Trimetazidine Mb Role in the Optimisation of the Acute Coronary Syndrome Treatment: Effects on Endothelial Dysfunction and Systemic Inflammation

Aim. To study the effects of trimetazidine MB therapy on the clinical manifestations and markers of endothelial dysfunction and systemic inflammation in patients with acute coronary syndrome (ACS). Material and methods. This open, comparative, randomised parallel-group study included 60 patients with a verified ACS diagnosis (34 men and 26 women, aged 40–84 years). All participants were randomised into two treatment groups: the main group receiving trimetazidine MB (PreductalMB) 35 mg twice a day, and the control group receiving standard therapy but not trimetazidine MB. The examination included electrocardiography (ECG), echocardiography, 24-hour ECG monitoring, and chest X-ray. Results. After 3 months of the treatment, the main group demonstrated a significant reduction in the incidence and duration of anginal attacks (–58% and –42%, respectively), as well as in the weekly nitrate intake (–66%). There was a nonsignificant (possibly, due a relatively small sample size) tendency towards a reduction in the severity of anginal attacks (–36%). The control group demonstrated a less prominent dynamics of clinical parameters: the incidence of anginal attacks decreased by 21%, the weekly nitrate intake by 20%, and the duration and severity of anginal attacks only by 6%. Conclusion. The combination of trimetazidine MB with the standard ACS therapy improves the treatment effectiveness, in terms of the anginal syndrome manifestations and endothelial function stabilisation, as suggested by a significant reduction in von Willebrand factor and endothelin levels, compared to the control group.