Effects of Trimetazidine on Left Ventricular Function in Patients with Acute Myocardial Infarction Treated with Thrombolytic Agents

We investigated the effect of trimetazidine (TMZ) on left ventricular function and infarct size in 35 acute myocardial infarction (AMI) patients to whom streptokinase (SK) was administered. Seventeen (group A) were given 40 mg TMZ orally on admission and then continued with a dose of 20 mg three times a day. The other eighteen patients (group B) served as the control group. Early stage (in the first five days) and follow up (1st and 3rd month) echocardiography and radionuclide ventriculography (RNV) were carried out. Coronary angiography was performed in 30 patients (15 from each group) on the 10th day of AMI. There was no difference in age, sex, atherosclerotic risk factors and old myocardial infarction between the groups A and B. Average angina period was 3.1±1.5 h in group A and 3.1±1.3 h in group B before SK administration was iniated (NS). Localization of AMI, rhythm and conduction disturbances and heart failure did not show any significant difference in group A and B. The number of diseased vessels and extension of lesions were also similar in each group. Wall motion score index was estimated with echocardiography. It was 6.7±3.4 at the early stage, 4.1±3.7 (1st month), 2.6±0.7 (3rd month) in group A. and group B it was 4.7±2.3, 3.2±1.8, 2.6±2.2, respectively. Ejection fraction (EF) was determined with RNV. In patients with anterior infarction in group A, EF was 28±13% (early stage), 31±17% (1st month) 37±17% (3rd month); in group B it was 29±8%, 35±9%, 36±9%, respectivel (NS). In patients with inferior infarction in group A. estimated EF was 46±4% (early stage), 53±4% (1st month), 55±1% (3rd month); in group B it was 46±6%, 52±5%, 53±4, respectively (NS). Also, there was no significant difference between the estimated EF values at the early stage, in the first and third months in both groups of patients with anterior and inferior MI. In conclusion, TMZ appeared to have no effect on left ventricular function in the early phase of AMI in patients treated with thrombolytic agents.