ResumoFundamento: A injúria de isquemia e reperfusão constitui um mecanismo fisiopatológico frequente e de difícil controle durante a Cirurgia de Revascularização do Miocárdio (CRVM) com circulação extracorpórea, sendo o momento crítico o término da cirurgia, quando ocorre o desclampeamento da aorta e a liberação dos radicais hiperóxidos causadores da injúria.Objetivo: Avaliar, em estudo prospectivo, duplo-cego randomizado, controlado com placebo, os efeitos da Trimetazidina (Tmz) sobre a injúria de isquemia e reperfusão miocárdica, identificando a variação dos marcadores plasmáticos de agressão miocárdica (troponina T e CPK-Mb), e as alterações ecocardiográficas da função ventricular.Métodos: Foram estudados 60 pacientes, divididos em dois grupos (Placebo e Tmz) com, no máximo, disfunção ventricular leve, estratificados por ecocardiografia e recebendo medicação/placebo na dose -no pré-operatório sem medicação, 12 a 15 dias de medicação/placebo colhida cinco minutos após o desclampeamento aórtico, e nas 12, 24 e 48 horas seguintes. Resultados: Tanto a troponina T como a CPK-Mb atingiram valores altamente significativos (p = 0,0001) no grupo tratado em relação ao grupo controle nos quatro momentos analisados − 5 min, 12 h, 24 h e 48 h. As variáveis ecocardiográficas não evidenciaram mudanças evolutivas em cada grupo isoladamente e quando comparados em conjunto. Conclusão AbstractBackground: The ischemia and reperfusion ischemia is a common physiopathological mechanisms, which has difficult control during Coronary Artery Bypass Grafting (CABG) with cardiopulmonary bypass, the critical moment of which happening by the end of surgery, when there is declamping of aorta and release of hyperoxic radicals causing the injury.

Background: Organic inflammatory response is a pathophysiological mechanism present at every coronary artery bypass grafting with extracorporeal circulation (CABG-ECC), the release of inflammatory mediators being one of its defense mechanisms.

Background: Organic cellular inflammatory response constitutes a pathophysiological mechanism present in all Coronary Artery Bypass Graftings (CABGs). In this aspect, the organism brings forth its defenses through answers that involve cellular components. Objectives: To evaluate, in a randomized double-blind prospective study, controlled with placebo, the effects of trimetazidine (Tmz) on cellular response, analyzed through the variation of leukocytes, neutrophils and monocytes. Patients and Method: 30 patients were randomly selected to be studied, with no more than a mild ventricular dysfunction, and divided into two groups (Tmz and placebo) stratified by echocardiography and receiving medication/placebo in a 60 mg/day dose. The samples of leukocytes, neutrophils and monocytes were obtained in the pre-operatory day without medication, at surgery day with 12 to 15 days of medication/placebo, with 5 minutes after the aortic declamping, and within 12, 24 and 48 hours after surgery. Results: The leukocytes and neutrophils levels have decreased significantly in the treated group when compared to the control group, in all analyzed moments (p = 0.012; p = 0.005). Conclusions and Clinical Implications: Trimetazidine has proved to reduce significantly the levels of total leukocytes and neutrophils in patients submitted to CABG.