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The impact of trimetazidine addition to conservative treatment on hs-CRP, NT-pro-BNP, hs-cTnT and plasma lipid levels in patients with non-ST segment elevation acute coronary syndrome

Objective: This study investigated the effect of interventional treatment with Trimetazidine (TMZ) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).

Methods: The study included 124 patients who were selected in the cardiology department of the Second Affiliated Hospital of Shandong University with a diagnosis of NSTE-ACS. Patients were randomly divided into three groups: group A (n=40) was given conservative anticoagulation/antiplatelet therapy; group B (n=44) was given low-dose TMZ (20 mg/d); and group C (n=40) was given high-dose TMZ (60 mg/d) with conservative therapy for 3 weeks. High-sensitivity C reactive protein (hs-CRP), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), high-sensitivity cardiac troponin T (hs-cTnT) and plasma lipid levels were measured before and after onset. Adverse reactions were recorded.

Results: The addition of TMZ to conservative therapy significantly reduced hs-CRP, NT-pro-BNP, hscTnT and plasma lipid levels in NSTE-ACS patients, and these effects were more profound in the highdose TMZ (60 mg/d) than the low-dose TMA (20 mg/d) group (P<0.01). Experimental patients exhibited no serious adverse events compared with the control patients (P>0.05).

Conclusion: The application of trimetazidine significantly inhibited the inflammatory reaction process and effectively protected the myocardium in NSTE-ACS patients, which was indicated by the suppression of hs-CRP, pro-B-type, hs-cTnT and plasma lipid levels. Our tests also preliminarily revealed that cardiovascular biomarkers (hs-CRP, pro-B-type, hs-cTnT) were positively correlated with plasma lipid levels during the development and treatment of NSTE-ACS.

Author(s): Ji Luo, Tong Zhao, Chengyuan Liang