The Cardioprotection Study Of Earlier Combined Treatment With Loading Dose Trimetazidine And Large Dose Atorvastatin Administration In Patients With Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Objective:The purpose of this study was to evaluate the cardioprotective effects of earlier oral loading dose trimetazidine and large dose atorvastatin therapies in patients with acute ST segment elevation myocardial infarction (STEMI) before treated with primary percutaneous coronary intervention (PCI). Our study observed the effect on levels of serum creatine kinase (CK)、 CK-MB, cardiac troponin I(cTnI) and early cardiac function by oral administration of loading dose trimetazidine and large dose atorvastatin initiated before PCI.Methods:Enrolled78patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent emergency PCI in our hospital (Jinan Central Hospital affiliated to Shandong University) from September2012to September2013were assigned into trimetazidine group and control group randomly. All of them were pretreated with the same dose of aspirin (300mg orally) and clopidogrel (600mg orally) just before PCI. Trimetazidine group (n=37) took60mg trimetazidine dihydrochloride tablets and atorvastatin calcium tablets (80mg orally) before PCI and while control group (n=41) took atorvastatin calcium tablets (20mg orally). After PCI, taking trimetazidine dihydrochloride tablets treatment (20mg/time, three times a day) was continued in trimetazidine group. The other therapies were same, for example antithrombotic drugs fully in accordance with the guidelines. Creatine kinase(CK), CK-MB and cardiac troponin I (cTnl) were measured respectively on the sixth hour and the twelfth hour after balloon angioplasty,and were compared between two groups. On the fourteenth day left ventricular wall motion score (WMS) and left ventricular ejection fraction (LVEF) were measured by2-dimensional echocardiography after angioplasty, and were compared between two groups also.Results:(1) In comparison with the control group, the levels of Creatine kinase(CK), CK-MB and cTnI in the trimetazidine group were significantly decreased.(P<0.05).(2) There were higher LVEF and lower left ventricular WMS in the trimetazidine group than in the control group14days after PCI (P<0.05)Conclusions:Earlier oral application of loading dose trimetazidine combined with large dose atorvastatin initiated before PCI and postoperative maintenance therapy can afford cardioprotection, protect myocardium, decrease the infarction area, and improve early cardiac function in patients with AMI underwent primary PCI.