Key result
Trimetazidine pretreatment cuts malondialdehyde production ~24% and preserves antioxidant capacity during CABG with CPB.
Why the study?
Does preoperative trimetazidine reduce oxidative stress in patients undergoing CABG under CPB?
RCT (n=24)
Double-blind
Randomized
No
Does preoperative trimetazidine reduce oxidative stress in patients undergoing CABG under CPB?
Answers are grounded in this paper and cite their sources.
Preoperative administration of trimetazidine preserves endogenous antioxidant capacity and reduces oxidative stress during CABG with cardiopulmonary bypass.
BACKGROUND: Trimetazidine is an anti-ischemic agent that is used to treat angina and it has cardioprotective effects without inducing any significant hemodynamic changes. It inhibits the long-chain mitochondrial 3-ketoacyl coenzyme A thiolase enzyme in the myocyte and can improve cardiac mitochondrial metabolism, as well as scavenge free radicals. The aim of this double-blind prospective randomized study was to investigate the effect of preoperative use of trimetazidine on the reduction of oxidative stress during coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). METHODS AND RESULTS: The study group (group T) and the control group (group C) each comprised 12 patients. Pretreatment began 2 weeks before CABG with trimetazidine (60 mg/day po); the control group did not receive any medication. Serial blood samples were collected before and after CPB for measurement of the serum concentrations of these major endogenous antioxidant enzyme systems, which are markers for oxidative degradation of the cellular membranes; postoperative levels were significantly different between the groups (p<0.05). There were no significant difference in hemodynamic values. CONCLUSION: The findings suggest that pretreatment with trimetazidine alleviates malondialdehyde production and preserves endogenous antioxidant capacity during CABG with CPB and cardioplegic arrest.
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Işkesen et al. (2006) conducted an RCT in Elective coronary artery bypass grafting (CABG) (n=24). Trimetazidine vs. No medication was evaluated on Malondialdehyde (MDA) levels 1 minute after release of the cross-clamp (T2) in nmol/ml (p=<0.05). Pretreatment with trimetazidine significantly reduced malondialdehyde production and preserved endogenous antioxidant capacity during coronary artery bypass grafting with cardiopulmonary bypass.
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