Intervention

Trimetazidine (preprocedure and postoperative administration)

Comparator

Controls

Outcome

Periprocedural myocardial injury (assessed by cardiac troponin I [cTnI] and serum creatine kinase-myocardial band levels) and postoperative left ventricular ejection fraction (LVEF)surrogate

Trimetazidine administration around the time of PCI may reduce periprocedural myocardial injury and improve short-term LVEF, though evidence is limited by study heterogeneity.

Limitations

Lack of high-quality trials
Heterogeneity of studies

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports adjunctive trimetazidine to protect against periprocedural myocardial injury during PCI; extends.

Cite This Study

Wang et al. (2021) studied this question.

synapsesocial.com/papers/6a70b88eb27f158178277caf https://doi.org/10.1177/0003319720987745

Topics

Percutaneous coronary intervention Coronary artery disease

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Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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