Role of Trimetazidine in Coronary Artery Bypass Graft Surgery

Martins, Gerez Fernandes

doi:10.4236/wjcs.2017.77011

Cited by 3 publications

(3 citation statements)

References 46 publications

(46 reference statements)

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“…Third, trimetazidine can reduce collagen accumulation and cardiac fibroblast connective tissue growth factor expression. Fourthly during reperfusion after an acute ischaemic episode, trimetazidine can improve the mechanical resistance of the sarcolemma to oedema-induced mechanical stress (16).…”

Section: Discussionmentioning

confidence: 99%

Potential of Trimetazidine in Protecting the Myocardium on Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis

et al. 2023

IJFMR

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Aims: Increased biochemicals such as Troponin T, CKMB, and CK from myocardial injury are side effects of CABG. Trimetazidine is an anti-ischemic agent that can also have a cardioprotective. We conducted a systematic review and meta-analysis to analyse the role of trimetazidine therapy on postoperative myocardial preservation in CABG. Methods: The research instrument used was RCT test articles that have been published in the PubMed, Cochrane, and Google Scholar databases in 2013 and 2023. We were classified into two group analyses based on sampling time (at least ≤12 or >12 hours after CABG). Results: Five RCTs were finally included in the meta-analysis. Significant differences in TnT, CK-MB, and CK were found between trimetazidine-treated CABG patients and control CABG patients (p < 00001) in the subgroup examinations conducted ≤12 and >12 post-CABG, indicating significantly lower postoperative TnT, CK-MB, and CK levels in trimetazidine-treated CABG patients compared with control CABG patients. Conclusion: Myocardial preservation of CABG by comparing the effects of trimetazidine and placebo by assessing several levels of myocardial damage such as TnT, CK-MB, and CK was significantly lower in CABG patients treated with trimetazidine compared with control CABG patients.

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Section: Discussionmentioning

confidence: 99%

Potential of Trimetazidine in Protecting the Myocardium on Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis

et al. 2023

IJFMR

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“…The mechanisms associated with the pathogenesis of IRI are complicated, with the overall outcome of ischemia-induced perturbations and damage to all biomolecules in cells and tissues when the blood supply is re-established. When several pathological events occur concurrently, the injury is cumulative and the probability of irreversible myocardial injury increases significantly [ 46 ].…”

Section: Nhe1 and Myocardial Ischemia-reperfusion Injury (Miri)mentioning

confidence: 99%

Na+/H+ Exchanger 1, a Potential Therapeutic Drug Target for Cardiac Hypertrophy and Heart Failure

et al. 2022

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Cardiac hypertrophy is defined as increased heart mass in response to increased hemodynamic requirements. Long-term cardiac hypertrophy, if not counteracted, will ultimately lead to heart failure. The incidence of heart failure is related to myocardial infarction, which could be salvaged by reperfusion and ultimately invites unfavorable myocardial ischemia-reperfusion injury. The Na+/H+ exchangers (NHEs) are membrane transporters that exchange one intracellular proton for one extracellular Na+. The first discovered NHE isoform, NHE1, is expressed almost ubiquitously in all tissues, especially in the myocardium. During myocardial ischemia-reperfusion, NHE1 catalyzes increased uptake of intracellular Na+, which in turn leads to Ca2+ overload and subsequently myocardial injury. Numerous preclinical research has shown that NHE1 is involved in cardiac hypertrophy and heart failure, but the exact molecular mechanisms remain elusive. The objective of this review is to demonstrate the potential role of NHE1 in cardiac hypertrophy and heart failure and investigate the underlying mechanisms.

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“…The free oxygen and nitrogen radicals induced by CPB can trigger harmful effects. The systemic release of free radicals during CPB disturbs the reperfusion of ischemic heart and probably participates in secondary myocardium damage (6,7). During ischemia and reperfusion, free oxygen radicals exert their harmful effects by inflicting mitochondria, sarcoplasm, vascular endothelium, adenosine, and nitric oxide (which is a vasoactive and anti-inflammatory mediator).…”

Section: Introductionmentioning

confidence: 99%

Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

MasihShafa

Azemati

MasoodAbasi

et al. 2019

Iran Red Crescent Med J

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Background: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. Selenium is the main cofactor for many antioxidant enzymes. Selenium level is decreased during heart surgeries affecting the cardiopulmonary pump, which in turn can aggravate the organ and heart dysfunction and mortality. Objectives: The aim of this study was to evaluate the cardiac protective effects of adding selenium to cardioplegia solution in these surgeries. Methods: In this randomized, double-blind, clinical trial study that was conducted in the department of cardiac surgery of Shiraz University of Medical Sciences (SUMS) in Shiraz, Iran, 67 elected CABG patients were allocated to the two control or selenium groups.In the intervention group, 1000 µg sodium selenite was added to cardioplegia solution. The same amount of normal saline was added to the cardioplegia solution in the control group. Arterial blood samples were withdrawn before anesthesia induction (T1), immediately after the surgery (T2), as well as, 6 and 24 hours after the surgery (T3 and T4 respectively), to determine the CK-MB and Troponin I levels.Results: According to our findings, the CK-MB and Troponin I cardiac enzyme levels were significantly different, considering different time points (P < 0.05). Despite lower enzyme levels in the selenium group, the differences were not statistically significant between the two groups (P > 0.05). There were also no significant differences between the two groups regarding systolic and diastolic blood pressures. Conclusions:The administration of 1000 µg sodium selenite via cardioplegia solution had no significant cardioprotective effect during coronary bypass surgery in CABG patients.

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Role of Trimetazidine in Coronary Artery Bypass Graft Surgery

Cited by 3 publications

References 46 publications

Potential of Trimetazidine in Protecting the Myocardium on Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis

Potential of Trimetazidine in Protecting the Myocardium on Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis

Na+/H+ Exchanger 1, a Potential Therapeutic Drug Target for Cardiac Hypertrophy and Heart Failure

Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

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