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Could an antianginal metabolic agent have an impact on prognosis in ischemic patients ? Beneficial effects of trimetazidine in patients with acute myocardial infarction. Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0. Impact of trimetazidine on prognosis. Methods
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Could an antianginal metabolic agent have an impact on prognosisin ischemic patients?Beneficial effects of trimetazidinein patients with acute myocardial infarction Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Impact of trimetazidine on prognosis • Methods • Among the 13 000 AMI patients involved in the large-scale, prospective, observational Korean Acute Myocardial Infarction Registry (KAMIR), those receiving trimetazidinewere included in the present analysis. • Two groups: patients treated with trimetazidine (either the 20 mg tablet or the 35 mg modified-release tablet) during their in-hospital management period and patients who were not. • A propensity score analysis was performed to equilibrate the 2 groups. • 75% received -blockers, 90% statins, and 90% ACE inhibitors/ARBs. • Primary end points: all-cause death and major adverse cardiac events (MACE), which included all-cause death, recurrent myocardial infarction, repeat PCI for target lesion revascularization, and CABG. Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Impact of trimetazidine on prognosis All results Trimetazidine Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Impact of trimetazidine on prognosis Results on MACE Trimetazidine Control One year MACE: all-cause death, recurrentmyocardialinfarction, repeated PCI for target lesion revascularization, and CABG. Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Impact of trimetazidine on prognosis Results on all-cause death Trimetazidine Trimetazidine Control Control One year Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Impact of trimetazidine on prognosis Discussion TMZ = Trimetazidine Kim JS et al. Clin Res Cardiol. DOI 10.1007/s00392-013-0611-0.
Conclusion • Several previous clinical studies have already shown that trimetazidine may improve prognosis in heart failure and post-MI patients.1-3 • This new study demonstrates that patients who receive trimetazidine seem to live longer after an MI. • This cardiac protection against ischemia could be linked to the 33% energy increase provided by trimetazidine in cardiomyocytes. 1. Gao D et al. Heart. 97:278-286. 2. Fragasso G et al. Int J Cardiol . 163:320-325. 3. Iyengar SS et al. (METRO). Am J Cardiovasc Drugs. 9:293-297.