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Cardiology Research and Practice
Volume 2019, Article ID 4230948, 7 pages
https://doi.org/10.1155/2019/4230948
Research Article

Effects of Trimetazidine Pretreatment on Endothelial Dysfunction and Myocardial Injury in Unstable Angina Patients Undergoing Percutaneous Coronary Intervention

1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
2Xi’An Number One Hospital, Xi’an 710002, China
3Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China
4Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China

Correspondence should be addressed to Tong Liu; moc.621@codgnotuil and Guangping Li; moc.621@loidracjt_cit

Received 16 January 2019; Revised 17 June 2019; Accepted 25 June 2019; Published 2 September 2019

Academic Editor: Robert Chen

Copyright © 2019 Shuai Shao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Trimetazidine is an anti-ischemic medication licensed for the treatment of angina pectoris. However, the molecular mechanisms underlying its action remain incompletely elucidated. In this study, therefore, we examined the potential beneficial effects of trimetazidine on myocardial injury and endothelial dysfunction in patients with unstable angina in the perioperative period of percutaneous coronary intervention (PCI). Methods. A total of 97 patients with unstable angina were randomly divided into trimetazidine (n = 48) and control (n = 49) groups. All subjects received standard medical therapy. The trimetazidine group additionally received 20 mg trimetazidine three times daily 24 hours before and after PCI. Serum levels of creatine kinase-muscle/brain (CK-MB), cardiac troponin I (cTnI), heart-type fatty acid-binding protein (h-FABP), von Willebrand factor (vWF), and nitric oxide (NO) were measured before and the morning following PCI. Results. In the control group, levels of CK-MB, cTnI, and vWF were significantly elevated () and NO level was decreased after PCI (). By contrast, no significant changes in the levels of these proteins were observed in the trimetazidine group after PCI (). Moreover, h-FABP levels were not significantly altered after PCI whether in the control or in the trimetazidine group (). Finally, a time-dependent increase in the levels of h-FABP from 0 to 6 hours after PCI, followed by a progressive decline, was observed (). Conclusions. PCI induces endothelial dysfunction and myocardial damage in patients with unstable angina. Trimetazidine therapy in the perioperative period can reduce this damage.